Uninsured/Underinsured Motorist Complaint - Minnesota

Before filing: Provide the district court administrator a completed Form CIV117 Civil Cover Sheet at the time this non-family civil case is filed, under Minn. Gen. R. Prac. 104.

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. Reservation of Rights — Insurance Bad-Faith Taxable Costs
9. Damages
10. Coverage Limits and Excess Insurance
11. Prayer for Relief
12. Verification

Caption

STATE OF MINNESOTA

DISTRICT COURT — [JUDICIAL DISTRICT] JUDICIAL DISTRICT

COUNTY OF [COUNTY NAME]

Parties

1. Plaintiff [PLAINTIFF FULL NAME] ("Plaintiff") is an individual residing in [CITY], [COUNTY] County, Minnesota, 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 Minnesota, 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 Minn. Stat. § 484.01 (District Court general jurisdiction).

5. Venue is proper in [COUNTY] County pursuant to Minn. Stat. § 542.09 because [☐ Defendant resided here when the action began, including through a corporate office, resident agent, or business place / ☐ the cause of action or part of it arose here]. Supporting facts: [____________________].

6. The amount in controversy exceeds $50,000.

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], [COUNTY] County, Minnesota.

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 Minn. Stat. § 169.[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.

11. Plaintiff has met the tort threshold under Minn. Stat. § 65B.51 in that [☐ Plaintiff's medical expenses exceed $4,000 / ☐ Plaintiff suffered permanent injury / ☐ Plaintiff suffered permanent disfigurement / ☐ Plaintiff was disabled for 60 or more days].

Policy Identification and Coverage

12. 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").

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

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

15. Plaintiff has paid all premiums due under the Policy and has complied with all conditions precedent.

16. Plaintiff's Basic Economic Loss ("BEL") / No-Fault benefits under Minn. Stat. § 65B.44 have been [☐ exhausted / ☐ applied as applicable], in the amount of $[BEL AMOUNT].

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

17. The at-fault motorist was uninsured at the time of the accident within the meaning of Minn. Stat. § 65B.49, in that [☐ the at-fault motorist had no 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:

18. The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT]. Plaintiff's actual damages exceed those liability limits; the vehicle therefore meets the definition of an underinsured motor vehicle in Minn. Stat. § 65B.43, subd. 17.

19. 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].

20. 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)

21. Plaintiff incorporates by reference all preceding paragraphs.

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

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

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

25. As a direct and proximate result of Defendant Insurer's breach, Plaintiff seeks reasonable unliquidated damages greater than $50,000, to be determined at trial.

Reservation of Rights

Insurance Bad-Faith Taxable Costs (Minn. Stat. § 604.18)

26. Plaintiff incorporates by reference all preceding paragraphs.

27. Defendant Insurer's handling of Plaintiff's claim has included, or may include, one or more of the following: unreasonably delaying investigation of the claim; failing to conduct a thorough and fair investigation; denying benefits without a reasonable basis; failing to make a reasonable settlement offer once liability and damages became reasonably clear; or misrepresenting policy terms or applicable law.

28. Plaintiff contends that Defendant Insurer lacked a reasonable basis for denying, delaying, or underpaying the UM/UIM benefits owed under the Policy, and that Defendant Insurer knew of, or recklessly disregarded, information establishing the absence of a reasonable basis for its denial.

29. Plaintiff reserves the right to move, under Minn. Stat. § 604.18, subd. 4, to amend this Complaint to seek an award of taxable costs (including attorney's fees, subject to the statutory cap) under Minn. Stat. § 604.18 once discovery or other evidence establishes a prima facie basis for that motion. This paragraph does not itself assert a claim for relief under Minn. Stat. § 604.18, and no such claim is made in this Complaint.

Damages

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

☐ Past medical expenses
☐ Future medical expenses
☐ Past lost wages/earnings
☐ Future lost wages/earning capacity
☐ Pain and suffering (past and future)
☐ Emotional distress
☐ Disability and disfigurement
☐ Loss of consortium (if applicable)
☐ Prejudgment interest under Minn. Stat. § 549.09
☐ Attorney's fees and costs (routine fee-shifting basis, if any, e.g., policy provision or other statute)

Coverage Limits and Excess Insurance

31. Under Minn. Stat. § 65B.49, subd. 3a(5)-(6), Plaintiff seeks the applicable limit for one vehicle, $[APPLICABLE SINGLE-VEHICLE LIMIT]. The limits for two or more vehicles are not added together, regardless of the number of policies, vehicles, or premiums.

32. ☐ Excess coverage, if applicable: Plaintiff occupied a vehicle of which Plaintiff was not an insured and seeks excess protection under a policy in which Plaintiff is insured. The claimed excess is limited to covered damages and to the difference, if any, between the limits for like coverage on the occupied vehicle and any one vehicle under Plaintiff's policy.

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 prejudgment interest under Minn. Stat. § 549.09;
4. For costs and disbursements of this action;
5. For leave, upon an appropriate factual showing under Minn. Stat. § 604.18, subd. 4, to move to amend this Complaint to seek an award of taxable costs (including attorney's fees, subject to the statutory cap) under Minn. Stat. § 604.18; and
6. For such other and further relief as this Court deems just and equitable.

DEMAND FOR JURY TRIAL

Plaintiff hereby demands a trial by jury on all issues triable of right.

Verification

I, [PLAINTIFF FULL NAME], declare under penalty of perjury that everything I have stated in this document is true and correct.

Signed: [__/__/____], in [COUNTY] County, Minnesota.

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

RESPECTFULLY SUBMITTED,

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

Acknowledgment under Minn. Stat. § 549.211, subd. 1: Plaintiff acknowledges that sanctions may be imposed under Minn. Stat. § 549.211.

Attorney signature: [________________________________] Date: [__/__/____]

State-Specific Notes — Minnesota

Sources and References

• Minn. Stat. § 65B.49 — Minnesota Revisor of Statutes
• Minn. Stat. § 65B.49 — Justia
• Minn. Stat. § 65B.51 — Minnesota Revisor of Statutes (tort threshold)
• Minn. Stat. § 604.18 — Minnesota Revisor of Statutes (insurance bad-faith taxable costs)
• Minnesota UM/UIM Practice Guide — McEllistrem Fargione