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. 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

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

4. This Court has jurisdiction over this action pursuant to N.J. Const. art. VI, § 3, ¶ 2, and N.J.S.A. 2A:13-2.

5. 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

6. 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.

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

8. 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: [________________________________]

9. 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

10. 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").

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

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

13. Plaintiff [☐ elected stacking / ☐ rejected stacking] of UM/UIM coverage across vehicles insured under the Policy.

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

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

Tort Threshold / Lawsuit Option

16. 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:

17. The at-fault motorist was uninsured at the time of the accident within the meaning of N.J.S.A. 17:28-1.1, in that [☐ the at-fault motorist had no bodily injury 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:

18. 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.

19. 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].

20. 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 and N.J.S.A. 17:28-1.1.

First Count

Breach of Contract (UM/UIM Benefits)

21. Plaintiff incorporates by reference all preceding paragraphs.

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

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

24. 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.

25. 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

26. Plaintiff incorporates by reference all preceding paragraphs.

27. Under New Jersey law, an insurer owes a duty of good faith and fair dealing to its insured. Defendant Insurer's conduct constitutes unfair claim settlement practices in violation of N.J.S.A. 17:29B-4 and the common law.

28. 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
☐ 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: [________________________________]

29. Defendant Insurer's conduct was undertaken in bad faith, entitling Plaintiff to consequential damages beyond policy limits and punitive damages.

Damages

30. 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

31. ☐ Arbitration Demanded: Plaintiff demands arbitration of the UM/UIM coverage dispute pursuant to the Policy and N.J.R. 4:21A-1 et seq.

32. ☐ 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

Sources and References

• N.J.S.A. 17:28-1.1 — Justia (2025)
• New Jersey UM/UIM Overview — Verp & Leddy
• New Jersey UM/UIM Coverage — Aiello Harris
• NJ MVC — Uninsured Motorist FAQ