Uninsured/Underinsured Motorist Complaint
UNINSURED / UNDERINSURED MOTORIST COMPLAINT
Table of Contents
- Caption
- Parties
- Jurisdiction and Venue
- General Allegations
- No-Fault / PIP Coverage Context
- Policy Identification and UM/UIM Coverage
- UM vs. UIM Status
- Serious Impairment Threshold
- Count I — Breach of Contract (UM/UIM Benefits)
- Count II — Bad Faith / Violation of Michigan Uniform Trade Practices Act
- Damages
- Jury Demand
- Prayer for Relief
Caption
IN THE CIRCUIT COURT FOR THE COUNTY OF [COUNTY NAME]
STATE OF MICHIGAN
| [PLAINTIFF FULL NAME], | Case No.: [________________________________] |
| Plaintiff, | Hon. [JUDGE NAME] |
| v. | |
| [INSURANCE COMPANY NAME], | COMPLAINT |
| Defendant. | (Uninsured/Underinsured Motorist) |
| ___________________________/ |
Parties
-
Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing in [CITY], [COUNTY] County, Michigan, and is an insured under the automobile insurance policy described herein.
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Defendant, [INSURANCE COMPANY NAME] ("Defendant Insurer"), is an insurance company authorized to transact business in the State of Michigan, with its principal place of business at [INSURER ADDRESS].
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[JOHN/JANE DOE] ("Uninsured/Underinsured Motorist") is an individual who, at all relevant times, operated a motor vehicle [☐ without bodily injury liability insurance / ☐ with bodily injury liability insurance inadequate to compensate Plaintiff's non-economic damages].
Jurisdiction and Venue
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This Court has jurisdiction over this action pursuant to the Michigan Constitution, Art. VI, § 13, and MCL § 600.605.
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The amount in controversy exceeds $25,000.
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Venue is proper in [COUNTY] County pursuant to MCL § 600.1629 because [☐ the accident occurred in this county / ☐ Defendant has a registered agent in this county / ☐ Plaintiff resides in this county].
General Allegations
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On or about [DATE OF ACCIDENT], at approximately [TIME], Plaintiff was [☐ operating / ☐ a passenger in] a motor vehicle on [STREET/HIGHWAY], in [CITY/TOWNSHIP], [COUNTY] County, Michigan.
-
At said time and place, the Uninsured/Underinsured Motorist negligently operated a motor vehicle and caused a collision with Plaintiff's vehicle.
-
The Uninsured/Underinsured Motorist was negligent in one or more of the following respects:
☐ Operating at an excessive or unreasonable speed
☐ Failure to yield the right of way
☐ Failure to maintain a proper lookout
☐ Following too closely
☐ Operating under the influence (MCL § 257.625)
☐ Disregarding a traffic control device
☐ Improper lane change
☐ Distracted driving / texting (MCL § 257.602b)
☐ Other: [________________________________]
- Each such act or omission was a proximate cause of the collision and Plaintiff's injuries.
No-Fault / PIP Coverage Context
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Plaintiff has made a claim for Personal Injury Protection (PIP) benefits under [☐ Plaintiff's own policy / ☐ the Michigan Assigned Claims Plan] for allowable expenses, work loss benefits, and replacement services arising from the accident.
-
The PIP claim is [☐ being paid / ☐ in dispute / ☐ not applicable] and is separate from this UM/UIM claim for non-economic damages.
-
Plaintiff's claim in this action is for NON-ECONOMIC DAMAGES (pain and suffering, loss of enjoyment of life, etc.) that are not covered by PIP benefits and arise from the negligence of the Uninsured/Underinsured Motorist.
Policy Identification and UM/UIM Coverage
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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").
-
The Policy provides uninsured motorist ("UM") bodily injury coverage with limits of $[UM LIMIT PER PERSON] per person / $[UM LIMIT PER ACCIDENT] per accident.
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☐ The Policy also provides underinsured motorist ("UIM") bodily injury coverage with limits of $[UIM LIMIT PER PERSON] per person / $[UIM LIMIT PER ACCIDENT] per accident.
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Plaintiff has paid all premiums due under the Policy and has complied with all conditions precedent, including providing notice of the claim within one year of the accident as required by MCL § 500.3145.
-
Plaintiff did not execute a valid written rejection of UM/UIM coverage.
UM vs. UIM Status
Select one:
☐ Uninsured Motorist (UM) Claim:
- The at-fault motorist was uninsured at the time of the accident in that [☐ no bodily injury liability policy was in effect / ☐ the at-fault motorist is unknown (hit-and-run) / ☐ the at-fault motorist's insurer denied coverage or is insolvent].
☐ Underinsured Motorist (UIM) Claim:
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The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], which is insufficient to compensate Plaintiff for the full extent of non-economic damages sustained.
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Plaintiff has exhausted the at-fault motorist's bodily injury liability limits and received $[AMOUNT RECOVERED FROM TORTFEASOR] in [☐ settlement / ☐ judgment].
-
Defendant Insurer was provided with timely written notice and the opportunity to consent to the settlement with the tortfeasor's insurer.
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Plaintiff's non-economic damages exceed the tortfeasor's coverage, and Plaintiff is entitled to recover additional amounts under the UIM provisions of the Policy.
Serious Impairment Threshold
- Plaintiff has suffered a "serious impairment of body function" as defined by MCL § 500.3135(5), meaning an objectively manifested impairment of an important body function that affects the person's general ability to lead a normal life. Specifically:
☐ The impairment is objectively manifested: [________________________________]
☐ The impairment affects an important body function: [________________________________]
☐ The impairment affects Plaintiff's general ability to lead a normal life: [________________________________]
-
☐ Alternatively, Plaintiff suffered permanent serious disfigurement as a result of the accident: [________________________________].
-
☐ Alternatively, the accident resulted in the death of [DECEDENT NAME], and this claim is brought by [☐ the personal representative of the estate / ☐ surviving family members].
Count I
Breach of Contract (UM/UIM Benefits)
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Plaintiff re-alleges and incorporates by reference paragraphs 1 through 26.
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The Policy constitutes a valid and enforceable contract between Plaintiff and Defendant Insurer.
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Plaintiff has performed all obligations and satisfied all conditions precedent required under the Policy, including timely notice under MCL § 500.3145.
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Defendant Insurer has breached the Policy by failing and refusing to pay UM/UIM benefits owed to Plaintiff despite proper demand.
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As a direct and proximate result of Defendant Insurer's breach, Plaintiff has been damaged in an amount to be proven at trial.
Count II
Bad Faith / Violation of Michigan Uniform Trade Practices Act
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Plaintiff re-alleges and incorporates by reference paragraphs 1 through 31.
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Defendant Insurer has violated the Michigan Uniform Trade Practices Act (MCL § 500.2001 et seq.) and acted in bad faith by:
☐ Failing to acknowledge and act reasonably promptly upon the claim
☐ Failing to conduct a reasonable investigation before denying the claim
☐ Refusing to pay a claim without a reasonable basis
☐ Failing to affirm or deny coverage within a reasonable time
☐ Failing to attempt in good faith to effectuate prompt, fair, and equitable settlement
☐ Other: [________________________________]
- As a result of Defendant Insurer's bad faith conduct, Plaintiff has suffered additional damages including emotional distress and the costs of pursuing this litigation.
Damages
- As a result of the accident and Defendant Insurer's breaches, Plaintiff has suffered the following damages:
Non-Economic Damages (UM/UIM Claim):
☐ Pain and suffering (past and future): $[AMOUNT]
☐ Mental anguish and emotional distress: $[AMOUNT]
☐ Loss of enjoyment of life: $[AMOUNT]
☐ Permanent disability or impairment: $[AMOUNT]
☐ Disfigurement: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
Excess Economic Damages (if PIP exhausted or not covering):
☐ Excess medical expenses beyond PIP limits: $[AMOUNT]
☐ Excess wage loss beyond PIP limits: $[AMOUNT]
Additional Damages:
☐ Consequential damages for bad faith: $[AMOUNT]
☐ Penalty interest under MCL § 500.2006 (12% per annum)
☐ Attorney's fees
☐ Costs of suit
Jury Demand
Plaintiff hereby demands a trial by jury on all issues so triable.
Prayer for Relief
WHEREFORE, Plaintiff prays for judgment against Defendant Insurer as follows:
- Non-economic compensatory damages in an amount to be determined at trial;
- UM/UIM benefits in the full amount owed under the Policy;
- Excess economic damages beyond PIP limits, if applicable;
- Consequential damages for Defendant Insurer's bad faith;
- Penalty interest at 12% per annum under MCL § 500.2006;
- Attorney's fees as permitted by law;
- Costs of this action; and
- Such other and further relief as this Court deems just and equitable.
Respectfully submitted,
[ATTORNEY NAME], P[BAR NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], Michigan [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff
State-Specific Notes — Michigan
| Topic | Detail |
|---|---|
| No-Fault State | Yes — PIP covers economic losses regardless of fault (MCL § 500.3101 et seq.) |
| UM/UIM Mandatory? | Insurer must offer; insured may reject in writing (MCL § 500.3163) |
| UM/UIM Purpose | Covers non-economic damages (pain/suffering) when tortfeasor is uninsured/underinsured |
| Serious Impairment Threshold | Must prove "serious impairment of body function" or "permanent serious disfigurement" for non-economic damages (MCL § 500.3135) |
| Minimum UM Limits | $20,000/$40,000 BI (Michigan minimum liability limits) |
| Notice Requirement | Must notify insurer within 1 year of accident (MCL § 500.3145) |
| Stacking | Generally not permitted |
| Arbitration | Not statutorily mandated; depends on policy terms |
| PIP Interaction | PIP covers economic losses (medical, wage loss, replacement services); UM/UIM covers non-economic excess |
| Penalty Interest | 12% per annum on overdue benefits (MCL § 500.2006) |
| 2019 No-Fault Reforms | Changed PIP options but UM/UIM provisions remain; verify PIP election level |
Sources and References
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