Uninsured/Underinsured Motorist Complaint - North Carolina

North Carolina 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. Stacking / Credit Rule Provisions
  8. First Claim for Relief — Breach of Contract (UM/UIM Benefits)
  9. Second Claim for Relief — Unfair and Deceptive Trade Practices (N.C.G.S. § 75-1.1)
  10. Damages
  11. Jury Demand
  12. Prayer for Relief
  13. Verification

Caption

IN THE GENERAL COURT OF JUSTICE

[SUPERIOR / DISTRICT] COURT DIVISION

[COUNTY NAME] COUNTY, NORTH CAROLINA

[PLAINTIFF FULL NAME], File No.: [________________________________]
Plaintiff,
v. COMPLAINT
[INSURANCE COMPANY NAME], (Uninsured/Underinsured Motorist)
Defendant.

Parties

  1. Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is a citizen and resident of [COUNTY] County, North Carolina, and is an insured under the automobile insurance policy described herein.

  2. Defendant, [INSURANCE COMPANY NAME] ("Defendant Insurer"), is an insurance company licensed to transact business in the State of North Carolina, which may be served at [INSURER ADDRESS / REGISTERED AGENT ADDRESS].

  3. [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 damages].


Jurisdiction and Venue

  1. This Court has jurisdiction over this action pursuant to N.C. Const. Art. IV, § 12.

  2. The amount in controversy exceeds $25,000, making the Superior Court Division the proper division for trial under N.C.G.S. § 7A-243.

  3. Venue is proper in [COUNTY] County because [☐ Plaintiff or an individual Defendant resides here under N.C.G.S. § 1-82 / ☐ a domestic entity Defendant resides here under § 1-79 / ☐ a foreign corporation satisfies § 1-80].

  4. Each claim is timely under its applicable limitation and accrual rule. For the underlying personal injury or physical property damage, N.C.G.S. § 1-52(16) runs from when the harm became or reasonably should have become apparent, subject to its outer limit and stated exceptions. Any contract claim for policy benefits requires a separate accrual calculation under § 1-52(1) and any more specific controlling law.


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/TOWN], [COUNTY] County, North Carolina.

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

  3. The Uninsured/Underinsured Motorist was negligent in one or more of the following respects:

☐ Operating at an excessive speed in violation of N.C.G.S. § 20-141
☐ Failure to yield the right of way
☐ Failure to maintain a proper lookout
☐ Following too closely in violation of N.C.G.S. § 20-152
☐ Driving while impaired in violation of N.C.G.S. § 20-138.1
☐ Running a red light or stop sign
☐ Improper lane change
☐ Texting while driving in violation of N.C.G.S. § 20-137.4A
☐ Other: [________________________________]

  1. Each such act or omission constituted negligence and was a proximate cause of Plaintiff's injuries and damages.

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. ☐ Policies issued/renewed on or after July 1, 2025: Both UM and UIM coverage are mandatory under the amended N.C.G.S. § 20-279.21. No rejection is permitted. Minimum limits are $50,000/$100,000.

  6. ☐ Policies issued/renewed before July 1, 2025: Plaintiff did not execute a valid written rejection of UM/UIM coverage. The prior minimum limits of $30,000/$60,000 apply.


UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

  1. 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:

  1. 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 damages sustained.

  2. Plaintiff has exhausted the at-fault motorist's bodily injury liability limits and received $[AMOUNT RECOVERED FROM TORTFEASOR] in [☐ settlement / ☐ judgment].

  3. Defendant Insurer was provided with timely written notice and the opportunity to consent to the settlement with the tortfeasor's insurer.


Stacking / Credit Rule Provisions

  1. ☐ New Law (policies issued/renewed on or after 7/1/2025): Plaintiff's UIM coverage stacks on top of the at-fault driver's liability limits without any setoff or credit. Plaintiff's total available recovery is $[TORTFEASOR LIMIT] + $[UIM LIMIT] = $[TOTAL AVAILABLE].

  2. ☐ Prior Law (policies issued/renewed before 7/1/2025): Plaintiff's UIM benefits are subject to a credit/setoff for amounts recovered from the tortfeasor's insurer. Plaintiff's net UIM recovery is $[UIM LIMIT] minus $[AMOUNT RECOVERED] = $[NET UIM AVAILABLE].


First Claim for Relief

Breach of Contract (UM/UIM Benefits)

  1. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 23.

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

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

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


Second Claim for Relief

Unfair and Deceptive Trade Practices (N.C.G.S. § 75-1.1)

  1. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 28.

  2. Defendant Insurer's conduct in handling Plaintiff's UM/UIM claim constitutes unfair or deceptive acts or practices in or affecting commerce in violation of N.C.G.S. § 75-1.1, including:

☐ Failing to acknowledge and act reasonably promptly upon the claim
☐ Refusing to pay the claim without conducting a reasonable investigation
☐ Failing to affirm or deny coverage within a reasonable time
☐ Failing to attempt in good faith to effectuate a prompt, fair, and equitable settlement when liability was reasonably clear
☐ Compelling Plaintiff to institute this action to recover amounts due
☐ Other: [________________________________]

  1. Defendant Insurer's unfair and deceptive acts proximately caused actual injury to Plaintiff.

  2. Pursuant to N.C.G.S. § 75-16, Plaintiff is entitled to treble the amount of actual damages sustained.


Damages

  1. As a result of the accident and Defendant Insurer's breaches, Plaintiff has suffered 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]
☐ Mental anguish and emotional distress: $[AMOUNT]
☐ Permanent injury and disability: $[AMOUNT]
☐ Disfigurement: $[AMOUNT]
☐ Loss of enjoyment of life: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Treble damages under N.C.G.S. § 75-16
☐ Prejudgment interest (N.C.G.S. § 24-5)
☐ Attorney's fees under N.C.G.S. § 75-16.1
☐ Costs of suit


Jury Demand

Plaintiff hereby demands a trial by jury on all issues so triable pursuant to N.C.G.S. § 1A-1, Rule 38.


Prayer for Relief

WHEREFORE, Plaintiff prays the Court for 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. Treble damages for unfair and deceptive trade practices pursuant to N.C.G.S. § 75-16;
  4. Reasonable attorney's fees pursuant to N.C.G.S. § 75-16.1;
  5. Prejudgment interest pursuant to N.C.G.S. § 24-5;
  6. Costs of this action; and
  7. Such other and further relief as this Court deems just and proper.

Verification

STATE OF NORTH CAROLINA
COUNTY OF [COUNTY NAME]

I, [PLAINTIFF FULL NAME], being duly sworn, depose and say that I am the Plaintiff in the above-captioned action; that I have read the foregoing Complaint and that the facts stated therein are true to the best of my knowledge and belief.

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

Sworn to and subscribed before me this [____] day of [__________], [____].

Notary Public: [________________________________]
My Commission Expires: [__/__/____]


Respectfully submitted,

[ATTORNEY NAME], N.C. State Bar No. [BAR NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], North Carolina [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff


State-Specific Notes — North Carolina

Topic Detail
UM/UIM Mandatory? YES — both UM and UIM mandatory for policies issued/renewed on or after 7/1/2025; rejection eliminated
Prior Law Before 7/1/2025: UM required, UIM could be rejected in writing
New Minimum Limits $50,000/$100,000 BI (effective 7/1/2025); prior: $30,000/$60,000
Maximum Limits Up to $1,000,000/$1,000,000 available
Credit Rule ABOLISHED for new policies (7/1/2025+): UIM stacks on top of liability limits
Prior Credit Rule Pre-7/1/2025 policies: UIM reduced by amounts recovered from tortfeasor
Stacking UIM stacks on top of liability for new policies; no inter-policy stacking
Contributory Negligence North Carolina applies pure contributory negligence — any plaintiff fault bars recovery
Statute of Limitations § 1-52(16): three years for covered personal injury or physical property damage, accruing when harm becomes or reasonably should become apparent, subject to its outer limit and exceptions; § 1-52(1): separate three-year contract route when applicable; calculate each claim independently
Arbitration Not statutorily mandated; depends on policy terms
Service on UM/UIM Carrier Insurer may be served as an unnamed party by registered/certified mail (or any manner provided by law); as of S.L. 2023-133, service outside the statute of limitations is valid so long as the summons was properly issued, preserved, and served under N.C.G.S. § 1A-1, Rule 4 — this reversed the older rule requiring service within the SOL (see Brown v. Lumbermens Mut. Cas. Co., 285 N.C. 313, 204 S.E.2d 829 (1974); Davis v. Urquiza, 233 N.C. App. 462, 757 S.E.2d 327 (2014))
UM Pre-Suit Notice For unknown/hit-and-run UM claims, no suit may be initiated until 60 days after written notice to the insurer; failure to give 60-day notice does not bar the action but only extends the insurer's time to answer, N.C.G.S. § 20-279.21(b)(3)
UIM Settlement/Consent Insurer that receives written notice before a tortfeasor settlement and fails to advance payment equal to the tentative settlement within 30 days forfeits its subrogation/consent rights, N.C.G.S. § 20-279.21(b)(4)
Bad Faith / UDAP N.C.G.S. § 75-1.1 (treble damages under § 75-16 + attorney's fees under § 75-16.1). Note: § 58-63-15(11) itself creates no private right of action — the statute is enforceable only by the Commissioner of Insurance — but a violation of § 58-63-15(11) constitutes a per se violation of § 75-1.1 and is actionable that way. Gray v. N.C. Ins. Underwriting Ass'n, 352 N.C. 61 (2000)

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About this template

Last updated
September 8, 2026
Jurisdiction
North Carolina
Category
Personal Injury

Legal authority

  • N.C. Gen. Stat. § 20-279.21 (UM/UIM Coverage)
  • N.C. Gen. Stat. § 58-63-15(11) (Unfair Claim Settlement Practices — Commissioner-enforced only; no private right of action; actionable indirectly through § 75-1.1 per Gray v. N.C. Ins. Underwriting Ass'n, 352 N.C. 61 (2000))
  • N.C. Gen. Stat. § 1A-1, Rule 3 (Commencement of Action)
  • N.C. Gen. Stat. § 1-52(1) (three-year limitation for qualifying contract claims unless a more specific period controls)
  • N.C. Gen. Stat. § 1-52(16) (three-year limitation and apparent-harm accrual rule for personal injury or physical property damage, subject to stated exceptions)
  • N.C. Gen. Stat. § 7A-243 (Proper Superior Court trial division when amount exceeds $25,000)

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.

N.C. Gen. Stat. § 1-52(1) (checked September 8, 2026): "Upon a contract, obligation or liability arising out of a contract, express or implied, except those mentioned in the preceding sections or in G.S. 1-53(1)."

N.C. Gen. Stat. § 1-52(16) (checked September 8, 2026): "Unless otherwise provided by law, for personal injury or physical damage to claimant's property, the cause of action, except in causes of actions referred to in G.S. 1-15(c), shall not accrue until bodily harm to the claimant or physical damage to his property becomes apparent or ought reasonably to have become apparent to the claimant, whichever event first occurs. Except as provided in G.S. 130A-26.3 or G.S. 1-17(d) and (e), no cause of action shall accrue more than 10 years from the last act or omission of the defendant giving rise to the cause of action."

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