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 Benefits Claim
9. Count II: UIM Benefits Claim (If Applicable)
10. Count III: Breach of Contract / Bad Faith
11. Damages
12. Stacking Provisions
13. Arbitration vs. Litigation
14. Prayer for Relief
15. Verification
16. Wyoming Practice Notes

Caption

IN THE DISTRICT COURT OF THE [________________________________] JUDICIAL DISTRICT
IN AND FOR [________________________________] COUNTY, STATE OF WYOMING

[PLAINTIFF NAME],
Plaintiff,

v.

[INSURANCE COMPANY NAME],
Defendant.

Civil Action No.: [________________________________]

Parties

1. Plaintiff, [PLAINTIFF NAME], is an individual residing at [________________________________], [________________________________] County, Wyoming, 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 Wyoming, with its principal office at [________________________________].

Jurisdiction and Venue

3. This Court has jurisdiction over this matter pursuant to Wyo. Stat. § 5-2-114 and the Wyoming Rules of Civil Procedure.

4. Venue is proper in [________________________________] County pursuant to W.R.C.P. 3, as the cause of action arose in this county and/or Defendant conducts business 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) coverage with limits of $[________________________________] per person / $[________________________________] per accident
   - ☐ Underinsured Motorist (UIM) coverage with limits of $[________________________________] per person / $[________________________________] per accident (if elected)

7. ☐ The insured did not reject UM coverage in writing; therefore, UM coverage applies by operation of law.
   ☐ The insured affirmatively elected UM coverage.
   ☐ The insured elected optional UIM coverage.

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

Facts of the Accident

9. On [__/__/____], at approximately [____] a.m./p.m., Plaintiff was operating/occupying a motor vehicle at or near [________________________________], [________________________________] County, Wyoming.

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

11. The tortfeasor's negligent acts include but are not limited to:
    - ☐ Failure to yield the right of way
    - ☐ Following too closely
    - ☐ Distracted driving
    - ☐ Driving under the influence of alcohol or drugs
    - ☐ Exceeding the posted speed limit
    - ☐ Failure to obey traffic control devices
    - ☐ Improper passing or lane change
    - ☐ Failure to maintain control
    - ☐ Other: [________________________________]

12. As a direct and proximate result, Plaintiff sustained serious bodily injuries and damages.

Uninsured or Underinsured Status of Tortfeasor

13. The tortfeasor's motor vehicle qualifies as:
    - ☐ Uninsured — No automobile liability insurance was in effect at the time of the accident
    - ☐ Underinsured — The tortfeasor's liability limits of $[________________________________] are insufficient to compensate Plaintiff (UIM coverage required)
    - ☐ Hit-and-Run / Unknown — The tortfeasor fled the scene and remains unidentified

Exhaustion of Tortfeasor's Coverage

14. ☐ 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 provided Defendant with notice of the proposed settlement and obtained Defendant's consent.

Count I: UM Benefits Claim

15. Plaintiff incorporates all preceding paragraphs by reference.

16. Plaintiff is a person insured under the policy who is legally entitled to recover damages from the owner or operator of an uninsured motor vehicle for bodily injury arising out of the ownership, maintenance, or use of such vehicle.

17. Pursuant to the Wyoming Uninsured Motorist Act, Wyo. Stat. § 31-10-101 et seq., Defendant is obligated to pay UM benefits to Plaintiff.

18. Defendant has failed or refused to pay the UM benefits owed under the policy.

Count II: UIM Benefits Claim (If Applicable)

19. Plaintiff incorporates all preceding paragraphs by reference.

20. ☐ Plaintiff purchased optional UIM coverage under the policy.
    ☐ This Count is not applicable because no UIM coverage was purchased.

21. The tortfeasor's motor vehicle is underinsured, having liability coverage insufficient to compensate Plaintiff for the damages sustained.

22. Defendant is obligated under the UIM endorsement to pay UIM benefits to Plaintiff for the difference between the tortfeasor's liability limits and Plaintiff's damages, up to the UIM policy limits.

23. Defendant has failed or refused to pay UIM benefits owed.

Count III: Breach of Contract / Bad Faith

24. Plaintiff incorporates all preceding paragraphs by reference.

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

26. ☐ Defendant has acted in bad faith by:
    - ☐ Unreasonably delaying investigation or payment
    - ☐ Denying the claim without a reasonable basis
    - ☐ Failing to effectuate a prompt, fair settlement
    - ☐ Compelling Plaintiff to initiate litigation to recover amounts clearly due
    - ☐ Misrepresenting policy provisions
    - ☐ Other: [________________________________]

Damages

27. 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: $[________________________________]
    - ☐ Other: [________________________________]

Stacking Provisions

28. ☐ Plaintiff seeks to stack UM/UIM limits across multiple vehicles or policies.
    ☐ The policy contains an anti-stacking provision.
    ☐ Stacking is not applicable.

Arbitration vs. Litigation

29. ☐ 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 demands 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 benefits up to the policy limits of $[________________________________];
3. UIM benefits up to the policy limits of $[________________________________] (if applicable);
4. Consequential damages for Defendant's bad faith conduct;
5. Prejudgment interest as allowed by law;
6. Attorney fees and costs of suit;
7. Such other and further relief as the Court deems just and equitable.

Verification

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

Date: [__/__/____]

Signature: [________________________________]

Subscribed and sworn to before me this [____] day of [________________________________], [____].

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

Wyoming Practice Notes

• UM Mandatory Unless Rejected: UM coverage is required by Wyo. Stat. § 31-10-101 unless the insured rejects it in writing. Rejection applies to renewals with the same insurer.
• UIM Not Statutory: Wyoming statutes are silent on UIM coverage. UIM is purely contractual and discretionary; no statute requires insurers to offer or provide UIM.
• UM Minimum Limits: $25,000/$50,000 for bodily injury or death.
• Statute of Limitations: Four (4) years for personal injury (Wyo. Stat. § 1-3-105).
• Comparative Fault: Wyoming applies modified comparative fault with a 51% bar (Wyo. Stat. § 1-1-109).
• Hit-and-Run Claims: Wyo. Stat. § 31-10-103 governs claims involving hit-and-run vehicles; review notice and proof requirements.
• Subrogation: Wyo. Stat. § 31-10-104 provides for insurer subrogation after UM payment.
• Bad Faith: Wyoming recognizes first-party bad faith claims. See McCullough v. Golden Rule Ins. Co., 789 P.2d 855 (Wyo. 1990).
• No No-Fault/PIP: Wyoming is a traditional tort state with no PIP requirements.
• Stacking: Not addressed by statute; governed by policy language and case law.

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