Uninsured/Underinsured Motorist Complaint - Tennessee

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 Cause of Action — Breach of Contract (UM/UIM Benefits)
8. Second Cause of Action — Bad Faith Refusal to Pay (Use With Caution — See Note)
9. Damages
10. Arbitration Under TCA § 56-7-1206
11. Prayer for Relief
12. Verification

Caption

IN THE CIRCUIT COURT FOR [COUNTY NAME] COUNTY, TENNESSEE

AT [CITY]

Parties

1. Plaintiff [PLAINTIFF FULL NAME] ("Plaintiff") is a citizen and resident of [COUNTY] County, Tennessee, and is an insured under the automobile insurance policy described herein.

2. Defendant [TORTFEASOR NAME] ("Defendant Motorist") is, upon information and belief, an individual who [☐ resides in [COUNTY] County, Tennessee / ☐ whose address is unknown].

3. Defendant [INSURANCE COMPANY NAME] ("Defendant Insurer") is an insurance company authorized to transact business in the State of Tennessee, with its principal place of business at [INSURER ADDRESS].

Jurisdiction and Venue

4. This Court has jurisdiction over this action pursuant to Tenn. Code Ann. § 16-10-101 et seq.

5. Venue is proper in [COUNTY] County pursuant to Tenn. Code Ann. § 20-4-101 because [☐ the accident occurred in this county / ☐ Defendant Motorist resides in this county / ☐ Defendant Insurer conducts 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], [COUNTY] County, Tennessee.

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

8. The Defendant 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
☐ Distracted driving
☐ 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 an 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 has paid all premiums due under the Policy and has complied with all conditions precedent.

14. Plaintiff did not execute a valid written rejection of UM/UIM coverage as contemplated by TCA § 56-7-1201.

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

15. The Defendant Motorist was uninsured at the time of the accident within the meaning of TCA § 56-7-1202, in that [☐ the Defendant Motorist had no bodily injury liability insurance in effect / ☐ the Defendant Motorist is unknown (hit-and-run) / ☐ the Defendant Motorist's insurer has denied coverage / ☐ the Defendant Motorist's insurer is insolvent].

15A. [IF HIT-AND-RUN/UNKNOWN MOTORIST BOX IS CHECKED, ADD:] ☐ Actual physical contact occurred between the unknown motorist's vehicle and Plaintiff's [vehicle / person] / ☐ the existence of the unknown motorist is established by clear and convincing evidence other than the testimony of occupants of Plaintiff's vehicle, as required by TCA § 56-7-1201(e)(1). Plaintiff [or someone on Plaintiff's behalf] reported the accident to [LAW ENFORCEMENT AGENCY] within a reasonable time after its occurrence, and Plaintiff was not negligent in failing to determine the identity of the unknown motorist, as required by TCA § 56-7-1201(e)(2)-(3). Plaintiff has named "John Doe" as a defendant and has issued or will issue a John Doe warrant against the unknown owner/operator as required by TCA § 56-7-1206(b).

☐ Underinsured Motorist (UIM) Claim:

16. The Defendant Motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], which is less than the Plaintiff's UM/UIM limits, and the tortfeasor's limits are insufficient to fully compensate Plaintiff's damages.

17. Plaintiff has exhausted or is prepared to exhaust the Defendant Motorist's liability policy limits and has obtained [☐ a settlement / ☐ a judgment] in the amount of $[AMOUNT RECOVERED FROM TORTFEASOR].

18. Defendant Insurer was given written notice and the opportunity to consent to or advance the tortfeasor's policy limits before settlement.

First Cause of Action

Breach of Contract (UM/UIM Benefits)

19. Plaintiff incorporates by reference all preceding paragraphs.

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

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

22. Defendant Insurer has breached the Policy by failing and refusing to pay UM/UIM benefits owed to Plaintiff, despite Plaintiff's timely demand.

23. 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 Cause of Action

Bad Faith Refusal to Pay — USE WITH CAUTION

24. ☐ [OPTIONAL — DELETE UNLESS INDEPENDENTLY VERIFIED APPLICABLE] Plaintiff incorporates by reference all preceding paragraphs.

25. On or about [DATE OF DEMAND], Plaintiff made a written demand upon Defendant Insurer for payment of UM/UIM benefits owed under the Policy.

26. More than sixty (60) days have elapsed since Plaintiff's demand, and Defendant Insurer has refused to pay said claim.

27. Defendant Insurer's refusal to pay was not in good faith, in that:

☐ Defendant Insurer unreasonably delayed investigation of the claim
☐ Defendant Insurer failed to conduct a thorough and fair investigation
☐ Defendant Insurer unreasonably denied benefits without basis
☐ Defendant Insurer failed to attempt in good faith to effectuate a prompt and fair settlement
☐ Defendant Insurer compelled Plaintiff to initiate litigation to recover amounts due
☐ Other: [________________________________]

28. [SUBJECT TO THE CAUTION NOTE ABOVE] If a viable statutory basis for a bad-faith penalty is independently confirmed to apply to this claim, Defendant Insurer would be liable for an additional penalty of up to twenty-five percent (25%) of the amount of the claim, together with all reasonable attorney's fees for the prosecution of the claim, under the applicable statute. Do NOT cite TCA § 56-7-105 for a UM/UIM automobile claim — see caution note above.

Damages

29. 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]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Bad faith penalty (ONLY if independently confirmed applicable — TCA § 56-7-105 does NOT apply to auto/UM/UIM policies; see caution note above)
☐ Attorney's fees (ONLY if independently confirmed applicable under a statute other than TCA § 56-7-105)
☐ Prejudgment interest (available only if the claim's gravamen sounds in contract, not personal injury; see Statute of Limitations note below — a claim seeking only personal-injury damages against the tortfeasor, with the UM/UIM carrier defending, is treated as a personal injury action for which prejudgment interest is unavailable: Haddon v. Vanlier, No. M2023-01151-SC-R11-CV (Tenn. May 12, 2026))
☐ Costs of suit

Arbitration Under TCA § 56-7-1206

30. ☐ The liability carrier has offered its full policy limits of $[TORTFEASOR POLICY LIMIT] in settlement, and Plaintiff has agreed, or is prepared to agree, to submit the UM/UIM claim to binding arbitration under the optional procedure described in TCA § 56-7-1206.

☐ The liability carrier has NOT offered its full policy limits, or Plaintiff has not agreed to arbitration, and this matter shall proceed through normal litigation. Arbitration is not mandatory under TCA § 56-7-1206(c).

Prayer for Relief

WHEREFORE, Plaintiff prays for judgment against Defendants as follows:

1. For compensatory damages against Defendant Motorist in an amount according to proof at trial;
2. For UM/UIM policy benefits against Defendant Insurer in the full amount owed under the Policy;
3. ☐ [OPTIONAL — DELETE UNLESS INDEPENDENTLY VERIFIED] For a bad-faith penalty under an applicable statute other than TCA § 56-7-105, which does not apply to automobile/UM/UIM policies (see caution note under Second Cause of Action);
4. ☐ [OPTIONAL — DELETE UNLESS INDEPENDENTLY VERIFIED] For reasonable attorney's fees under an applicable statute other than TCA § 56-7-105;
5. For prejudgment interest as permitted by law, to the extent the claim sounds in contract rather than personal injury (see Statute of Limitations note; Haddon v. Vanlier, No. M2023-01151-SC-R11-CV (Tenn. May 12, 2026));
6. For costs of suit incurred herein; and
7. For such other and further relief as this Court deems just and proper.

Verification

STATE OF TENNESSEE
COUNTY OF [COUNTY NAME]

I, [PLAINTIFF FULL NAME], being duly sworn, state that the facts set forth in the foregoing Complaint are true and correct to the best of my knowledge, information, and belief.

Dated: [__/__/____]

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

Sworn to and subscribed before me this [____] day of [____________], [________].

Notary Public: [________________________________]
My Commission Expires: [__/__/____]

RESPECTFULLY SUBMITTED,

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

State-Specific Notes — Tennessee

Sources and References

• TCA § 56-7-1201 — Justia (2024)
• TCA § 56-7-1202 — Justia (2024)
• TCA § 56-7-1206 — Justia (2024)
• TCA § 56-7-1206 Explained — Santel Garner
• TCA § 28-3-109 (contract SOL) — Justia (2024)
• TCA § 56-7-105 (bad faith — inapplicable to auto/UM/UIM) — Justia (2024)
• Giles v. Geico General Ins. Co., No. M2021-00165-COA-R3-CV (Tenn. Ct. App. Oct. 28, 2021) — holding TCA § 56-7-105 inapplicable to automobile insurance
• Haddon v. Vanlier, No. M2023-01151-SC-R11-CV (Tenn. May 12, 2026) — UM claim against tortfeasor, defended by carrier, is a personal-injury (not contract) action; no prejudgment interest
• Fults v. MetLife Auto & Home Ins. Agency, Inc., No. M2018-00647-COA-R3-CV (Tenn. Ct. App. Mar. 7, 2019) — John Doe warrant must be issued within one-year SOL
• TCA § 16-11-102 (Chancery Court concurrent jurisdiction, excludes unliquidated personal-injury damages) — Justia (2024)