COMPLAINT FOR WRONGFUL DEATH AND SURVIVAL ACTION
[// GUIDANCE: Replace bracketed placeholders with case-specific information before filing]
IN THE SUPERIOR COURT OF [COUNTY] COUNTY
STATE OF GEORGIA
CIVIL ACTION FILE NO. ______
[PLAINTIFF NAME],
Individually and as [Relationship, e.g., Surviving Spouse / Natural Parent / Administrator]
of the Estate of [DECEDENT NAME], Deceased,
Plaintiff,
v.
[DEFENDANT NAME(S)],
[Georgia] Corporation / Individual / Other Entity,
Defendant(s).
COMPLAINT
TABLE OF CONTENTS
- Document Header
- Definitions
- Jurisdiction, Venue, and Service
- Factual Allegations
- Causes of Action
5.1 Count I – Negligence Resulting in Wrongful Death
5.2 Count II – Survival Action (Pain, Suffering & Medical Expenses)
5.3 Count III – Punitive Damages (Estate Claim)
5.4 Count IV – Limited Injunctive Relief (If Applicable) - Recoverable Damages
- Reservation of Rights & Statutory Damage Caps
- Demand for Jury Trial
- Prayer for Relief
- Verification
- Signature Block
[// GUIDANCE: Pagination will auto-adjust in word-processing software.]
1. DOCUMENT HEADER
1.1 Parties and Introductory Statement.
Plaintiff [PLAINTIFF NAME] (“Plaintiff”), individually and in the representative capacities set forth herein, brings this Complaint against Defendant(s) [DEFENDANT NAME(S)] (“Defendant”), and alleges as follows:
1.2 Effective Date.
This pleading is filed as of [FILING DATE] in the Superior Court of [COUNTY] County, State of Georgia, pursuant to O.C.G.A. § 9-11-1 et seq.
2. DEFINITIONS
For purposes of this Complaint, the following terms shall have the meanings described below:
“Decedent” means [DECEDENT NAME], born [DOB] and deceased on [DATE OF DEATH].
“Eligible Beneficiaries” means those persons entitled to recover for wrongful death under O.C.G.A. § 51-4-2 or § 51-4-4, specifically the [Spouse / Minor Children / Parents] of the Decedent.
“Estate” means the probate estate of the Decedent, represented herein by [ADMINISTRATOR/EXECUTOR NAME] pursuant to Letters [Testamentary/Administration] issued on [DATE].
“Full Value of the Life” has the meaning set forth in O.C.G.A. § 51-4-1 and includes both (a) the intangible value of the Decedent’s life to herself, and (b) the present value of lost economic benefits and services.
“Incident” means the events of [DATE] at [LOCATION] resulting in Decedent’s fatal injuries.
[// GUIDANCE: Add or delete defined terms as appropriate.]
3. JURISDICTION, VENUE, AND SERVICE
3.1 Subject-Matter Jurisdiction.
This Court has subject-matter jurisdiction over this action pursuant to Ga. Const. art. VI, § IV, ¶ I and O.C.G.A. § 15-6-8 because it is a civil action for damages exceeding the jurisdictional limits of inferior courts.
3.2 Personal Jurisdiction.
Defendant is subject to personal jurisdiction in Georgia because [it is incorporated in / has its principal place of business in / committed a tortious act in] this State. See O.C.G.A. § 9-10-91(2).
3.3 Venue.
Venue is proper in this county under O.C.G.A. § 14-2-510(b)(3) / § 9-10-31 because [Defendant resides / principal office located / cause of action arose] here.
3.4 Service of Process.
Defendant may be served via [Registered Agent / Personal Service] at [SERVICE ADDRESS]. [// GUIDANCE: Insert detailed service information.]
4. FACTUAL ALLEGATIONS
4.1 Overview of Incident.
On [DATE], at approximately [TIME], Defendant’s [vehicle/product/employee] [brief description of negligent act or omission], causing severe injuries to Decedent.
4.2 Medical Treatment and Death.
Decedent was transported to [HOSPITAL] where she underwent [procedures]. Despite medical intervention, Decedent succumbed to her injuries on [DATE].
4.3 Negligence and Causation.
Defendant breached duties of reasonable care by, inter alia, [list specific negligent acts], directly and proximately causing the Incident and Decedent’s death.
4.4 Relationship of Parties.
Plaintiff is the [spouse/parent] of Decedent and statutory beneficiary under O.C.G.A. § 51-4-2. [If estate claim:] Plaintiff also acts as duly appointed [Administrator/Executor] of the Estate pursuant to O.C.G.A. § 53-6-20.
4.5 Compliance with Conditions Precedent.
All conditions precedent to maintaining this action have occurred, have been performed, or have been waived.
5. CAUSES OF ACTION
5.1 Count I – Negligence Resulting in Wrongful Death
5.1.1 Plaintiff realleges paragraphs 1–4.
5.1.2 Defendant owed Decedent duties of reasonable care under Georgia common and statutory law.
5.1.3 Defendant’s breaches directly caused Decedent’s death.
5.1.4 Under O.C.G.A. § 51-4-1 et seq., Plaintiff, on behalf of the Eligible Beneficiaries, is entitled to recover the full value of Decedent’s life.
5.2 Count II – Survival Action (Pain, Suffering & Medical Expenses)
5.2.1 Pursuant to O.C.G.A. § 9-2-41 and Georgia common law, the Estate may recover damages accruing to Decedent prior to death, including conscious pain and suffering, medical bills, and funeral expenses.
5.2.2 Plaintiff, as personal representative, seeks all such damages.
5.3 Count III – Punitive Damages (Estate Claim)
5.3.1 Defendant’s conduct evidences willful misconduct, malice, fraud, wantonness, or conscious indifference to consequences.
5.3.2 The Estate therefore seeks punitive damages under O.C.G.A. § 51-12-5.1, subject to the statutory cap of $250,000, unless an exception applies.
[// GUIDANCE: Verify applicability of exceptions in § 51-12-5.1(c)–(e).]
5.4 Count IV – Limited Injunctive Relief (If Applicable)
5.4.1 To prevent ongoing harm to the public and Plaintiff, Plaintiff seeks a narrowly tailored injunction requiring Defendant to [correct dangerous condition / cease specified practice], consistent with O.C.G.A. § 9-5-1.
5.4.2 Legal remedies are inadequate because [reason].
[// GUIDANCE: Delete this Count if injunctive relief is not sought.]
6. RECOVERABLE DAMAGES
6.1 Wrongful-Death Damages.
Full value of Decedent’s life, economic and intangible, including but not limited to:
a. Expected lifetime earnings;
b. Loss of services, consortium, advice, and care;
c. Loss of enjoyment of life’s intangible elements.
6.2 Survival Damages (Estate).
a. Conscious pain and suffering between injury and death;
b. Medical expenses per O.C.G.A. § 51-4-5(b);
c. Funeral and burial expenses.
6.3 Punitive Damages.
As pled in Count III, subject to statutory limits.
6.4 Pre- and Post-Judgment Interest & Costs.
Plaintiff seeks interest as allowed by O.C.G.A. § 7-4-12 and recoverable costs under O.C.G.A. § 9-15-14.
7. RESERVATION OF RIGHTS & STATUTORY DAMAGE CAPS
7.1 Plaintiff reserves the right to amend this Complaint to conform to evidence.
7.2 Plaintiff acknowledges any applicable statutory caps on punitive damages (O.C.G.A. § 51-12-5.1) and does not seek damages barred by law.
7.3 No statutory cap exists on wrongful-death “full value” damages under O.C.G.A. Title 51, Chapter 4.
8. DEMAND FOR JURY TRIAL
Pursuant to Ga. Const. art. I, § I, Para. XI and O.C.G.A. § 9-11-38, Plaintiff demands trial by jury on all triable issues.
9. PRAYER FOR RELIEF
WHEREFORE, Plaintiff respectfully requests that the Court:
a. Enter judgment against Defendant for the full value of Decedent’s life;
b. Award survival damages to the Estate;
c. Award punitive damages as permitted by law;
d. Grant limited injunctive relief as set forth above (if applicable);
e. Award pre- and post-judgment interest, costs of suit, and attorney’s fees as allowed; and
f. Grant such other and further relief the Court deems just and proper.
10. VERIFICATION
[OPTIONAL – include only if verification is desired or required by local rule.]
I, [PLAINTIFF NAME], being duly sworn, depose and say that I am the Plaintiff in the foregoing action; that I have read the foregoing Complaint and know the contents thereof, and that the same is true and correct to the best of my knowledge, information, and belief.
[PLAINTIFF NAME]
Sworn to and subscribed before me this _ day of _, 20__.
Notary Public
My commission expires: _______
[// GUIDANCE: Omit verification if not required; Georgia generally does not require verified pleadings.]
11. SIGNATURE BLOCK
Respectfully submitted this ___ day of ____, 20__.
[LAW FIRM NAME]
[Address]
[City, State, Zip]
[Phone] | [Fax] | [Email]
BY: ______
[ATTORNEY NAME]
Georgia Bar No. __
Counsel for Plaintiff
[// GUIDANCE:
1. Confirm local court rules regarding font size, page limitations, civil cover sheets, electronic filing requirements, and mandatory discovery disclosures.
2. Review venue statute to ensure proper county selection (corporate defendants may be sued where the accident occurred if corporate venue exception applies).
3. Attach exhibits (e.g., Letters of Administration) as needed.
4. If multiple defendants, duplicate jurisdictional and factual allegations for each.
5. Remove counts or sections that do not apply to the specific matter (e.g., punitive damages against governmental entities).]