Uninsured/Underinsured Motorist Complaint

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. Exhaustion of Tortfeasor's Coverage
8. Count I: UM/UIM Benefits Claim
9. Count II: Breach of Contract / Bad Faith
10. Damages
11. Stacking Provisions
12. Arbitration vs. Litigation
13. Prayer for Relief
14. Verification
15. Vermont Practice Notes

Caption

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

[PLAINTIFF NAME],
Plaintiff,

v.

[INSURANCE COMPANY NAME],
Defendant.

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 matter pursuant to 4 V.S.A. § 111 and the Vermont Rules of Civil Procedure.

4. Venue is proper in the [________________________________] Unit pursuant to 12 V.S.A. § 402, as the cause of action arose in this county and/or Defendant may be found here.

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 (subject to $150 deductible)

7. Plaintiff has paid all premiums due and has fully complied with all conditions of the policy.

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 — The tortfeasor's liability limits of $[________________________________] are less than Plaintiff's damages
    - ☐ Unknown Motorist (Hit-and-Run) — The tortfeasor fled the scene and remains unidentified
    - ☐ Insurer Insolvent — The tortfeasor's insurer is insolvent

Exhaustion of Tortfeasor's Coverage

13. ☐ The tortfeasor had no liability insurance; exhaustion is not applicable.
    ☐ Plaintiff has settled with or obtained judgment against the tortfeasor's insurer for the policy limits of $[________________________________].
    ☐ Plaintiff has notified Defendant of the proposed settlement and provided an opportunity to consent or substitute payment.

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: Breach of Contract / Bad Faith

18. Plaintiff incorporates all preceding paragraphs by reference.

19. Defendant's failure to pay UM/UIM benefits constitutes a breach of the insurance contract.

20. ☐ Defendant has acted in bad faith by:
    - ☐ Unreasonably delaying investigation or payment
    - ☐ Denying the claim without a reasonable basis
    - ☐ Failing to provide a reasonable explanation for the denial
    - ☐ Offering an unreasonably low settlement
    - ☐ Failing to communicate in a timely manner
    - ☐ Other: [________________________________]

Damages

21. 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

22. ☐ Plaintiff's policy covers multiple vehicles and Plaintiff seeks to stack UM/UIM limits.
    ☐ Plaintiff holds multiple policies and seeks to aggregate coverage.
    ☐ Stacking is not applicable.

Arbitration vs. Litigation

23. ☐ The policy contains an arbitration clause; Plaintiff elects to submit this dispute to arbitration.
    ☐ The policy does not contain a mandatory arbitration clause; Plaintiff proceeds by civil action.
    ☐ Plaintiff has demanded arbitration and Defendant has failed to participate.

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. Consequential damages for Defendant's bad faith, if applicable;
5. Prejudgment interest as allowed by law;
6. Attorney fees and costs of litigation;
7. Such other and further relief as the Court deems just and proper.

Verification

I, [PLAINTIFF NAME], hereby declare under penalty of perjury that the statements contained in this Complaint are true and correct to the best of my knowledge, information, and belief.

Date: [__/__/____]

Signature: [________________________________]

Vermont Practice Notes

• Mandatory Coverage: UM/UIM coverage is mandatory under 23 V.S.A. § 941 and cannot be waived.
• High Minimum Limits: Vermont requires UM/UIM minimums of $50,000/$100,000 for bodily injury, which are higher than most states.
• Coverage Equals Liability: UM/UIM limits must equal the policy's liability limits.
• Property Damage UM: Vermont uniquely requires UM property damage coverage of up to $10,000 per claim with a $150 deductible.
• Statute of Limitations: Three (3) years for personal injury (12 V.S.A. § 512).
• Comparative Negligence: Vermont applies modified comparative negligence with a 51% bar (12 V.S.A. § 1036).
• Unknown Motorist Coverage: 23 V.S.A. § 941 expressly covers hit-and-run/unknown motorist situations.
• No PIP/No-Fault: Vermont is a traditional tort state; no PIP requirements.
• Bad Faith: Vermont recognizes bad faith claims against insurers for unreasonable claims handling.

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.