Uninsured/Underinsured Motorist Complaint - New Jersey

New Jersey Personal Injury Updated July 9, 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. Tort Threshold / Lawsuit Option
  7. UM vs. UIM Status
  8. First Count — Breach of Contract (UM/UIM Benefits)
  9. Second Count — Bad Faith / Unfair Claim Practices
  10. Damages
  11. Arbitration / Litigation Election
  12. Prayer for Relief
  13. Certification

Caption

SUPERIOR COURT OF NEW JERSEY

LAW DIVISION — [COUNTY] COUNTY

[PLAINTIFF FULL NAME], Docket No.: [________________________________]
Plaintiff,
vs. COMPLAINT
[INSURANCE COMPANY NAME], (Uninsured/Underinsured Motorist)
Defendant.
Civil Action

Parties

  1. Plaintiff [PLAINTIFF FULL NAME] ("Plaintiff") is an individual residing in [CITY/TOWN], [COUNTY] County, New Jersey, 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 Jersey, 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 N.J. Const. art. VI, § 3, ¶ 2, and N.J.S.A. 2A:13-2.

  2. Venue is proper in [COUNTY] County pursuant to N.J.R. 4:3-2 because [☐ the accident occurred in this county / ☐ Plaintiff resides in this county / ☐ Defendant transacts business in this county].


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, New Jersey.

  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 N.J.S.A. 39:4-[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.

Policy Identification and Coverage

  1. At the time of the accident, Plaintiff was insured under a [☐ standard / ☐ basic] 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 [☐ elected stacking / ☐ rejected stacking] of UM/UIM coverage across vehicles insured under the Policy.

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

  6. Plaintiff's Personal Injury Protection ("PIP") benefits have been [☐ exhausted / ☐ applied as applicable], in the amount of $[PIP AMOUNT].


Tort Threshold / Lawsuit Option

  1. Plaintiff elected the following lawsuit option under N.J.S.A. 39:6A-8:

☐ No Limitation on Lawsuit (Zero Threshold): Plaintiff may sue for all injuries, including pain and suffering, without restriction.

☐ Limitation on Lawsuit (Verbal Threshold): Plaintiff may sue for noneconomic damages only if injuries qualify under the verbal threshold, i.e., the injury constitutes one of the following:

☐ Death
☐ Dismemberment
☐ Significant disfigurement or significant scarring
☐ Displaced fracture
☐ Loss of a fetus
☐ Permanent injury within a reasonable degree of medical probability (other than scarring or disfigurement)


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 N.J.S.A. 17:28-1.1(e), in that [☐ the at-fault motorist had no bodily injury liability insurance in effect / ☐ the at-fault motorist is a hit-and-run/phantom vehicle whose identity, or the identity of its operator and owner, cannot be ascertained, or which was operated without the owner's consent by a person whose identity cannot be ascertained, as defined in N.J.S.A. 39:6-78 / ☐ the at-fault motorist's insurer is insolvent or bankrupt / ☐ the at-fault motorist's insurer has denied coverage].
  1. If this is a hit-and-run/phantom vehicle claim, Plaintiff made reasonable efforts, including [☐ reporting the accident to police within a reasonable time / ☐ attempting to identify the vehicle, its owner, and its operator / ☐ other: [________________________________]], to ascertain the identity of the unknown motorist, but such identity could not be ascertained.

☐ 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.

  2. A motor vehicle is underinsured under N.J.S.A. 17:28-1.1(e)(1) only where all bodily injury liability insurance or bonds applicable at the time of the accident have been exhausted by payment of settlements or judgments, and 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 prompt written notice (a "Longworth letter," see Longworth v. Van Houten, 223 N.J. Super. 174 (App. Div. 1988)) and the opportunity to consent to the settlement, advance the tortfeasor's policy limits, or otherwise protect its subrogation rights, as required by the Policy and N.J.S.A. 17:28-1.1(e). Failure to provide such notice may bar the UIM claim. See Ferrante v. N.J. Mfrs. Ins. Grp., 232 N.J. 490 (2018).


First Count

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 and submission of proof of loss.

  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].


Second Count

Bad Faith / Unfair Claim Practices

  1. Plaintiff incorporates by reference all preceding paragraphs.

  2. Under New Jersey law, an insurance carrier owes a duty of good faith and fair dealing to its insured, and a bad-faith failure to pay a first-party claim is actionable at common law where the denial or withholding of benefits is not even fairly debatable and the resulting economic losses were within the insurer's contemplation. Pickett v. Lloyd's, 131 N.J. 457 (1993). [☐ Plaintiff further alleges that Defendant Insurer's conduct violates the Unfair Claims Settlement Practices Act, N.J.S.A. 17:29B-4(9), enforceable pursuant to the private right of action created by the Insurance Fair Conduct Act, N.J.S.A. 17:29BB-1 et seq., to the extent that Act applies to this claim.]

  3. Defendant Insurer's bad faith conduct includes:

☐ Unreasonably delaying investigation of the claim
☐ Failing to conduct a thorough and fair investigation
☐ Unreasonably denying benefits without a reasonable basis, where no valid reason for denial was fairly debatable
☐ Failing to promptly settle when liability is reasonably clear
☐ Compelling Plaintiff to initiate litigation/arbitration to recover amounts due
☐ Misrepresenting pertinent facts or policy provisions
☐ Failing to provide a reasonable explanation of the basis for denial
☐ Other: [________________________________]

  1. Defendant Insurer's conduct was undertaken in bad faith, entitling Plaintiff to consequential damages beyond policy limits and, upon a showing of actual malice or wanton and willful disregard, punitive damages.

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 impairment: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Punitive damages (bad faith claim only): According to proof
☐ Prejudgment interest under N.J.R. 4:42-11
☐ Attorney's fees and costs (if applicable)


Arbitration / Litigation Election

  1. ☐ Arbitration Demanded: Plaintiff demands arbitration of the UM/UIM coverage dispute pursuant to the arbitration clause of the Policy, as authorized by N.J.S.A. 17:28-1.1(d), and subject to the limitations on enforcement of that clause recognized in Zirger v. Gen. Accident Ins. Co., 144 N.J. 327 (1996).

  2. ☐ Litigation Elected: Plaintiff elects to litigate the UM/UIM coverage dispute and associated bad faith claims in this Court.


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 consequential damages arising from Defendant Insurer's bad faith;
  4. For punitive damages for Defendant Insurer's bad faith conduct;
  5. For prejudgment interest as permitted by N.J.R. 4:42-11;
  6. For attorney's fees and costs as permitted by law;
  7. For costs of suit incurred herein; and
  8. 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.


Certification

I hereby certify that confidential personal identifiers have been redacted from documents now submitted to the court, and will be redacted from all documents submitted in the future in accordance with N.J.R. 1:38-7(b).

I certify that the matter in controversy is not the subject of any other action pending in any court or of any pending arbitration proceeding, and that no other action or arbitration proceeding is contemplated. [If applicable: I certify that there are other related matters, as follows: [________________________________].]

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment.

Dated: [__/__/____]

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


RESPECTFULLY SUBMITTED,

[ATTORNEY NAME], N.J. Attorney ID No. [BAR NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], New Jersey [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff


State-Specific Notes — New Jersey

Topic Detail
UM Mandatory? Yes, on standard policies; not on basic policies (N.J.S.A. 17:28-1.1)
UIM Mandatory? Must be offered on standard policies; optional but default included
Minimum Limits (2026) $35,000/$70,000 BI on standard policies (N.J.S.A. 17:28-1.1)
No-Fault State Yes — choice between verbal threshold and zero threshold (N.J.S.A. 39:6A-8)
Verbal Threshold Limits noneconomic damages unless qualifying permanent injury proven
Stacking Optional; insured elects stacking or non-stacking; rejection must be in writing
Arbitration UM/UIM disputes are arbitrated under the Policy's own arbitration clause, as authorized by N.J.S.A. 17:28-1.1(d) — NOT under Rule 4:21A-1, which governs mandatory court-annexed arbitration of the underlying auto-negligence tort action against the tortfeasor. A UIM carrier that intervenes in (or forgoes intervening in) that tort action may be barred from later enforcing its own policy arbitration clause. Zirger v. Gen. Accident Ins. Co., 144 N.J. 327 (1996)
Statute of Limitations Default is 6 years for breach of contract (N.J.S.A. 2A:14-1); 2 years for personal injury against the tortfeasor. However, NJ courts enforce a shorter contractual limitations period in the UM/UIM policy itself if one is stated (e.g., 4 years from accident / 1 year from discovery of the claim) — check the Policy. Vanrell v. United Servs. Auto. Ass'n, 2025 N.J. Super. Unpub. LEXIS 1479 (App. Div. Aug. 6, 2025)
Bad Faith First-party bad faith recognized under the common-law "fairly debatable" standard (Pickett v. Lloyd's, 131 N.J. 457 (1993); reaffirmed in Badiali v. N.J. Mfrs. Ins. Grp., 220 N.J. 544 (2015)); consequential damages and, on a showing of actual malice or willful disregard, punitive damages are available. N.J.S.A. 17:29B-4 alone creates no private right of action — a statutory private right of action exists only under the Insurance Fair Conduct Act, N.J.S.A. 17:29BB-1 et seq. (effective Jan. 18, 2022, prospective only)
UIM Offset UIM benefits are reduced (credited) by amounts recovered from the tortfeasor's liability coverage; tortfeasor's limits must be exhausted before a vehicle is "underinsured" (N.J.S.A. 17:28-1.1(e)(1))
Hit-and-Run UM Physical contact is NOT required. A "hit-and-run"/"phantom vehicle" claim is valid under N.J.S.A. 39:6-78 and N.J.S.A. 17:28-1.1(e)(2)(c) where the vehicle's or driver's identity cannot be ascertained despite the claimant's reasonable efforts, even where the phantom vehicle never made contact (e.g., forced the claimant off the road). Scheckel v. State Farm Mut. Auto. Ins. Co., 316 N.J. Super. 326 (App. Div. 1998)
Basic vs. Standard Basic policies exclude UM/UIM; confirm policy type

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About this template

Last updated
July 9, 2026
Citations checked
July 9, 2026
Jurisdiction
New Jersey
Category
Personal Injury

Legal authority

  • N.J.S.A. 17:28-1.1 (required UM/UIM coverage; hit-and-run includes non-contact 'phantom vehicle' claims)
  • N.J.S.A. 17:28-1.1(e) (UIM definition and exhaustion requirement)
  • N.J.S.A. 17:28-1.1(d) (UM/UIM subject to policy arbitration clause approved by Commissioner)
  • N.J.S.A. 39:6-78 (hit-and-run motor vehicle definition)
  • N.J.S.A. 39:6A-8 (verbal threshold / tort option)
  • N.J.S.A. 17:29B-4 (Unfair Claims Settlement Practices Act — enforced via common-law bad faith, Pickett v. Lloyd's, 131 N.J. 457 (1993); see also Insurance Fair Conduct Act, N.J.S.A. 17:29BB-1 et seq.)
  • N.J.S.A. 2A:14-1 (six-year contract statute of limitations, subject to shorter contractual limitations period in the policy — Vanrell v. USAA, App. Div. Aug. 6, 2025)

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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Checked against the law it cites

A reviewer verified this template's legal citations against the official source on July 9, 2026.

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