Uninsured/Underinsured Motorist Complaint - Nebraska

Nebraska Personal Injury Updated July 13, 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 Claim — Breach of Contract (UM/UIM Benefits)
  8. Second Claim — Bad Faith Denial of Benefits
  9. Damages
  10. Jury Demand
  11. Prayer for Relief

Caption

IN THE DISTRICT COURT OF [COUNTY NAME] COUNTY, NEBRASKA

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

Parties

  1. Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing at [PLAINTIFF ADDRESS], [CITY], [COUNTY] County, Nebraska [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 Nebraska, 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 matter pursuant to Neb. Rev. Stat. § 24-302.

  2. Venue is proper in [COUNTY] County pursuant to Neb. Rev. Stat. § 25-403.01 because [☐ a Defendant resides in this county / ☐ the cause of action arose in this county / ☐ the transaction or part of the transaction giving rise to the claim occurred in this county / ☐ all Defendants are nonresidents and this county was selected].

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


General Allegations

  1. 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, Nebraska.

  2. At said time and place, the Uninsured/Underinsured Motorist negligently operated a motor vehicle, proximately causing 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 or unreasonable speed (Neb. Rev. Stat. § 60-6,185)
☐ Failure to yield the right of way (Neb. Rev. Stat. § 60-6,146)
☐ Following too closely (Neb. Rev. Stat. § 60-6,140)
☐ Driving under the influence (Neb. Rev. Stat. § 60-6,196)
☐ Failure to obey a traffic control device (Neb. Rev. Stat. § 60-6,119)
☐ Improper lane change (Neb. Rev. Stat. § 60-6,139)
☐ Reading, typing, or sending a written communication on a handheld device while the vehicle was moving (Neb. Rev. Stat. § 60-6,179.01)
☐ Other: [________________________________]

  1. As a direct and proximate result of the above-described negligence, Plaintiff sustained serious bodily 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 includes uninsured motorist ("UM") bodily injury coverage with limits of $[UM LIMIT PER PERSON] per person / $[UM LIMIT PER ACCIDENT] per accident.

  3. The Policy includes 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 [☐ received the statutory UM/UIM coverage / ☐ requested higher limits in writing / ☐ is covered under policy terms more favorable than the statutory minimum].


Anti-Stacking Provision

  1. ☐ Multiple policies may apply to this claim.

☐ Anti-stacking provision applies; Plaintiff claims the highest single policy limit of $[AMOUNT]
☐ Stacking is not at issue in this claim


No Mandatory Arbitration

  1. Under Neb. Rev. Stat. § 25-2602.01(f)(4), the statute validating predispute arbitration provisions does not apply to agreements concerning or relating to an insurance policy, subject to the statutory exception and possible federal preemption. This does not prevent the parties from voluntarily agreeing under § 25-2602.01(a) to arbitrate an existing controversy. [ALLEGATIONS CONCERNING THE ACTUAL POLICY, AGREEMENT DATE, AND ANY PREEMPTION ISSUE: ________________________________________________].

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

  1. The vehicle was uninsured under Neb. Rev. Stat. § 44-6405 because [☐ no bodily injury liability policy or bond applied / ☐ the liability insurer denied coverage / ☐ the liability insurer became insolvent within the statutory period / ☐ the owner or operator was unknown and actual physical contact caused the injury / ☐ the owner or operator was unknown, the accident was reported as required, and an independent disinterested person can corroborate the no-contact accident].

☐ Underinsured Motorist (UIM) Claim:

  1. The at-fault vehicle had bodily injury liability insurance or a bond of $[TORTFEASOR COVERAGE], which was less than Plaintiff's bodily-injury damages of $[DAMAGES] [or was reduced below those damages by payments to other injured persons], making it underinsured under Neb. Rev. Stat. § 44-6406.

  2. Plaintiff has received $[AMOUNT PAID] from or for persons or organizations legally liable for the injury, an amount credited under Neb. Rev. Stat. § 44-6409.

  3. [If a tentative liability-limits settlement was reached:] Plaintiff gave Defendant Insurer the certified- or registered-mail notice and supporting materials required by Neb. Rev. Stat. § 44-6412(2), and [☐ Defendant did not substitute payment within 30 days after receipt / ☐ Defendant substituted payment / ☐ settlement and subrogation allegations: ________________________________].


First Claim

Breach of Contract (UM/UIM Benefits)

  1. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 21.

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

  3. Plaintiff has performed all obligations and satisfied all conditions precedent required under the Policy.

  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

Bad Faith Denial of Benefits

  1. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 26.

  2. Under Millard Gutter Co. v. Shelter Mutual Insurance Co., 312 Neb. 606, 980 N.W.2d 420 (2022), the insurer-insured relationship implies a covenant of good faith and fair dealing, and only a covered policyholder or qualifying beneficiary may bring the first-party tort claim.

  3. Defendant Insurer breached its duty of good faith and fair dealing by engaging in one or more of the following acts:

☐ Denying benefits without a reasonable basis
☐ Knowledge or reckless disregard of the lack of a reasonable basis for denial
☐ Unreasonably delaying investigation and/or processing of the claim
☐ Failing to make prompt payment of the undisputed portion of the claim
☐ Misrepresenting policy provisions to the insured
☐ Failing to adopt reasonable standards for claim investigation
☐ Other: [________________________________]

  1. Defendant Insurer's conduct proximately caused Plaintiff economic loss and/or mental distress in the amount proved at trial. [Plead this count only if the evidence supports both the absence of a reasonable basis and knowledge or reckless disregard of that absence.]

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]
☐ Physical disability and disfigurement: $[AMOUNT]
☐ Loss of enjoyment of life: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Compensatory damages for bad faith
☐ Prejudgment interest, if authorized after satisfying Neb. Rev. Stat. §§ 45-103.02 and 45-104
☐ Attorney's fees (if authorized)
☐ Costs of suit


Jury Demand

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


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. Compensatory damages proximately caused by proven bad faith;
  4. Prejudgment interest to the extent authorized by Neb. Rev. Stat. §§ 45-103.02 and 45-104;
  5. Costs of this action; and
  6. Such other and further relief as this Court deems just and equitable.

Respectfully submitted,

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


State-Specific Notes — Nebraska

Topic Detail
UM Mandatory? Required by § 44-6408 for covered liability policies on vehicles principally garaged in Nebraska
UIM Mandatory? Required on the same statutory terms; the Act spans §§ 44-6401–6414
Minimum UM Limits $25,000 per person / $50,000 per accident
Maximum Required Insurer not required to provide more than $100,000/$300,000 at insured's written request
Anti-Stacking No stacking; if multiple policies apply, recovery cannot exceed the highest one-policy limit and § 44-6411 sets priority
Arbitration Predispute insurance-policy clauses are outside § 25-2602.01(b), subject to exceptions/preemption; an existing controversy may be voluntarily submitted
Bad Faith Covered policyholder/beneficiary must prove no reasonable basis + knowledge/reckless disregard — Millard Gutter
SOL — Contract 5 years (Neb. Rev. Stat. § 25-205) applies to a UM/UIM breach-of-contract claim against the insurer ONLY if the insured timely preserved (filed suit against or settled with, per § 44-6412(2)) the claim against the uninsured/underinsured motorist within the tort SOL. If that underlying tort claim was not timely preserved, § 44-6413(1)(e) independently bars the UM/UIM claim once the tort SOL against the tortfeasor has expired — it does not extend or default to 5 years. See Schrader v. Farmers Mut. Ins. Co., 259 Neb. 87 (2000); Snyder v. Case and EMCASCO Ins. Co., 259 Neb. 621 (2000); Dworak v. Farmers Ins. Exch., 269 Neb. 386 (2005).
SOL — Personal Injury 4 years (Neb. Rev. Stat. § 25-207); this is the deadline for the underlying claim against the tortfeasor that must be preserved to avoid the § 44-6413(1)(e) bar described above
Hit-and-Run Section 44-6405 requires physical contact or, for no-contact claims, required reporting plus independent disinterested corroboration
Exceptions/Exclusions See § 44-6413 for permitted exceptions and exclusions

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About this template

Last updated
July 13, 2026
Citations checked
July 13, 2026
Jurisdiction
Nebraska
Category
Personal Injury

Legal authority

  • Neb. Rev. Stat. §§ 44-6405 and 44-6406 (Uninsured and underinsured motor vehicles defined)
  • Neb. Rev. Stat. § 44-6408 (Motor Vehicle Liability Policy — UM/UIM Coverage Required)
  • Neb. Rev. Stat. § 44-6409 (Maximum UM/UIM liability; offsets)
  • Neb. Rev. Stat. § 44-6410 (Anti-Stacking Provision)
  • Neb. Rev. Stat. §§ 44-6411 and 44-6412 (Multiple policies; settlement notice and subrogation)
  • Neb. Rev. Stat. § 44-6413 (UM/UIM Coverages — Exceptions, Exclusions, Requirements)
  • Neb. Rev. Stat. § 25-2602.01 (Uniform Arbitration Act — Insurance Policy Exclusion)
  • Neb. Rev. Stat. § 25-205 (Five-Year Statute of Limitations — Written Contracts)
  • Neb. Rev. Stat. § 25-207(3) (Four-Year Limitation — Most Injury Claims)
  • Neb. Rev. Stat. §§ 45-103.02 and 45-104 (Prejudgment Interest)
  • Millard Gutter Co. v. Shelter Mut. Ins. Co., 312 Neb. 606, 980 N.W.2d 420 (2022) (First-Party Bad Faith)

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.

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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

A reviewer verified this template's legal citations against the official source on July 13, 2026.

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