Uninsured/Underinsured Motorist Complaint - Massachusetts

UNINSURED / UNDERINSURED MOTORIST COMPLAINT

Filing attachments: For Superior Court, file a separate signed Civil Action Cover Sheet with the itemized statement of money damages under Superior Court Rule 29. For District Court or Boston Municipal Court, file the separate Statement of Damages form for a money-damages action. Use the selected court's filing attachment for claimed dollar amounts.

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. First Cause of Action — Breach of Contract (UM/UIM Benefits)
8. Second Cause of Action — Unfair or Deceptive Acts (M.G.L. c. 93A / c. 176D)
9. Damages
10. Prayer for Relief
11. Verification

Caption

COMMONWEALTH OF MASSACHUSETTS

[TRIAL COURT DEPARTMENT] — [COUNTY] DIVISION

Parties

1. Plaintiff [PLAINTIFF FULL NAME] ("Plaintiff") is an individual residing in [CITY/TOWN], [COUNTY] County, Massachusetts, 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 Commonwealth of Massachusetts, 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 liability insurance / ☐ with liability insurance inadequate to compensate Plaintiff's damages].

Jurisdiction and Venue

4. This Court has jurisdiction over this action pursuant to M.G.L. c. 212, § 3 [Superior Court] / M.G.L. c. 218, § 19 [District Court].

5. Venue is proper in [COUNTY] County pursuant to M.G.L. c. 223, § 1 because [☐ Plaintiff or Defendant resides in this county / ☐ Plaintiff or Defendant has a usual place of business in this county].

6. Based on [DESCRIBE EXPECTED RECOVERY], [if filed in Superior Court: there is no reasonable likelihood that Plaintiff’s recovery will be $50,000 or less / if filed in District Court or Boston Municipal Court: there is no reasonable likelihood that Plaintiff’s recovery will exceed $50,000], exclusive of interest and costs, under the Supreme Judicial Court’s order effective January 1, 2020.

General Allegations

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

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

9. The Uninsured/Underinsured Motorist's negligent acts include but are not limited to:

☐ 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
☐ Violation of M.G.L. c. 90, § [SPECIFIC TRAFFIC STATUTE]
☐ Other: [________________________________]

10. As a direct and proximate result of the collision, Plaintiff sustained serious bodily injuries, incurred medical expenses, lost wages, and experienced pain and suffering. For any pain-and-suffering recovery arising from the underlying motor-vehicle tort, Plaintiff [incurred reasonable and necessary treatment expenses in excess of $2,000 / sustained a qualifying injury under M.G.L. c. 231, § 6D: DESCRIBE].

Policy Identification and Coverage

11. 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").

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

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

14. Plaintiff has paid all premiums due under the Policy and has complied with all conditions precedent, including the timely submission of proof of loss.

15. Plaintiff's Personal Injury Protection ("PIP") benefits under M.G.L. c. 90, § 34M have been [☐ exhausted / ☐ applied as applicable].

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

16. The at-fault motorist qualifies as uninsured under M.G.L. c. 175, § 113L and the Policy because [☐ no bodily injury liability insurance applied / ☐ the motorist was unknown after a hit-and-run / ☐ the liability insurer was unable to pay because of insolvency / ☐ coverage was denied and the Policy treats that circumstance as uninsured]. [IDENTIFY SUPPORTING FACTS AND THE APPLICABLE POLICY TERM.]

☐ Underinsured Motorist (UIM) Claim:

17. The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], less than the uninsured motorist coverage limit of $[PLAINTIFF POLICY LIMIT] elected under Plaintiff’s Policy and insufficient to satisfy Plaintiff’s claimed damages. M.G.L. c. 175, § 113L(2).

18. Plaintiff has exhausted or is prepared to exhaust the at-fault motorist's liability policy limits and has obtained [☐ a settlement / ☐ a judgment] in the amount of $[AMOUNT RECOVERED FROM TORTFEASOR].

19. Defendant Insurer was given written notice and the opportunity to consent to the settlement or advance the tortfeasor's policy limits, as required by the Policy.

First Cause of Action

Breach of Contract (UM/UIM Benefits)

20. Plaintiff incorporates by reference all preceding paragraphs.

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

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

23. Defendant Insurer has breached the Policy by failing and refusing to pay UM/UIM benefits owed to Plaintiff, despite Plaintiff's timely demand.

24. As a direct and proximate result of Defendant Insurer's breach, Plaintiff has sustained damages in an amount to be proven at trial.

Second Cause of Action

Unfair or Deceptive Acts (M.G.L. c. 93A / c. 176D)

25. Plaintiff incorporates by reference all preceding paragraphs.

26. At least thirty (30) days before filing, Plaintiff [mailed / delivered] Defendant Insurer a written demand under M.G.L. c. 93A, § 9(3), on [DATE], identifying Plaintiff and describing the challenged claim practice and resulting injury. [STATE THE DEMAND RECIPIENT AND RESPONSE, OR THE APPLICABLE STATUTORY EXCEPTION TO DEMAND.]

27. Defendant Insurer has engaged in unfair claim settlement practices in violation of M.G.L. c. 176D, § 3(9), which constitutes an unfair or deceptive act or practice under M.G.L. c. 93A, including:

☐ Failing to effectuate prompt, fair, and equitable settlement when liability is reasonably clear
☐ Compelling Plaintiff to litigate by offering substantially less than the amount ultimately recovered
☐ Failing to adopt and implement reasonable standards for prompt investigation of claims
☐ Refusing to pay claims without conducting a reasonable investigation
☐ Failing to affirm or deny coverage within a reasonable time after completed proof of loss
☐ Misrepresenting pertinent facts or policy provisions
☐ Other: [________________________________]

28. If Defendant Insurer's violation was willful or knowing, or its refusal to grant relief on demand was in bad faith with knowledge or reason to know of the violation, Plaintiff seeks the statutory multiple of two to three times the applicable damages under M.G.L. c. 93A, § 9(3), as determined by the Court, plus attorney's fees and costs where allowed.

Damages

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

☐ Past and future medical expenses
☐ Past and future lost wages and earning capacity
☐ Pain and suffering for which Plaintiff was legally entitled to recover from the at-fault motorist under M.G.L. c. 231, § 6D, if covered by the Policy
☐ Emotional distress, if recoverable under an applicable claim
☐ Loss of consortium, if separately owned and recoverable
☐ Statutory multiple damages under M.G.L. c. 93A, § 9(3), if proven
☐ Prejudgment interest under M.G.L. c. 231, § 6C on the contract claim
☐ Attorney's fees and costs under M.G.L. c. 93A

Prayer for Relief

WHEREFORE, Plaintiff demands judgment against Defendant Insurer as follows:

1. For compensatory damages in an amount according to proof at trial;
2. For UM/UIM policy benefits in the full amount owed under the Policy;
3. For multiple damages between two and three times the applicable amount under M.G.L. c. 93A, § 9(3), if a willful or knowing violation is proven;
4. For prejudgment interest on the contract claim under M.G.L. c. 231, § 6C;
5. For reasonable attorney's fees and costs under M.G.L. c. 93A;
6. For costs of suit incurred herein; and
7. For such other and further relief as this Court deems just and proper.

Verification

I, [PLAINTIFF FULL NAME], declare under the pains and penalties of perjury that the foregoing is true and correct to the best of my knowledge and belief.

Dated: [__/__/____]

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

RESPECTFULLY SUBMITTED,

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

State-Specific Notes — Massachusetts

Sources and References

• M.G.L. c. 175, § 113L — Massachusetts Legislature
• Massachusetts Insurance Statutes Overview — Mass.gov
• Massachusetts UM/UIM Coverage — Gavagan Law