Templates Personal Injury Uninsured/Underinsured Motorist Complaint

Uninsured/Underinsured Motorist Complaint

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UNINSURED/UNDERINSURED MOTORIST COMPLAINT

State of Indiana — Circuit/Superior Court


TABLE OF CONTENTS

  1. Caption
  2. Parties
  3. Jurisdiction and Venue
  4. Insurance Policy Information
  5. Coverage Type — UM vs. UIM
  6. Facts of the Accident
  7. Uninsured/Underinsured Status of At-Fault Driver
  8. Exhaustion of Liability Coverage
  9. Breach of Contract
  10. Bad Faith (If Applicable)
  11. Damages
  12. Stacking Allegations
  13. Arbitration vs. Litigation
  14. Prayer for Relief
  15. Verification
  16. Indiana Practice Notes

1. CAPTION

IN THE [____] COURT OF [____] COUNTY

STATE OF INDIANA

[PLAINTIFF FULL LEGAL NAME]
Cause No. [________________]
Plaintiff,
v.
[INSURANCE COMPANY FULL LEGAL NAME]
Defendant.

COMPLAINT FOR UNINSURED/UNDERINSURED MOTORIST BENEFITS


2. PARTIES

2.1 Plaintiff

  1. Plaintiff, [PLAINTIFF FULL LEGAL NAME], is an individual who at all relevant times resided at [________________________________], [CITY], Indiana [__________], in [____] County.

  2. Plaintiff was, at the time of the incident, a named insured or covered person under a motor vehicle insurance policy issued by Defendant that included UM/UIM coverage.

2.2 Defendant — Insurance Company

  1. Defendant, [INSURANCE COMPANY FULL LEGAL NAME], is an insurance company organized under the laws of [________________________________], authorized to issue motor vehicle insurance policies in the State of Indiana, with its principal place of business at [________________________________].

3. JURISDICTION AND VENUE

  1. This Court has jurisdiction over this matter pursuant to IC § 33-28-1-2 (Circuit Court) or IC § 33-29-1-1.5 (Superior Court).

  2. Venue is proper in [____] County pursuant to Indiana Trial Rule 75 because (select applicable):

☐ The accident occurred in [____] County
☐ Defendant may be found or transacts business in [____] County
☐ Plaintiff resides in [____] County


4. INSURANCE POLICY INFORMATION

  1. At all relevant times, Plaintiff was insured under a motor vehicle insurance policy issued by Defendant, Policy No. [________________________________], effective from [__/__/____] to [__/__/____].

  2. The policy provided the following relevant coverages:

☐ Uninsured Motorist Bodily Injury: $[________] per person / $[________] per accident
☐ Underinsured Motorist Bodily Injury: $[________] per person / $[________] per accident
☐ Bodily Injury Liability: $[________] per person / $[________] per accident
☐ Medical Payments: $[________]

  1. The named insured did not reject UM/UIM coverage in writing as permitted by IC § 27-7-5-2.

  2. Plaintiff paid all required premiums and fulfilled all conditions precedent under the policy.


5. COVERAGE TYPE — UM vs. UIM

  1. This claim is brought under (select applicable):

Uninsured Motorist (UM) Coverage — The at-fault driver had no applicable bodily injury liability insurance at the time of the accident, rendering the vehicle "uninsured" under IC § 27-7-5-4.

Underinsured Motorist (UIM) Coverage — The at-fault driver had bodily injury liability insurance with limits less than the insured's damages, rendering the vehicle "underinsured" under IC § 27-7-5-4.

Uninsured Motorist (UM) Coverage — Hit-and-Run — The at-fault vehicle left the scene and the owner/operator cannot be identified.

Uninsured Motorist (UM) Coverage — Insurer Insolvency — The at-fault driver's insurer is or becomes insolvent.


6. FACTS OF THE ACCIDENT

  1. On or about [__/__/____], at approximately [____] ☐ a.m. ☐ p.m., Plaintiff was operating/occupying a motor vehicle at or near [________________________________], [CITY], [____] County, Indiana.

  2. At said time and place, a motor vehicle operated by [AT-FAULT DRIVER NAME, if known] (hereinafter "Tortfeasor") collided with Plaintiff's vehicle.

  3. The collision occurred under the following circumstances: [________________________________]
    [________________________________]
    [________________________________]

  4. The Tortfeasor was negligent in one or more of the following respects:

☐ Failing to maintain a proper lookout
☐ Failing to yield the right-of-way
☐ Operating at an excessive or unreasonable speed
☐ Following too closely in violation of IC § 9-21-8-14
☐ Operating a vehicle while intoxicated in violation of IC § 9-30-5
☐ Violating applicable Indiana traffic laws, specifically: [________________________________]
☐ Other: [________________________________]

  1. As a direct and proximate result of the Tortfeasor's negligence, Plaintiff sustained serious bodily injuries and damages.

7. UNINSURED/UNDERINSURED STATUS OF AT-FAULT DRIVER

  1. The Tortfeasor's vehicle qualifies as an uninsured/underinsured motor vehicle as defined in IC § 27-7-5-4 because (select applicable):

☐ No bodily injury liability insurance was in effect at the time of the accident
☐ The applicable insurer has denied coverage or disclaimed liability
☐ The applicable insurer is or becomes insolvent
☐ The vehicle is a hit-and-run vehicle whose owner/operator cannot be identified
☐ The bodily injury liability limits ($[________]) are less than Plaintiff's total damages

  1. [If UIM:] The Tortfeasor maintained bodily injury liability insurance through [________________________________] with limits of $[________] per person / $[________] per accident, which are insufficient to fully compensate Plaintiff.

8. EXHAUSTION OF LIABILITY COVERAGE (UIM Claims)

  1. [If applicable:] Plaintiff has exhausted or is in the process of exhausting the Tortfeasor's bodily injury liability coverage, having received or being entitled to receive $[________] representing the full available policy limits.

  2. Despite such payment, Plaintiff's total damages substantially exceed the Tortfeasor's liability limits, triggering UIM coverage under the policy.

  3. Plaintiff provided Defendant with notice prior to settling with the Tortfeasor's insurer, in compliance with the policy terms.


9. COUNT I — BREACH OF CONTRACT

  1. Plaintiff re-alleges and incorporates all preceding paragraphs.

  2. The insurance policy constitutes a valid and enforceable contract between Plaintiff and Defendant.

  3. Plaintiff has performed all conditions required under the policy, including timely notification of the claim, cooperation with investigation, and payment of all premiums.

  4. Defendant has breached the contract by failing and refusing to pay UM/UIM benefits owed to Plaintiff under the policy and IC § 27-7-5-2.

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


10. COUNT II — BAD FAITH (If Applicable)

  1. Plaintiff re-alleges and incorporates all preceding paragraphs.

  2. Under Indiana law, Defendant owed Plaintiff a duty of good faith and fair dealing in handling the UM/UIM claim.

  3. Defendant breached said duty by engaging in the following conduct:

☐ Failing to conduct a reasonable and timely investigation of the claim
☐ Unreasonably delaying the processing and payment of benefits
☐ Denying the claim without a reasonable basis in law or fact
☐ Failing to attempt a prompt, fair, and equitable settlement when liability was reasonably clear
☐ Compelling the insured to initiate litigation to recover benefits due under the policy
☐ Other: [________________________________]


11. DAMAGES

  1. As a direct and proximate result of the accident and Defendant's failure to pay benefits, Plaintiff has suffered the following damages:

☐ Past medical expenses: $[________]
☐ Future medical expenses: $[________]
☐ Past lost wages/income: $[________]
☐ Future lost earning capacity: $[________]
☐ Pain and suffering: $[________]
☐ Mental anguish and emotional distress: $[________]
☐ Loss of enjoyment of life: $[________]
☐ Permanent impairment/disfigurement: $[________]
☐ Loss of consortium (if applicable): $[________]
☐ Consequential damages from bad faith (if applicable): $[________]
☐ Attorney fees and costs: $[________]


12. STACKING ALLEGATIONS

  1. ☐ Plaintiff asserts the right to stack UM/UIM coverages across multiple vehicles insured under the same policy and/or across multiple policies.

  2. ☐ Plaintiff contends that IC § 27-7-5-6 does not bar stacking under the circumstances of this case.

  3. ☐ Plaintiff contends the anti-stacking provision in the policy is unenforceable because: [________________________________]


13. ARBITRATION VS. LITIGATION

  1. ☐ The policy does not contain a mandatory arbitration clause, and Plaintiff elects litigation.

  2. ☐ The policy contains an arbitration clause, but Plaintiff contends it is unenforceable because: [________________________________]

  3. ☐ Plaintiff has completed arbitration and seeks judicial confirmation or review of the award.


14. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that this Court enter judgment in Plaintiff's favor and against Defendant as follows:

a. Compensatory damages in an amount to be determined at trial;

b. UM/UIM policy benefits in the full amount owed under the policy;

c. Pre-judgment interest at the statutory rate per IC § 34-51-4-9;

d. Post-judgment interest as provided by law;

e. Consequential damages and punitive damages for bad faith conduct (if applicable);

f. Reasonable attorney fees and costs of litigation;

g. All other relief to which Plaintiff may be justly entitled.


15. VERIFICATION

I, [PLAINTIFF FULL LEGAL NAME], affirm under penalties of perjury that the foregoing representations are true and correct to the best of my knowledge, information, and belief.

Date: [__/__/____]

Signature: [________________________________]


RESPECTFULLY SUBMITTED,

[________________________________]
Attorney for Plaintiff
Indiana Attorney No. [________________]
[________________________________]
[________________________________]
[CITY], Indiana [__________]
Telephone: [________________________________]
Email: [________________________________]


16. INDIANA PRACTICE NOTES

Statutory Framework:

  • IC § 27-7-5-2 mandates UM and UIM coverage at limits equal to BI liability limits unless rejected in writing.
  • UIM coverage may not be issued in amounts less than $50,000.
  • The statute is construed "liberally" and "in favor of the insured" as a remedial statute.

Definitions (IC § 27-7-5-4):

  • "Uninsured motor vehicle" includes vehicles with no insurance, denied coverage, insolvent insurer, or hit-and-run.
  • "Underinsured motor vehicle" — the liability limits available are less than the insured's damages.

Stacking (IC § 27-7-5-6):

  • Indiana limits stacking; generally, the insured recovers under the single highest available limit.
  • Review the specific policy language and recent court decisions.

Minimum Insurance Requirements (IC § 9-25-4-5):

  • Bodily Injury Liability: $25,000 per person / $50,000 per accident.
  • Property Damage Liability: $25,000 per accident.

Statute of Limitations:

  • Personal injury: Two (2) years from the date of injury (IC § 34-11-2-4).
  • Contract claims: Six (6) years written; six (6) years oral (IC § 34-11-2-7).

Comparative Fault:

  • Indiana follows modified comparative fault (IC § 34-51-2); plaintiff barred if fault is greater than 50%.

Recent Developments:

  • In 2024, the Indiana Supreme Court ruled that ambiguities in the UIM statute must be construed in favor of coverage, and that "retained limits" do not insulate insurers from statutory UIM obligations.

SOURCES AND REFERENCES

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About This Template

Personal injury cases are brought by people who were hurt because of someone else's carelessness: car crashes, slip and falls, defective products, and more. Demand letters, settlement agreements, and court filings in these cases have to document the injuries, the medical treatment, the lost income, and the exact legal basis for holding the other side responsible. Well-prepared paperwork is what drives higher settlements and forces insurers to take the claim seriously.

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Last updated: May 2026