Uninsured/Underinsured Motorist Complaint - Vermont

UNINSURED/UNDERINSURED MOTORIST COMPLAINT

Table of Contents

1. Caption
2. Parties
3. Jurisdiction and Venue
4. Insurance Policy Identification
5. Facts of the Accident
6. Uninsured or Underinsured Status of Tortfeasor
7. Liability Coverage and Settlement
8. Count I: UM/UIM Benefits Claim
9. Count II: Bad Faith (If Supported)
10. Damages
11. Stacking Provisions
12. Prayer for Relief
13. Verification
14. Vermont Practice Notes

Caption

STATE OF VERMONT
SUPERIOR COURT, CIVIL DIVISION
[________________________________] UNIT

Docket No.: [________________________________]

Parties

1. Plaintiff, [PLAINTIFF NAME], is an individual residing at [________________________________], Town/City of [________________________________], County of [________________________________], State of Vermont, and a person insured under the motor vehicle insurance policy described herein.

2. Defendant, [INSURANCE COMPANY NAME], is an insurance company authorized to do business in Vermont, with its principal office at [________________________________].

Jurisdiction and Venue

3. This Court has jurisdiction over this civil action pursuant to 4 V.S.A. § 31.

4. Venue is proper in this Unit under 12 V.S.A. § 402(a) because Plaintiff resides in this Unit.

Insurance Policy Identification

5. On or about [__/__/____], Defendant issued automobile insurance policy number [________________________________] to Plaintiff, effective from [__/__/____] to [__/__/____].

6. The policy provides:

   • ☐ Uninsured Motorist (UM) bodily injury coverage: $[________________________________] per person / $[________________________________] per accident
   • ☐ Underinsured Motorist (UIM) bodily injury coverage: $[________________________________] per person / $[________________________________] per accident
   • ☐ UM property damage coverage: $[________________________________] per claim (check the applicable deductible and 23 V.S.A. § 941(a) exceptions)

7. Plaintiff has paid all premiums due and has complied with the applicable policy conditions, including [________________________________].

Facts of the Accident

8. On [__/__/____], at approximately [____] a.m./p.m., Plaintiff was operating/occupying a motor vehicle at or near [________________________________], Town/City of [________________________________], [________________________________] County, Vermont.

9. At that time and place, a motor vehicle operated by [TORTFEASOR NAME] negligently caused a collision with Plaintiff's vehicle.

10. The tortfeasor's negligent acts include but are not limited to:

    • ☐ Failure to yield the right of way
    • ☐ Following too closely
    • ☐ Distracted driving
    • ☐ Operating under the influence of alcohol or drugs
    • ☐ Excessive speed for conditions
    • ☐ Failure to obey traffic control devices
    • ☐ Failure to maintain control of vehicle
    • ☐ Other: [________________________________]

11. As a direct and proximate result of the collision, Plaintiff sustained serious bodily injuries, property damage, and economic losses.

Uninsured or Underinsured Status of Tortfeasor

12. The tortfeasor's motor vehicle qualifies as:
    • ☐ Uninsured — No liability insurance was in effect at the time of the accident
    • ☐ Underinsured — Liability limits applicable at the crash ($[________________________________]) are below Plaintiff's applicable UM limits ($[________________________________]); or payments to others injured in the crash reduced available liability insurance to $[________________________________], below those UM limits (23 V.S.A. § 941(f))
    • ☐ Unknown Motorist (Hit-and-Run) — The tortfeasor fled the scene and remains unidentified
    • ☐ Insurer Insolvent — The tortfeasor's liability insurer became insolvent at the time of or within one year after the crash and cannot pay within its policy limits (23 V.S.A. § 941(d))

Liability Coverage and Settlement

13. ☐ The tortfeasor had no liability insurance.
    ☐ Plaintiff received $[________________________________] from the tortfeasor or liability insurer on [__/__/____].
    ☐ A liability claim remains pending; available liability coverage is $[________________________________].
    ☐ Plaintiff gave Defendant notice of a proposed settlement on [__/__/____] as required by the applicable policy.

Count I: UM/UIM Benefits Claim

14. Plaintiff incorporates all preceding paragraphs by reference.

15. Plaintiff is a person insured under the policy who is legally entitled to recover damages from the owner or operator of an uninsured, underinsured, or unknown motor vehicle for bodily injury, sickness, disease, including death, and for property damage.

16. Pursuant to 23 V.S.A. § 941, Defendant is obligated to provide UM/UIM benefits to Plaintiff.

17. Defendant has failed or refused to pay Plaintiff the UM/UIM benefits owed under the policy.

Count II: Bad Faith (If Supported)

18. Plaintiff incorporates all preceding paragraphs by reference.

19. Defendant denied the claim on [__/__/____] and stated this reason: [________________________________].

20. If supported by the facts, Plaintiff separately alleges that Defendant denied benefits without a reasonable basis and knew or recklessly disregarded that lack of a reasonable basis. Murphy v. Patriot Insurance Co., 2014 VT 96, ¶ 17. The unfair claim settlement practices listed in 8 V.S.A. § 4724(9) require conduct frequent enough to indicate a business practice; this complaint does not assert a separate statutory claim from a single incident.

21. ☐ Facts supporting the separate bad-faith claim: [identify the denial, lack of a reasonable basis, and facts showing Defendant's knowledge or reckless disregard: ________________________________________________].

Damages

22. As a direct and proximate result of the accident, Plaintiff has suffered:
    • ☐ Past medical expenses: $[________________________________]
    • ☐ Future medical expenses: $[________________________________]
    • ☐ Past lost wages: $[________________________________]
    • ☐ Future lost earning capacity: $[________________________________]
    • ☐ Pain and suffering: $[________________________________]
    • ☐ Mental anguish and emotional distress: $[________________________________]
    • ☐ Loss of enjoyment of life: $[________________________________]
    • ☐ Permanent impairment or disability: $[________________________________]
    • ☐ Property damage (if applicable): $[________________________________]
    • ☐ Other: [________________________________]

Stacking Provisions

23. ☐ Plaintiff is an insured under these additional applicable UM/UIM policies: [insurer, policy, limit, and basis for insured status: ________________________________________________]. Plaintiff seeks the benefits available under those policies, subject to applicable priority and offsets. Humphrey v. Vermont Mutual Automobile Insurance Co., 2009 VT 53, ¶¶ 9-10.
    ☐ No additional UM/UIM policy is alleged to apply.

Prayer for Relief

WHEREFORE, Plaintiff respectfully requests that this Court enter judgment against Defendant as follows:

1. Compensatory damages for bodily injury, pain, suffering, and economic losses in an amount to be proven at trial;
2. UM/UIM benefits up to the applicable policy limits of $[________________________________];
3. Property damage UM benefits of up to $[________________________________];
4. Damages caused by bad faith, if Count II is supported and proven;
5. Prejudgment interest as allowed by law;
6. Attorney fees only if authorized by a policy term, statute, or applicable exception, and recoverable costs of litigation;
7. Such other and further relief as the Court deems just and proper.

Verification

I, [PLAINTIFF NAME], have reviewed this Complaint and state that the factual allegations are true to the best of my knowledge, information, and belief.

Date: [__/__/____]

Signature: [________________________________]

Vermont Practice Notes

• Coverage and limits: Section 941(a) requires UM/UIM protection in covered Vermont motor-vehicle policies. Section 941(c) sets bodily injury minimums of $50,000 per person and $100,000 for two or more injured or killed. When liability limits exceed those minimums, UM limits match them unless the policyholder otherwise directs.
• Underinsurance: Section 941(f) compares the tortfeasor's liability limits, or liability coverage left after payments to others injured in the crash, with the insured's applicable UM limits. Damages exceeding liability limits alone do not establish underinsured status.
• Property damage: Section 941(a) provides up to $10,000 per claim, generally subject to a $150 deductible, with exceptions when other direct damage coverage is valid and collectible and for certain other property damage claims.
• Limitations and accrual: Section 511 generally allows six years after accrual for a civil contract claim, except as otherwise provided. Contract breach accrues when the breach occurs; insurer bad faith accrues upon unreasonable denial of coverage. Benson v. MVP Health Plan, 2009 VT 57, ¶ 5. A separate personal-injury claim may instead implicate the three-year period and injury-discovery wording of 12 V.S.A. § 512(4). Assess each claim and any exception separately.
• Comparative negligence: For covered negligence claims, 12 V.S.A. § 1036(a) permits proportionately reduced recovery when the plaintiff's negligence is no greater than the defendants' causal total negligence.
• Hit-and-run: Section 941(a) expressly covers hit-and-run vehicles. Check the policy's proof and notice terms; the statute itself does not state a physical-contact condition.
• Additional policies: Humphrey, 2009 VT 53, ¶¶ 9-10, protects interpolicy stacking of applicable UM/UIM coverage and permits policy terms that establish primary and excess priority without impairing the insured's rights. Identify every policy and applicable offset.
• Arbitration: Section 5653(a) excludes arbitration agreements in insurance contracts from the Vermont Arbitration Act. Review any policy dispute provision before filing or seeking arbitration.
• Bad faith: Under Murphy, 2014 VT 96, ¶ 17, an insurer's mistaken position alone is insufficient; the plaintiff must show lack of a reasonable basis and knowing or reckless disregard. Section 4724(9) lists unfair claims practices only when committed frequently enough to indicate a business practice.

This template is for informational purposes only and does not constitute legal advice. Consult a licensed Vermont attorney before filing. Verify all statutory citations against the current Vermont Statutes Annotated.