Uninsured/Underinsured Motorist Complaint

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 — Unfair Insurance Practices (RSA 417)
9. Damages
10. Jury Demand
11. Prayer for Relief

Caption

STATE OF NEW HAMPSHIRE
[COUNTY NAME], SS. SUPERIOR COURT

Parties

1. Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing at [PLAINTIFF ADDRESS], [CITY], [COUNTY] County, New Hampshire [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 New Hampshire, 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 matter pursuant to RSA 491:7.

5. Venue is proper in [COUNTY] County pursuant to RSA 507:9 because [☐ the accident occurred in this county / ☐ Defendant transacts business in this county / ☐ Plaintiff resides in this county].

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

General Allegations

7. 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, New Hampshire.

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

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

☐ Operating at an excessive or unreasonable speed (RSA 265:60)
☐ Failure to yield the right of way (RSA 265:29)
☐ Following too closely (RSA 265:25)
☐ Driving under the influence (RSA 265-A:2)
☐ Failure to obey a traffic control device (RSA 265:6)
☐ Improper lane change (RSA 265:22)
☐ Handheld electronic device use while driving (RSA 265:79-c)
☐ Other: [________________________________]

10. As a direct and proximate result of the above-described negligence, Plaintiff sustained serious bodily injuries and damages.

Policy Identification and Coverage

11. 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").

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

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

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

15. ☐ UM/UIM coverage was automatically provided at BI liability limits pursuant to RSA 264:15.

Stacking Provisions

16. ☐ Multiple policies or vehicles may apply to this claim.

☐ Plaintiff claims stacking of UM/UIM coverages
☐ Anti-stacking provision applies
☐ Stacking is not at issue in this claim

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

17. 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:

18. The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], which is less than Plaintiff's UIM coverage limits.

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

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

First Claim

Breach of Contract (UM/UIM Benefits)

21. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 20.

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

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

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

25. 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

Unfair Insurance Practices (RSA 417)

26. Plaintiff re-alleges and incorporates by reference paragraphs 1 through 25.

27. Pursuant to RSA 417, it is an unfair or deceptive act for an insurer to engage in unfair claims settlement practices.

28. Defendant Insurer violated RSA 417 by engaging in one or more of the following acts:

☐ Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue
☐ Failing to acknowledge and act reasonably promptly upon communications with respect to claims
☐ Failing to adopt and implement reasonable standards for the prompt investigation of claims
☐ Refusing to pay claims without conducting a reasonable investigation
☐ Failing to effectuate prompt, fair, and equitable settlements when liability has become reasonably clear
☐ Compelling insureds to institute litigation to recover amounts due
☐ Other: [________________________________]

29. Plaintiff has been damaged by Defendant Insurer's unfair insurance practices and is entitled to damages as provided by law.

Damages

30. 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]
☐ Consequential damages for unfair insurance practices
☐ Prejudgment interest (RSA 524:1-b)
☐ 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. Damages for unfair insurance practices pursuant to RSA 417;
4. Prejudgment interest pursuant to RSA 524:1-b;
5. Costs of this action; and
6. Such other and further relief as this Court deems just and equitable.

Respectfully submitted,

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

State-Specific Notes — New Hampshire

Sources and References

• RSA 264:15 — Justia (2024)
• New Hampshire UM Coverage — NH Injury Law Firm
• NH Auto Insurance Guide — NH Insurance Department
• NH UM/UIM Coverage — Plymouth Rock