Uninsured/Underinsured Motorist Complaint - Minnesota

Minnesota Personal Injury Updated September 8, 2026 Free Word and PDF

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. Stacking Allegations
  11. Prayer for Relief
  12. Verification

Caption

STATE OF MINNESOTA

DISTRICT COURT — [JUDICIAL DISTRICT] JUDICIAL DISTRICT

COUNTY OF [COUNTY NAME]

[PLAINTIFF FULL NAME], Court File No.: [________________________________]
Plaintiff,
vs. COMPLAINT
[INSURANCE COMPANY NAME], (Uninsured/Underinsured Motorist)
Defendant.
Case Type: Personal Injury

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

  1. This Court has jurisdiction over this action pursuant to Minn. Stat. § 484.01 (District Court general jurisdiction).

  2. Venue is proper in [COUNTY] County pursuant to Minn. Stat. § 542.09 because [☐ the accident occurred in this county / ☐ Plaintiff resides in this county / ☐ Defendant transacts business in this county].

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


General Allegations

  1. 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.

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

  3. 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: [________________________________]

  1. As a direct and proximate result of the collision, Plaintiff sustained serious bodily injuries, incurred medical expenses, lost wages, and experienced pain and suffering.

  2. 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

  1. 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").

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

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

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

  5. 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:

  1. 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:

  1. 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, thereby qualifying as an underinsured motorist under Minn. Stat. § 65B.49, subd. 3a.

  2. 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].

  3. 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)

  1. Plaintiff incorporates by reference all preceding paragraphs.

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

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

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

  5. 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].


Reservation of Rights

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

  1. Plaintiff incorporates by reference all preceding paragraphs.

  2. 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.

  3. 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.

  4. 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

  1. 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]
☐ Disability and disfigurement: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ 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)


Stacking Allegations

  1. ☐ Stacking Applicable: The Policy insures [NUMBER] vehicles. The Policy [does not contain / contains unenforceable] anti-stacking provisions. Accordingly, Plaintiff is entitled to stack UM/UIM limits across all insured vehicles, for total available limits of $[STACKED LIMIT].

  2. ☐ Stacking Not Applicable: The Policy contains a valid anti-stacking provision limiting recovery to the single highest applicable limit of $[SINGLE VEHICLE LIMIT].


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


State-Specific Notes — Minnesota

Topic Detail
UM Mandatory? Yes; separate mandatory coverage (Minn. Stat. § 65B.49, subd. 3a)
UIM Mandatory? Yes; separate mandatory coverage (Minn. Stat. § 65B.49, subd. 3a)
Minimum Limits $25,000 per person / $50,000 per accident for each coverage
No-Fault State Yes — BEL benefits apply first (Minn. Stat. § 65B.44)
Tort Threshold $4,000 medical expenses, permanent injury/disfigurement, or 60+ days disability (§ 65B.51)
Stacking Generally permitted unless valid anti-stacking language in policy
Comparative Fault Person-specific not-greater-than comparison; equal fault does not bar recovery against that person (Minn. Stat. § 604.01)
Statute of Limitations (UIM) 4 years from date of accrual (§ 65B.49, subd. 10(b)). Primary UM claims and general no-fault-policy claims carry a 6-year limitation (§ 65B.49, subd. 10(a), citing § 541.05, subd. 1(1)). For a settled UIM claim, Minnesota courts hold accrual runs from the date the insured receives notice that the UIM carrier declines to substitute its check for the tortfeasor's settlement check to preserve subrogation (the Schmidt v. Clothier notice), not from the date of the accident. Oanes v. Allstate Ins. Co., 617 N.W.2d 401 (Minn. 2000). For UM (not UIM) claims, both primary and excess UM limitations run from the date of the accident. Hegseth v. Am. Family Mut. Ins. Grp., 877 N.W.2d 191 (Minn. 2016).
Arbitration Not statutorily mandated; depends on policy terms
Bad Faith Recognized under Minn. Stat. § 604.18 as an award of taxable costs (attorney's fees plus a share of excess proceeds), not punitive damages; requires a post-complaint motion to amend the pleadings supported by affidavits showing a prima facie case (§ 604.18, subds. 2–4)
UIM Offset UIM benefits reduced by amounts paid by tortfeasor's insurer
Rental Vehicle Extension UM/UIM extends to rental vehicles (§ 65B.49, subd. 5a)

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About this template

Last updated
September 8, 2026
Jurisdiction
Minnesota
Category
Personal Injury

Legal authority

  • Minn. Stat. § 65B.49
  • Minn. Stat. § 65B.43 (definitions)
  • Minn. Stat. § 65B.44 (economic loss benefits)
  • Minn. Stat. § 65B.51 (tort threshold)
  • Minn. Stat. § 604.01 (comparative fault)
  • Minn. Stat. § 604.18 (first-party insurance bad-faith taxable costs)
  • Minn. Stat. § 358.116 (verification of court documents without notarization)

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.

Not legal advice

This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Checked against the law it cites

The statutes this template relies on are listed under Legal authority.

Minn. Stat. § 604.01, subd. 1 (checked September 8, 2026): "Contributory fault does not bar recovery in an action by any person or the person's legal representative to recover damages for fault resulting in death, in injury to person or property, or in economic loss, if the contributory fault was not greater than the fault of the person against whom recovery is sought, but any damages allowed must be diminished in proportion to the amount of fault attributable to the person recovering."

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