Uninsured/Underinsured Motorist Complaint - Ohio

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 for Relief — Breach of Contract (UM/UIM Benefits)
8. Second Claim for Relief — Bad Faith
9. Damages
10. Jury Demand
11. Prayer for Relief

Caption

IN THE COURT OF COMMON PLEAS

[COUNTY NAME] COUNTY, OHIO

Parties

1. Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing at [PLAINTIFF ADDRESS], [CITY], [COUNTY] County, Ohio, 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 Ohio, 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 Ohio Rev. Code § 2305.01 and the Ohio Constitution, Art. IV, § 4.

5. The amount in controversy exceeds the jurisdictional minimum of this Court.

5A. For purposes of Ohio Civ.R. 8(A), Plaintiff [seeks more than $25,000 / does not seek more than $25,000] in monetary relief.

6. Venue is proper in [COUNTY] County under Ohio Civ.R. 3(C) because [☐ Defendant has its principal place of business here / ☐ all or part of the claim for relief arose here / ☐ this is an action described in Civ.R. 4.3 and Plaintiff resides here]. Select only a basis supported by the facts.

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 [CITY/VILLAGE/TOWNSHIP], [COUNTY] County, Ohio.

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 a vehicle at an excessive or unreasonable speed
☐ Failure to yield the right of way (ORC § 4511.43)
☐ Failure to maintain an assured clear distance ahead (ORC § 4511.21)
☐ Following too closely (ORC § 4511.34)
☐ Operating under the influence (ORC § 4511.19)
☐ Failure to obey a traffic control device (ORC § 4511.12)
☐ Improper lane change
☐ Distracted driving / texting while driving (ORC § 4511.204)
☐ 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 under Ohio Rev. Code § 3937.18 is optional and not required by law; however, Defendant Insurer offered and Plaintiff affirmatively selected such coverage under the Policy, as reflected in the declarations and/or selection documents referenced herein. [☐ Plaintiff did not execute any valid written rejection of the UM/UIM coverage selected under the Policy.]

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

16. 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:

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

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

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

20. Under Ohio Rev. Code § 3937.18(C), UIM coverage provides protection not greater than the amount that would be available under the insured's UM coverage if the tortfeasor were uninsured. The UIM policy limits are reduced by amounts available from all applicable bodily injury liability policies covering the tortfeasor.

First Claim for Relief

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 for Relief

Bad Faith

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

27. Under Ohio law, an insurer has a duty to act in good faith in the handling and payment of claims presented by its insureds. Zoppo v. Homestead Ins. Co., 71 Ohio St.3d 552 (1994).

28. Defendant Insurer acted in bad faith by:

☐ Unreasonably delaying investigation and/or processing of the claim
☐ Denying benefits without a reasonable justification
☐ Failing to make a good-faith effort to settle the claim
☐ Refusing to pay an amount clearly owed while disputing only the excess
☐ Other: [________________________________]

29. Defendant Insurer's conduct lacked reasonable justification and caused Plaintiff compensatory damages distinct from unpaid policy benefits. [If supported by specific facts, describe conduct showing actual malice, fraud, or insult: FACTS.] Punitive damages on the bad-faith claim require that additional showing; bad faith alone does not establish entitlement to them. Buckeye Union Ins. Co. v. New England Ins. Co., 1999-Ohio-67, ¶¶ 31–32, 38.

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]
☐ Punitive damages (bad faith claim, only if actual malice, fraud, or insult is proved): According to proof
☐ Prejudgment interest (ORC § 1343.03)
☐ Attorney's fees (if applicable)
☐ 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. Punitive damages on the bad-faith claim, if the pleaded facts and proof establish actual malice, fraud, or insult;
4. Prejudgment interest pursuant to Ohio Rev. Code § 1343.03;
5. Attorney's fees and costs as permitted by law;
6. Costs of this action; and
7. Such other and further relief as this Court deems just and equitable.

Respectfully submitted,

[ATTORNEY NAME], Ohio Supreme Court Reg. No. [REG NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], Ohio [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff

State-Specific Notes — Ohio

Sources and References

• ORC § 3937.18 — Ohio Legislature
• ORC § 3937.181 (Property Damage Coverage) — Ohio Legislature
• ORC § 2305.06 (Written Contract SOL) — Ohio Legislature
• ORC § 2711.01 (Arbitration) — Ohio Legislature
• Girgis v. State Farm Mut. Auto. Ins. Co., 75 Ohio St.3d 302 (1996) (historical no-contact holding; see current statutory corroboration rule)
• Smith v. Erie Ins. Co., 148 Ohio St.3d 192, 2016-Ohio-7742
• Zoppo v. Homestead Ins. Co., 71 Ohio St.3d 552 (1994) (bad-faith "reasonable justification" standard)
• Buckeye Union Ins. Co. v. New England Ins. Co., 1999-Ohio-67, ¶¶ 31–32, 38 (additional malice, fraud, or insult showing for punitive damages)
• Ohio UM/UIM Guide — Gruhin & Gruhin