Uninsured/Underinsured Motorist Complaint - Maine

Before filing: Complete and file the separate Maine Civil Summary Sheet (CV-001) with this complaint under Me. R. Civ. P. 5(h). The official Summary Sheet does not replace this 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. First Claim — Breach of Contract (UM/UIM Benefits)
8. Second Claim — Unfair Claims Settlement Practices (24-A M.R.S. § 2436-A)
9. Damages
10. Jury Demand
11. Prayer for Relief

Caption

STATE OF MAINE — [COUNTY NAME] COUNTY
SUPERIOR COURT

Parties

1. Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing at [PLAINTIFF ADDRESS], [CITY], [COUNTY] County, Maine [ZIP CODE], 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 Maine, with its principal place of business at [INSURER ADDRESS].

3. [JOHN/JANE DOE] ("Other Motorist") operated the vehicle involved in the collision and was [☐ uninsured / ☐ underinsured under the limit comparison in 24-A M.R.S. § 2902(1) / ☐ unidentified in a hit-and-run]. State the facts supporting the selected status: [FACTS].

Jurisdiction and Venue

4. This Court has subject-matter jurisdiction over this civil action under 4 M.R.S. § 105.

5. Venue is proper in [COUNTY] County under 14 M.R.S. § 501 because [☐ Plaintiff lives in this county / ☐ Defendant lives in this county / ☐ the cause of action arose in this county].

6. The amount in controversy exceeds $[AMOUNT].

General Allegations

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

8. At said time and place, the Other Motorist negligently operated a motor vehicle, proximately causing a collision involving Plaintiff.

9. The Other Motorist was negligent in one or more of the following respects:

☐ Operating at an excessive or unreasonable speed (29-A M.R.S. § 2074)
☐ Failure to yield the right of way (29-A M.R.S. § 2053)
☐ Following too closely (29-A M.R.S. § 2066)
☐ Operating under the influence (29-A M.R.S. § 2411)
☐ Failure to obey a traffic control device (29-A M.R.S. § 2057)
☐ Unsafe movement from a marked traffic lane (29-A M.R.S. § 2051(1-A))
☐ Text messaging while operating on a public way (29-A M.R.S. § 2119(2))
☐ Other: [________________________________]

10. As a direct and proximate result of the above-described negligence, Plaintiff sustained serious bodily injuries and damages.

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 includes uninsured vehicle bodily injury coverage, which may apply to an uninsured, underinsured, or hit-and-run motorist under 24-A M.R.S. § 2902, with limits of $[UM LIMIT PER PERSON] per person / $[UM LIMIT PER ACCIDENT] per accident.

13. The applicable coverage limit for this claim is $[APPLICABLE LIMIT] under [IDENTIFY THE POLICY AND ANY ENDORSEMENT]. [STATE ANY DISTINCT LIMIT ONLY IF THE ACTUAL POLICY PROVIDES ONE.]

14. The Policy was in force on the collision date because [PREMIUM AND COVERAGE FACTS]. Plaintiff has satisfied, or disputes the enforceability or application of, the following claim conditions: [IDENTIFY CONDITIONS AND FACTS].

15. If the Policy is a private-passenger or assigned-risk policy subject to 24-A M.R.S. § 2902(2), Plaintiff [☐ selected coverage equal to the Policy's bodily injury liability limit / ☐ signed a dated rejection of equal coverage and selected $[LOWER LIMIT] / ☐ disputes the effectiveness of an asserted rejection because [FACTS]]. For a different policy type, state its actual coverage limit and the applicable § 2902(2) or (7) rule: [FACTS].

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

16. The Other Motorist was [☐ uninsured because no bodily injury liability coverage applied / ☐ unidentified in a hit-and-run / ☐ insured by an insolvent liability insurer satisfying 24-A M.R.S. § 2902(3), including its coverage-at-occurrence and written-notice requirements]. Supporting facts: [FACTS].

☐ Underinsured Motorist (UIM) Claim:

17. The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT]. Those limits are less than [☐ Maine's minimum bodily injury liability limits / ☐ Plaintiff's uninsured vehicle coverage limit of $[PLAINTIFF UM LIMIT]], making the vehicle underinsured under 24-A M.R.S. § 2902(1).

18. Plaintiff has received $[AMOUNT] from the at-fault motorist or a liability insurer through [SETTLEMENT / JUDGMENT / OTHER PAYMENT]. The applicable liability limit, amounts paid to other injured persons, and any policy condition concerning recovery or offset are [FACTS AND POLICY TERMS].

19. Plaintiff gave Defendant Insurer notice of this claim on [DATE] by [METHOD]. If the Policy requires insurer consent before settlement with the at-fault motorist, state how that condition was satisfied, waived, or disputed: [FACTS AND POLICY TERM].

First Claim

Breach of Contract (UM/UIM Benefits)

20. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 19.

21. The Policy is a valid and enforceable insurance contract under which Plaintiff qualifies as an insured because [POLICY TERMS AND FACTS].

22. Plaintiff has performed all enforceable obligations and satisfied, was excused from, or disputes the application of each relevant condition precedent under the Policy, as described in paragraph 14.

23. Defendant Insurer has breached the Policy by failing and refusing to pay UM/UIM benefits owed to Plaintiff despite proper and 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.

Second Claim

Unfair Claims Settlement Practices (24-A M.R.S. § 2436-A)

25. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 24.

26. Section 2436-A permits an insured injured by one of its five enumerated acts by that insured's own insurer to bring a civil action. Plaintiff alleges only the selected acts below.

27. Defendant Insurer violated the Unfair Claims Settlement Practices Act by engaging in one or more of the following acts:

☐ Knowingly misrepresenting to Plaintiff pertinent facts or Policy provisions relating to the coverage at issue
☐ Failing to acknowledge and review Plaintiff's claim within a reasonable time after receiving Plaintiff's written notice of claim
☐ Failing to affirm or deny coverage, while reserving appropriate defenses, within a reasonable time after completing the claim investigation
☐ Threatening to appeal an arbitration award in Plaintiff's favor solely to compel acceptance of a settlement below the award
☐ Without just cause, failing to make a prompt, fair and equitable settlement when liability became reasonably clear

28. Plaintiff was injured by the selected conduct of Plaintiff's own insurer and seeks damages, costs and disbursements, reasonable attorney's fees, and interest on damages at 1 1/2% per month under § 2436-A(1).

Damages

29. Plaintiff's accident-related losses supporting the coverage claim, and any separate losses caused by Defendant Insurer's conduct, include the following as applicable and subject to the Policy and proof:

☐ 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 and emotional distress: $[AMOUNT]
☐ Physical disability and disfigurement: $[AMOUNT]
☐ Loss of enjoyment of life: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Damages and interest on damages for unfair claims practices (§ 2436-A)
☐ Prejudgment interest (14 M.R.S. § 1602-B)
☐ Attorney's fees (if authorized under § 2436-A)
☐ Costs of suit

Jury Demand

Plaintiff demands a trial by jury on all issues triable of right by jury and will file the demand and pay the fee as required by the Superior Court's scheduling order under M.R. Civ. P. 38(b).

Prayer for Relief

WHEREFORE, Plaintiff demands judgment against Defendant Insurer as follows:

1. Compensatory damages in an amount to be determined at trial;
2. UM/UIM benefits in the full amount owed under the Policy;
3. Actual damages for unfair claims settlement practices pursuant to 24-A M.R.S. § 2436-A;
4. Costs and disbursements, reasonable attorney's fees, and interest on § 2436-A damages at 1 1/2% per month under that section;
5. Prejudgment interest pursuant to 14 M.R.S. § 1602-B;
6. Such other and further relief as this Court deems just and equitable.

Respectfully submitted,

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

State-Specific Notes — Maine

Sources and References

• 24-A M.R.S. § 2902 — Maine Legislature
• 24-A M.R.S. § 2436-A — Maine Legislature
• 14 M.R.S. § 5927 — Maine Legislature