Wrongful Death Complaint - Wisconsin

Wisconsin Personal Injury Updated November 9, 2026 Free Word and PDF

STATE OF WISCONSIN

CIRCUIT COURT – [COUNTY] COUNTY

[BRANCH DESIGNATION]

Party Role
[PLAINTIFF NAME], individually and as Personal Representative of the Estate of [DECEDENT NAME], Plaintiff
v. Case No. [____________]
[DEFENDANT NAME(S)], Defendant(s)

VERIFIED COMPLAINT

(Wrongful Death and Survival Action)


TABLE OF CONTENTS

  1. Parties, Capacity, and Service .............................................................. ¶ 1
  2. Jurisdiction & Venue ......................................................................... ¶ 6
  3. Factual Allegations .......................................................................... ¶ 11
  4. Count I – Wrongful Death (Wis. Stat. §§ 895.03, 895.04) ................. ¶ 20
  5. Count II – Survival Claim (Wis. Stat. §§ 895.01, 895.04) ................. ¶ 30
  6. Damages ............................................................................................ ¶ 36
  7. Demand for Jury Trial .................................................................. ¶ 42
  8. Prayer for Relief ............................................................................. ¶ 44
  9. Verification, Signature Block & Certifications ............................ ¶ 49

DEFINITIONS

For purposes of this Complaint, the following capitalized terms shall have the meanings set forth below:

A. “Decedent” means [DECEDENT NAME], who died on [DATE OF DEATH].
B. “Estate” means the probate estate of the Decedent, pending in [COUNTY] County Case No. ________, for which Plaintiff serves as duly appointed Personal Representative.
C. “Statutory Beneficiaries” means those individuals designated under Wis. Stat. § 895.04(2), in the following order of priority: (i) the surviving spouse or domestic partner (subject to a court-determined set-aside, not to exceed 50% of the net recovery, for surviving minor children with whose support the Decedent was legally charged); (ii) if none, the Decedent's lineal heirs as determined under Wis. Stat. § 852.01; or (iii) if none, the Decedent's brothers and sisters. Only certain of these relatives — the spouse/domestic partner, children, or parents of the Decedent, or the Decedent's minor siblings at the time of death — may additionally recover loss-of-society-and-companionship damages under Wis. Stat. § 895.04(4).
D. “Defendant” or “Defendants” means [DEFENDANT NAME(S)], together with any agents, servants, or employees whose acts or omissions are alleged herein.


1. PARTIES, CAPACITY, AND SERVICE

  1. Plaintiff [PLAINTIFF NAME] (“Plaintiff”) is an adult resident of the State of Wisconsin, residing at [ADDRESS], and is the duly appointed Personal Representative of the Estate.
  2. Decedent died intestate/testate on [DATE] as a direct and proximate result of Defendant’s wrongful acts and omissions described herein.
  3. The Statutory Beneficiaries include:
    a. [SPOUSE/DOMESTIC PARTNER NAME], spouse/domestic partner;
    b. [CHILD NAME(S)], minor/adult child(ren); and
    c. Any other beneficiaries to be identified pursuant to Wis. Stat. § 895.04(2).

  4. Defendant [DEFENDANT NAME] is a [corporation/LLC/individual] organized under the laws of [STATE] with its principal place of business at [ADDRESS] and may be served through its registered agent, [AGENT NAME & ADDRESS].

  5. All parties have the requisite capacity to sue and be sued.

2. JURISDICTION & VENUE

  1. This Court has subject-matter jurisdiction over this civil action under Wis. Const. art. VII, § 8.
  2. Personal jurisdiction exists because Defendant [is domiciled in/does substantial business in/committed tortious acts within] Wisconsin.
  3. Venue is proper in [COUNTY] County under Wis. Stat. § 801.50 (2023) because the events giving rise to this action occurred here and/or Defendant resides or conducts business here.
  4. Plaintiff seeks the relief stated below for Decedent's death and the Estate's alleged losses.
  5. All statutory conditions precedent to bringing this action have been satisfied, waived, or excused. This action is timely commenced within the applicable statute of limitations: Wis. Stat. § 893.54(1m)(b) generally allows three years for wrongful death, while § 893.54(2m) allows two years for a death arising from a motor vehicle accident. For a death caused by a health care provider's treatment or omission, § 893.55(1m) instead governs: the later of three years from injury or one year from discovery of injury, subject to the five-year outside limit for the discovery route and the statutory exceptions. Counsel must identify the applicable period before filing.

3. FACTUAL ALLEGATIONS

  1. On [DATE], at approximately [TIME], Decedent was [brief description of activity—e.g., driving northbound on Hwy XX, undergoing surgery at Hospital Y, using Product Z].
  2. Defendant owed Decedent a duty of reasonable care [describe source of duty—statutory, common-law, contractual].
  3. Defendant breached that duty by [specific acts/omissions].
  4. As a direct and proximate result of Defendant’s breach, Decedent sustained severe injuries, conscious pain and suffering, and ultimately death on [DATE OF DEATH].
  5. Decedent incurred medical expenses in the amount of approximately $[AMOUNT].
  6. Funeral and burial expenses totaled approximately $[AMOUNT].
  7. Decedent was [AGE] years old and had a normal life expectancy of [NUMBER] additional years.
  8. Prior to death, Decedent provided financial support, society, and companionship to the Statutory Beneficiaries.
  9. Plaintiff incorporates paragraphs 1–18 as though fully set forth herein.

4. COUNT I – WRONGFUL DEATH

(Against All Defendants)
(Wis. Stat. §§ 895.03, 895.04)

  1. Plaintiff realleges paragraphs 1–19.
  2. Defendant’s negligent acts and omissions constitute a “wrongful act, neglect or default” within the meaning of Wis. Stat. § 895.03 (2023).
  3. Pursuant to Wis. Stat. § 895.04(1) (2023), Plaintiff, as Personal Representative, is authorized to maintain this action.
  4. As a direct and proximate result of Defendant’s negligence, Decedent died, causing pecuniary injury to the Statutory Beneficiaries.
  5. Recoverable wrongful-death damages include but are not limited to:
    a. Reasonable medical expenses and funeral/cemetery expenses (including the cost of a cemetery lot, grave marker, and care of the lot) pursuant to Wis. Stat. § 895.04(5);
    b. Loss of society and companionship, awardable only to the spouse, children, or parents of the Decedent, or to the Decedent's siblings if the siblings were minors at the time of death, subject to the statutory cap under Wis. Stat. § 895.04(4) of $350,000 per occurrence if the Decedent was an adult, or $500,000 per occurrence if the Decedent was a minor (current figures; confirm no intervening legislative amendment before filing); and
    c. Pecuniary damages, including loss of support, services, care, and guidance.

  6. Plaintiff demands judgment accordingly.


5. COUNT II – SURVIVAL CLAIM

(Against All Defendants)
(Wis. Stat. §§ 895.01, 895.04)

  1. Plaintiff realleges paragraphs 1–29.
  2. Under Wis. Stat. § 895.01 (2023), Decedent’s cause of action for personal injuries, conscious pain, and suffering survived his/her death and is now vested in the Estate.
  3. Prior to death, Decedent endured conscious pain and suffering, loss of enjoyment of life, and emotional distress.
  4. Plaintiff seeks all damages recoverable by the Estate under Wisconsin law, including but not limited to:
    a. Pre-death medical expenses;
    b. Pre-death lost earnings;
    c. Conscious pain and suffering; and
    d. Punitive damages under Wis. Stat. § 895.043, if the evidence establishes that Defendant acted maliciously toward Decedent or in intentional disregard of Decedent's rights; and
    e. Any other lawful damages.

  5. Plaintiff further seeks prejudgment interest and costs allowable by law.

  6. Plaintiff demands judgment accordingly.

6. DAMAGES

  1. Plaintiff seeks compensatory damages for the losses alleged above in an amount to be determined at trial, subject to applicable statutory limits.
  2. Plaintiff reserves the right to amend to conform to proof at trial.
  3. Any award for loss of society and companionship shall not exceed the statutory limit set forth in Wis. Stat. § 895.04(4), and the aggregate of damages under Wis. Stat. § 895.04(4)-(5) shall be diminished as provided in Wis. Stat. § 895.045 if the Decedent or a person entitled to recover is found causally negligent.
  4. Punitive damages are not recoverable as an element of the wrongful-death claim itself (Count I). To the extent Plaintiff seeks punitive damages, they are sought solely on the survival claim (Count II), pursuant to Wis. Stat. § 895.043(3), if discovery establishes that Defendant acted maliciously toward Decedent or in intentional disregard of Decedent's rights. The § 895.043(6) cap is generally the greater of twice compensatory damages or $200,000, but does not apply to qualifying conduct involving unsafe operation of a covered vehicle while impaired by an intoxicant.

  5. Plaintiff also seeks taxable costs and disbursements, together with prejudgment and post-judgment interest as allowed by law.

  6. Liability is sought against each Defendant under the allocation applicable to the proven theory. For negligence under Wis. Stat. § 895.045(1), a person below 51 percent causal negligence is liable only for that person's percentage, while a person at 51 percent or more is jointly and severally liable for the damages allowed; subsection (2) separately governs concerted action.

7. DEMAND FOR JURY TRIAL

  1. Pursuant to Article I, Section 5 of the Wisconsin Constitution and Wis. Stat. § 805.01, Plaintiff demands a jury trial on all triable issues and requests twelve (12) jurors under Wis. Stat. § 756.06(2)(b). This written demand must be made by the first scheduling or pretrial conference, whichever occurs first, under § 805.01(2); the party demanding a jury must pay the fee under § 814.61(4) within the time allowed for the demand. The verdict is governed by the five-sixths rule of Wis. Stat. § 805.09(2).

8. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in Plaintiff’s favor and against Defendant(s) as follows:

a. For compensatory damages in an amount to be determined at trial, within statutory limits;
b. For punitive damages as allowed by Wis. Stat. § 895.043, if proven;
c. For prejudgment and post-judgment interest as allowed by law;
d. For Plaintiff’s taxable costs, disbursements, and attorney fees as permitted;
e. For such other and further relief as the Court deems just and proper.


9. VERIFICATION, SIGNATURE BLOCK & CERTIFICATIONS

[PLAINTIFF NAME]
Personal Representative of the Estate of [DECEDENT NAME]
By Counsel:

________________________________
[ATTORNEY NAME]
State Bar No. __________
[FIRM NAME]
[ADDRESS]
[PHONE] | [EMAIL]

DATED: __________

Verification

I, [PLAINTIFF NAME], verify under penalty of perjury that the factual allegations contained in the foregoing Complaint are true and correct to the best of my knowledge, information, and belief.
________________________________
[PLAINTIFF NAME]

Wis. Stat. § 802.05 Certification

By signing and presenting this pleading, counsel makes the representations in Wis. Stat. § 802.05(2): it is presented for a proper purpose; its legal contentions are warranted by existing law or a nonfrivolous argument for a change in law; and its factual allegations have, or where identified are likely to have after reasonable investigation or discovery, evidentiary support.
________________________________
[ATTORNEY NAME]


OPTIONAL ADDENDA

  1. Proposed Summons (Wis. Stat. § 801.095).
  2. Probate Letters of Authority appointing Plaintiff as Personal Representative.
  3. For a claim governed by Wis. Stat. ch. 655, file a mediation request before commencing suit under § 655.44, or within 15 days after filing suit under § 655.445; include the required fee and follow the applicable mediation procedure.

END OF DOCUMENT

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About this template

Last updated
November 9, 2026
Jurisdiction
Wisconsin
Category
Personal Injury

Legal authority

  • Wis. Stat. § 895.03 (recovery for death by wrongful act; cause of action for death caused in Wisconsin)
  • Wis. Stat. § 895.04 (plaintiff in wrongful death action; beneficiary hierarchy; loss-of-society-and-companionship cap of $350,000 per occurrence for a deceased adult / $500,000 per occurrence for a deceased minor, payable to spouse, children, or parents of the deceased, or to minor siblings at the time of death)
  • Wis. Stat. § 895.01(1)(bm), (2) (survival of decedent's personal-injury cause of action to the estate)
  • Wis. Stat. § 895.045 (contributory/comparative negligence; diminishes recovery under § 895.04(4)-(5))
  • Wis. Stat. § 895.043 (punitive damages standard and cap; not recoverable on the wrongful-death claim itself per Wangen v. Ford Motor Co., 97 Wis. 2d 260 (1980), but available on the survival claim)
  • Wis. Stat. § 893.54(1m)(b) (3-year statute of limitations for a general wrongful death action)
  • Wis. Stat. § 893.54(2m) (2-year statute of limitations for a wrongful death action arising from a motor vehicle accident)
  • Wis. Stat. § 753.03 (circuit court general jurisdiction)
  • Wis. Stat. § 801.04 (jurisdictional requirements for judgments)
  • Wis. Stat. § 801.50 (venue)
  • Wis. Stat. § 801.09, § 801.095 (summons contents and form)
  • Wis. Stat. § 802.05 (attorney certification of pleadings)
  • Wis. Stat. § 805.01 (right to and demand/waiver of jury trial)
  • Wis. Stat. § 756.06(2)(b) (six-person civil jury unless more requested, up to twelve); § 805.09(2) (five-sixths verdict rule)
  • Wis. Const. art. I, § 5 (right to trial by jury)
  • Wis. Const. art. VII, § 8 (circuit court original jurisdiction)

Personal injury cases are brought by people who were hurt because of someone else's carelessness: car crashes, slip and falls, defective products, and more. Demand letters, settlement agreements, and court filings in these cases have to document the injuries, the medical treatment, the lost income, and the exact legal basis for holding the other side responsible. Well-prepared paperwork is what drives higher settlements and forces insurers to take the claim seriously.

Not legal advice

This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Checked against the law it cites

The statutes this template relies on are listed under Legal authority.

Wis. Stat. § 895.043(6) — intoxicated vehicle operator exception (checked November 9, 2026): "while under the influence of an intoxicant to a degree that rendered the defendant incapable of safe operation of the vehicle."

Wis. Const. art. VII, § 8 (checked October 27, 2026): "Except as otherwise provided by law, the circuit court shall have original jurisdiction in all matters civil and criminal within this state"

Wis. Stat. § 802.02(1m)(a) (checked October 28, 2026): "With respect to a tort claim seeking the recovery of money, the demand for judgment may not specify the amount of money the pleader seeks."

Wis. Stat. § 655.445(1) (checked October 30, 2026): "The request shall be prepared and delivered in person or sent by registered mail to the director of state courts"

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