Uninsured/Underinsured Motorist Complaint

UNINSURED / UNDERINSURED MOTORIST COMPLAINT

Table of Contents

1. Caption
2. Parties
3. Jurisdiction and Venue
4. General Allegations
5. Policy Identification and Coverage
6. UM vs. UIM Status
7. Stacking Provisions
8. Count I — Breach of Contract (UM/UIM Benefits)
9. Count II — Statutory Bad Faith (Fla. Stat. § 624.155)
10. Damages
11. Prayer for Relief
12. Verification

Caption

IN THE CIRCUIT COURT OF THE [____] JUDICIAL CIRCUIT
IN AND FOR [COUNTY NAME] COUNTY, FLORIDA

Parties

1. Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing in [COUNTY] County, Florida, and is an insured under the automobile insurance policy described herein.

2. Defendant, [INSURANCE COMPANY NAME] ("Defendant Insurer"), is an insurance company authorized to transact business in the State of Florida, with its principal place of business at [INSURER ADDRESS].

3. [JOHN/JANE DOE] ("Uninsured/Underinsured Motorist") is an individual who, at all relevant times, operated a motor vehicle [☐ without bodily injury liability insurance / ☐ with bodily injury liability insurance inadequate to compensate Plaintiff's damages].

Jurisdiction and Venue

4. This Court has jurisdiction over this action pursuant to Fla. Stat. § 26.012 because the amount in controversy exceeds $50,000, exclusive of interest, costs, and attorney's fees.

5. Venue is proper in [COUNTY] County, Florida, pursuant to Fla. Stat. § 47.011 because [☐ the cause of action accrued in this county / ☐ Defendant maintains an office in this county / ☐ Plaintiff resides in this county].

General Allegations

6. On or about [DATE OF ACCIDENT], at approximately [TIME], Plaintiff was [☐ operating / ☐ a passenger in] a motor vehicle on [STREET/HIGHWAY], in [CITY], [COUNTY] County, Florida.

7. At said time and place, the Uninsured/Underinsured Motorist negligently operated a motor vehicle and caused a collision with Plaintiff's vehicle.

8. The Uninsured/Underinsured Motorist was negligent in one or more of the following respects:

☐ Failure to maintain a safe speed
☐ Failure to yield the right of way
☐ Failure to maintain a proper lookout
☐ Following too closely
☐ Driving under the influence of alcohol or drugs
☐ Running a red light or stop sign
☐ Improper lane change
☐ Texting or using a handheld device while driving
☐ Other: [________________________________]

9. Each such act or omission constituted negligence and was a legal cause of Plaintiff's injuries and damages.

Policy Identification and Coverage

10. At the time of the accident, Plaintiff was insured under an automobile insurance policy issued by Defendant Insurer, Policy No. [POLICY NUMBER], effective from [POLICY START DATE] to [POLICY END DATE] (the "Policy").

11. The Policy provides uninsured motorist ("UM") bodily injury coverage with limits of $[UM LIMIT PER PERSON] per person / $[UM LIMIT PER ACCIDENT] per accident.

12. ☐ The Policy also provides underinsured motorist ("UIM") bodily injury coverage with limits of $[UIM LIMIT PER PERSON] per person / $[UIM LIMIT PER ACCIDENT] per accident.

13. The UM/UIM coverage under the Policy is [☐ stacked / ☐ non-stacked].

14. Plaintiff has paid all premiums due and has complied with all conditions precedent under the Policy.

15. Plaintiff did not execute a valid written rejection of UM coverage as required by Fla. Stat. § 627.727(1).

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

16. The at-fault motorist was uninsured at the time of the accident in that [☐ no bodily injury liability policy was in effect / ☐ the at-fault motorist is unknown (hit-and-run) / ☐ the at-fault motorist's insurer denied coverage or is insolvent].

☐ Underinsured Motorist (UIM) Claim:

17. The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], which is insufficient to compensate Plaintiff for the damages sustained.

18. Plaintiff has exhausted the at-fault motorist's bodily injury liability limits and received $[AMOUNT RECOVERED FROM TORTFEASOR].

19. Plaintiff's damages exceed the tortfeasor's policy limits, and Plaintiff is entitled to recover additional amounts under the UIM provisions of the Policy.

Stacking Provisions

20. ☐ Stacked Coverage Applies: Plaintiff is a [☐ Class I / ☐ Class II] insured. The Policy insures [NUMBER] vehicles. Plaintiff's stacked UM/UIM limits are $[STACKED LIMIT] ($[PER-VEHICLE LIMIT] x [NUMBER OF VEHICLES]).

21. ☐ Non-Stacked Coverage Applies: The named insured executed a valid written election of non-stacked coverage pursuant to Fla. Stat. § 627.727(9). Plaintiff's UM/UIM limits are $[NON-STACKED LIMIT].

22. ☐ Stacking Waiver Invalid: Plaintiff contends the non-stacking election was invalid because [☐ the form did not comply with statutory requirements / ☐ no written election was obtained / ☐ the insurer failed to provide the required annual reminder]. Stacked limits should apply.

Count I

Breach of Contract (UM/UIM Benefits)

23. Plaintiff re-alleges and incorporates paragraphs 1 through 22 as if fully set forth herein.

24. The Policy constitutes a valid and enforceable contract between Plaintiff and Defendant Insurer.

25. Plaintiff has performed all conditions, obligations, and covenants required under the Policy, or performance has been excused or waived.

26. Defendant Insurer has breached the Policy by failing and refusing to pay UM/UIM benefits owed to Plaintiff despite timely notice and demand.

27. As a direct and proximate result of Defendant Insurer's breach, Plaintiff has been damaged.

WHEREFORE, Plaintiff demands judgment against Defendant Insurer for compensatory damages, prejudgment interest, attorney's fees pursuant to Fla. Stat. § 627.428, costs, and such other relief as the Court deems just and proper.

Count II

Statutory Bad Faith (Fla. Stat. § 624.155)

28. Plaintiff re-alleges and incorporates paragraphs 1 through 27 as if fully set forth herein.

29. Plaintiff filed a Civil Remedy Notice with the Florida Department of Financial Services on [DATE OF CRN], and the 60-day cure period has expired without Defendant Insurer curing the violation.

30. Defendant Insurer has violated Fla. Stat. § 624.155 by:

☐ Not attempting in good faith to settle the claim when it could and should have done so
☐ Failing to conduct a reasonable investigation of the claim
☐ Unreasonably delaying payment of the claim
☐ Other: [________________________________]

31. As a direct result of Defendant Insurer's bad faith, Plaintiff has suffered damages in excess of the Policy limits.

WHEREFORE, Plaintiff demands judgment against Defendant Insurer for all damages caused by the bad faith, including extra-contractual damages, attorney's fees, and costs.

Damages

32. As a result of the accident and Defendant Insurer's breaches, Plaintiff has suffered the following damages:

☐ Past medical expenses: $[AMOUNT]
☐ Future medical expenses: $[AMOUNT]
☐ Past lost wages/earnings: $[AMOUNT]
☐ Future lost wages/earning capacity: $[AMOUNT]
☐ Pain and suffering (past and future): $[AMOUNT]
☐ Mental anguish: $[AMOUNT]
☐ Aggravation of pre-existing condition: $[AMOUNT]
☐ Loss of capacity for enjoyment of life: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Extra-contractual damages (bad faith claim only): $[AMOUNT]
☐ Prejudgment interest
☐ Attorney's fees under Fla. Stat. § 627.428
☐ Costs

Prayer for Relief

WHEREFORE, Plaintiff demands judgment against Defendant Insurer and respectfully requests:

1. Compensatory damages in an amount to be determined at trial;
2. UM/UIM benefits in the full amount owed under the Policy, including stacked limits if applicable;
3. Extra-contractual and consequential damages for Defendant Insurer's bad faith;
4. Prejudgment interest from the date of loss;
5. Attorney's fees pursuant to Fla. Stat. § 627.428;
6. Taxable costs of this action;
7. Trial by jury on all issues so triable; and
8. Such other and further relief as this Court deems just and proper.

Verification

Under penalties of perjury, I declare that I have read the foregoing Complaint and that the facts stated in it are true to the best of my knowledge and belief.

Dated: [__/__/____]

Signature: [________________________________]
Printed Name: [PLAINTIFF FULL NAME]

Respectfully submitted,

[ATTORNEY NAME], Florida Bar No. [BAR NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], Florida [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff

State-Specific Notes — Florida

Sources and References

• Fla. Stat. § 627.727 — Florida Legislature
• Florida Stacking vs. Non-Stacking — Taylor Day Law
• Florida UM Statute — LegalClarity