Uninsured/Underinsured Motorist Complaint - Massachusetts

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. 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. Arbitration Demand
11. Prayer for Relief
12. 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 [☐ the accident occurred in this county / ☐ Plaintiff resides in this county / ☐ Defendant transacts business in this county].

6. The amount in controversy exceeds the jurisdictional minimum of this Court.

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.

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 was uninsured at the time of the accident within the meaning of M.G.L. c. 175, § 113L, in that [☐ the at-fault motorist had no bodily injury liability insurance in effect / ☐ the at-fault motorist is unknown (hit-and-run) / ☐ the at-fault motorist's insurer is insolvent / ☐ the at-fault motorist's insurer has denied coverage].

☐ Underinsured Motorist (UIM) Claim:

17. The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], which is less than the UIM limits of Plaintiff's Policy.

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 been damaged in an amount to be proven at trial, but not less than $[ESTIMATED DAMAGES].

Second Cause of Action

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

25. Plaintiff incorporates by reference all preceding paragraphs.

26. Prior to commencing this action, Plaintiff sent a demand letter to Defendant Insurer pursuant to M.G.L. c. 93A, § 9(3), on or about [DATE OF 93A DEMAND], and more than thirty (30) days have elapsed without a reasonable settlement offer.

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 institute litigation to recover amounts due
☐ 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
☐ Misrepresenting pertinent facts or policy provisions
☐ Other: [________________________________]

28. Defendant Insurer's conduct was willful or knowing, entitling Plaintiff to treble damages under M.G.L. c. 93A, § 9(3), plus attorney's fees and costs.

Damages

29. As a result of the accident and Defendant Insurer's breaches, Plaintiff has suffered and continues to suffer 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]
☐ Emotional distress: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Treble damages under M.G.L. c. 93A (bad faith claim only)
☐ Prejudgment interest at 12% under M.G.L. c. 231, § 6B/6C
☐ Attorney's fees and costs under M.G.L. c. 93A

Arbitration Demand

30. To the extent required by the Policy and M.G.L. c. 175, § 113L, Plaintiff demands arbitration of the UM/UIM coverage dispute and requests appointment of a neutral arbitrator.

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 treble damages under M.G.L. c. 93A, § 9(3), for willful or knowing violations;
4. For prejudgment interest as permitted by M.G.L. c. 231, § 6B/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