Templates Personal Injury Uninsured/Underinsured Motorist Complaint

Uninsured/Underinsured Motorist Complaint

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UNINSURED/UNDERINSURED MOTORIST COMPLAINT

Commonwealth of Kentucky — Circuit 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 and Settlement Notice
  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. Kentucky Practice Notes

1. CAPTION

COMMONWEALTH OF KENTUCKY

[____] CIRCUIT COURT

[____] COUNTY

[PLAINTIFF FULL LEGAL NAME]
Civil Action 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], [____] County, Kentucky [__________].

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

2.2 Defendant — Insurance Company

  1. Defendant, [INSURANCE COMPANY FULL LEGAL NAME], is an insurance company authorized to transact motor vehicle insurance business in the Commonwealth of Kentucky, with its principal place of business at [________________________________].

3. JURISDICTION AND VENUE

  1. This Court has jurisdiction over this action pursuant to KRS § 23A.010 (Circuit Court general jurisdiction), the amount in controversy exceeding $5,000.

  2. Venue is proper in [____] County pursuant to KRS § 452.480 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
☐ Basic Reparation Benefits (BRB/PIP): $[________]
☐ Property Damage Liability: $[________]

  1. 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 maintained no applicable bodily injury liability insurance at the time of the accident, under KRS § 304.20-020.

Underinsured Motorist (UIM) Coverage — The at-fault driver maintained bodily injury liability insurance with limits insufficient to compensate Plaintiff for the full extent of damages, under KRS § 304.39-320.

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 has become insolvent per KRS § 304.20-020.


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, Kentucky.

  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 KRS § 189.340
☐ Operating a vehicle while under the influence of alcohol or drugs (KRS § 189A.010)
☐ Violating applicable Kentucky traffic laws, specifically: [________________________________]
☐ Other: [________________________________]

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

7. UNINSURED/UNDERINSURED STATUS OF AT-FAULT DRIVER

  1. The Tortfeasor's vehicle qualifies as an uninsured/underinsured motor vehicle 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 has become 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 AND SETTLEMENT NOTICE (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 $[________].

  2. Settlement Notice: Plaintiff provided written notice to Defendant of the proposed settlement with the Tortfeasor's insurer on [__/__/____], in compliance with KRS § 304.39-320.

  3. Defendant responded to said notice by (select applicable):

☐ Consenting to the settlement
☐ Advancing payment equal to the tortfeasor's liability limits to preserve subrogation rights
☐ Failing to respond within the time required
☐ Other: [________________________________]

  1. Despite the Tortfeasor's payment, Plaintiff's damages exceed the available liability limits, entitling Plaintiff to UIM benefits.

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 notice, cooperation with investigation, payment of premiums, and providing settlement notice per KRS § 304.39-320.

  4. Defendant has breached the contract by failing and refusing to pay UM/UIM benefits owed to Plaintiff under the policy and applicable Kentucky statutes.

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

  3. Defendant violated this duty and KRS § 304.12-230 (Unfair Claims Settlement Practices) by engaging in the following conduct:

☐ Failing to conduct a reasonable and timely investigation
☐ 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
☐ Not attempting in good faith to effectuate prompt and fair settlement of claims in which liability has become reasonably clear
☐ Compelling the insured to institute litigation to recover amounts 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): $[________]
☐ Punitive damages (bad faith — clear and convincing evidence): $[________]
☐ 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 the policy does not contain a valid anti-stacking clause.

  3. ☐ Plaintiff contends the anti-stacking provision is unenforceable under Kentucky law because: [________________________________]


13. ARBITRATION VS. LITIGATION

  1. ☐ The policy does not contain a mandatory arbitration clause, and Plaintiff elects to pursue this claim through 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 by the jury;

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

c. Pre-judgment interest at the statutory rate per KRS § 360.010;

d. Post-judgment interest as provided by law;

e. Punitive damages for bad faith conduct pursuant to KRS § 304.12-230 (if applicable);

f. Reasonable attorney fees and costs of litigation;

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

JURY TRIAL DEMANDED


15. VERIFICATION

COMMONWEALTH OF KENTUCKY )
) ss.
COUNTY OF [____] )

I, [PLAINTIFF FULL LEGAL NAME], being first duly sworn, state that the facts set forth in the foregoing Complaint are true and correct to the best of my knowledge, information, and belief.

Date: [__/__/____]

Signature: [________________________________]

SUBSCRIBED AND SWORN to before me this [____] day of [________________], [____].

Notary Public, Commonwealth of Kentucky
My commission expires: [__/__/____]
Notary ID: [________________]


RESPECTFULLY SUBMITTED,

[________________________________]
Attorney for Plaintiff
Kentucky Bar Association No. [________________]
[________________________________]
[________________________________]
[CITY], Kentucky [__________]
Telephone: [________________________________]
Email: [________________________________]


16. KENTUCKY PRACTICE NOTES

Statutory Framework:

  • UM Coverage (KRS § 304.20-020): MANDATORY in Kentucky — cannot be rejected. Provides protection against uninsured and insolvent motorists.
  • UIM Coverage (KRS § 304.39-320): Must be OFFERED by insurer; may be rejected in writing. Provides protection when at-fault driver's limits are insufficient.
  • Minimum liability limits: $25,000/$50,000/$25,000 (KRS § 304.39-110).

Settlement Notice Requirement (CRITICAL):

  • KRS § 304.39-320 requires the injured party to notify the UIM carrier when agreeing to settle with the tortfeasor's insurer.
  • Notice must be given at the time of the actual binding settlement agreement.
  • Failure to provide notice can completely extinguish UIM coverage rights.
  • The UIM carrier may advance the tortfeasor's limits to preserve subrogation rights.

2024 Statutory Amendment:

  • Clarified that the UIM carrier receives credit only for amounts actually paid to the injured party, not the full policy limits of the tortfeasor's coverage.

No-Fault / MVRA:

  • Kentucky is a "choice" no-fault state under the Motor Vehicle Reparations Act (MVRA).
  • Tort threshold: Medical expenses exceeding $1,000, or fracture, disfigurement, permanent injury, loss of body function, or death (KRS § 304.39-060(2)).
  • Basic reparation benefits (BRB) of $10,000 are mandatory (KRS § 304.39-020).

Statute of Limitations:

  • Personal injury: Two (2) years from the date of injury (KRS § 304.39-230 for MVRA claims; KRS § 413.140(1) generally).
  • Contract claims: Fifteen (15) years written (KRS § 413.090); five (5) years oral (KRS § 413.120).

Comparative Fault:

  • Kentucky applies pure comparative fault (KRS § 411.182) — plaintiff's recovery reduced by percentage of fault but not barred.

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.

Important Notice

This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Last updated: May 2026