STATE OF MICHIGAN

IN THE ☐ CIRCUIT COURT

FOR THE COUNTY OF ☐

ESTATE OF [DECEDENT FULL LEGAL NAME], by [ESTATE REPRESENTATIVE NAME],
Personal Representative,
Plaintiff,

v.

[DEFENDANT NAME 1], a [STATE] [corporation/LLC/individual], and
[DEFENDANT NAME 2] (if any),
Defendants.

Case No.: __________
Hon.: __________
COMPLAINT FOR WRONGFUL DEATH
AND DEMAND FOR JURY TRIAL

[// GUIDANCE: Use Michigan Circuit Court caption formatting. Verify judge/case‐assignment requirements with the clerk’s office.]

TABLE OF CONTENTS

1. Preliminary Statement
2. Parties
3. Jurisdiction, Venue & Governing Law
4. Definitions
5. General Allegations
6. Count I – Wrongful Death (MCL 600.2922)
7. Count II – Survival Action (MCL 600.2921)
8. Damages Sought & Statutory Caps
9. Conditions Precedent, Tolling & Reservation of Rights
10. Demand for Jury Trial
11. Prayer for Relief
12. Alternative Dispute Resolution (Optional)
13. Verification & Certificate of Compliance
14. Signature Block

1. PRELIMINARY STATEMENT

1.1 Plaintiff, the duly appointed Personal Representative of the Estate of [DECEDENT NAME] (the “Decedent”), brings this civil action pursuant to Michigan’s Wrongful Death Act, Mich. Comp. Laws § 600.2922, arising out of Defendants’ wrongful acts, neglect, and/or fault that directly and proximately caused the Decedent’s death on [DATE OF DEATH].

1.2 Plaintiff seeks all damages recoverable under Michigan law on behalf of the Estate and the statutory Beneficiaries identified below.

2. PARTIES

2.1 Plaintiff: [ESTATE REPRESENTATIVE NAME], in his/her capacity as Personal Representative of the Estate of [DECEDENT NAME], appointed by the [NAME OF PROBATE COURT, COUNTY, CASE NO.] on [DATE OF APPOINTMENT].

2.2 Decedent: [DECEDENT NAME], who at all relevant times was a resident of [COUNTY] County, Michigan.

2.3 Defendant(s):
a. [DEFENDANT NAME 1], a [corporation/LLC/individual] doing business in Michigan, with its principal office at [ADDRESS].
b. [DEFENDANT NAME 2] (if applicable).

2.4 Statutory Beneficiaries (collectively, the “Beneficiaries”) pursuant to MCL 600.2922(3):
• [SPOUSE NAME], surviving spouse;
• [CHILD(REN) NAME(S)], minor/adult child(ren);
• [PARENT(S) NAME(S)], surviving parent(s);
• [OTHER DEPENDENTS/HEIRS].

[// GUIDANCE: Insert only those classes of persons who statutorily qualify; update upon probate court’s issuance of distribution order.]

3. JURISDICTION, VENUE & GOVERNING LAW

3.1 Subject-matter jurisdiction is proper under MCL 600.605 because the amount in controversy exceeds $25,000.

3.2 Venue is proper in this Court pursuant to MCL 600.1621(a) and/or (c) because the acts or omissions complained of occurred in [COUNTY] County and/or Defendants reside or do business here.

3.3 This action is governed by Michigan substantive law, including but not limited to the Wrongful Death Act, Mich. Comp. Laws § 600.2922, and the Survival Statute, Mich. Comp. Laws § 600.2921.

4. DEFINITIONS

For ease of reference, capitalized terms have the meanings set forth below:

“Act” – the Michigan Wrongful Death Act, Mich. Comp. Laws § 600.2922.
“Beneficiaries” – the persons entitled to recover under Section 2.4.
“Complaint” – this pleading and all amendments hereto.
“Decedent” – [DECEDENT NAME].
“Defendants” – collectively, [DEFENDANT NAME 1] and [DEFENDANT NAME 2].
“Estate” – the probate estate of the Decedent opened in [COUNTY] Probate Court.

5. GENERAL ALLEGATIONS

5.1 On [DATE], at approximately [TIME], Decedent was located at [LOCATION] when Defendants, through their agents, servants, and/or employees, committed negligent and wrongful acts described herein.

5.2 [Set forth specific factual narrative: duty owed, breach, causation, foreseeability, statutory/regulatory violations, etc.]

5.3 As a direct and proximate result of Defendants’ wrongful conduct, Decedent sustained severe injuries culminating in death on [DATE].

6. COUNT I – WRONGFUL DEATH

(Mich. Comp. Laws § 600.2922)

6.1 Plaintiff incorporates by reference Paragraphs 1.1 through 5.3 as though fully restated.

6.2 Defendants owed Decedent a duty of reasonable care under the circumstances.

6.3 Defendants breached that duty by, inter alia, [SPECIFY ACTS/OMISSIONS].

6.4 The breach directly and proximately caused Decedent’s death.

6.5 Pursuant to the Act, Plaintiff is entitled to recover all damages on behalf of the Estate and Beneficiaries, including but not limited to those listed in Section 8.2 below.

7. COUNT II – SURVIVAL ACTION

(Mich. Comp. Laws § 600.2921)

7.1 Plaintiff re-alleges Paragraphs 1.1 through 6.5.

7.2 Any claims the Decedent could have asserted had death not ensued survive to the Estate, including claims for pre-death pain, suffering, and economic loss.

7.3 Plaintiff seeks judgment for all such survivable damages, to be distributed in accordance with probate court orders.

8. DAMAGES SOUGHT & STATUTORY CAPS

8.1 Plaintiff seeks all damages recoverable under Michigan law, including but not limited to:

a. Past medical, hospital, and related expenses;
b. Funeral and burial expenses;
c. Conscious pain and suffering endured by Decedent;
d. Loss of financial support, services, gifts, and benefits;
e. Loss of society, companionship, and consortium;
f. Loss of prospective inheritance;
g. Interest, costs, and allowable statutory attorney fees.

8.2 If the wrongful act arises from alleged medical malpractice, noneconomic damages are subject to the statutory limitations set forth in Mich. Comp. Laws § 600.1483.

[// GUIDANCE: Insert current annual cap amounts published by the Michigan Department of Treasury only after verifying the correct figures for the year of verdict/judgment.]

9. CONDITIONS PRECEDENT, TOLLING & RESERVATION OF RIGHTS

9.1 All statutory notice requirements, including letters of intent or presuit notices (e.g., for medical malpractice under MCL 600.2912b), have been satisfied or are inapplicable.

9.2 Statutes of limitation and repose have been tolled and/or satisfied by the timely filing of this Complaint.

9.3 Plaintiff reserves the right to amend this Complaint, add additional parties, and assert further claims as discovery warrants.

10. DEMAND FOR JURY TRIAL

Pursuant to the Michigan Constitution art. 1, § 14 and MCR 2.508, Plaintiff demands trial by jury on all issues so triable.

11. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that this Court enter judgment in favor of the Estate and the Beneficiaries and against Defendants, jointly and severally, for:

1. Compensatory damages in an amount to be proven at trial;
2. Statutory interest, costs, and attorney fees as permitted by law;
3. Such other and further relief as the Court deems just and equitable.

12. ALTERNATIVE DISPUTE RESOLUTION (OPTIONAL)

12.1 The parties may, by written mutual agreement, submit this matter to facilitative mediation or binding arbitration pursuant to MCR 2.410–2.411. Absent such agreement, Plaintiff elects judicial resolution by jury trial.

12.2 Any arbitration shall occur in [MICHIGAN COUNTY], apply Michigan substantive law, and allow the full range of discovery provided under the Michigan Court Rules, unless otherwise stipulated.

13. VERIFICATION & CERTIFICATE OF COMPLIANCE

I, [ESTATE REPRESENTATIVE NAME], declare under the penalties of perjury that I have read the foregoing Complaint and that the factual statements made therein are true to the best of my knowledge, information, and belief.

Date: ____________ ____________________________________
[ESTATE REPRESENTATIVE NAME],
Personal Representative, Plaintiff

Counsel’s certification under MCR 1.109(E)(5) and (8): I certify that to the best of my knowledge, information, and belief formed after reasonable inquiry, this document is well-grounded in fact and warranted by existing law.

Date: ____________ ____________________________________
[ATTORNEY NAME] (P_____)
Attorney for Plaintiff

14. SIGNATURE BLOCK

Respectfully submitted,

[LAW FIRM NAME]
By: __________________________________
[ATTORNEY NAME] (P____)
[ADDRESS]
[PHONE] | [EMAIL]
Attorneys for Plaintiff

[// GUIDANCE:
1. File an “Inventory of Interested Parties” if local rules require.
2. Serve a copy on all potential statutory Beneficiaries within 30 days of filing, and file proof of service.
3. Open the Estate in probate court before or contemporaneously with filing this Complaint to ensure standing.
4. Calendar the two-year distribution petition deadline under MCL 600.2922(6).]