IN THE CIRCUIT COURT OF THE ☐[CIRCUIT NUMBER]⟡ CIRCUIT

STATE OF HAWAIʻI

☐[PLAINTIFF FULL NAME],
Plaintiff,

v. Civil No. ☐[to be assigned]
(Tort—Motor Vehicle Accident)

☐[DEFENDANT FULL NAME],
Defendant.

COMPLAINT; DEMAND FOR JURY TRIAL; VERIFICATION;
SUMMONS TO ISSUE; CERTIFICATE OF SERVICE

[// GUIDANCE: Attach the state-court summons form (Hawai‘i Form 1C-PNF) when filing.]

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Jurisdiction & Venue
4. Compliance With Hawai‘i No-Fault Statute
5. Factual Allegations
6. Causes of Action
    6.1 Count I – Negligence
    6.2 Count II – Negligence Per Se (optional)
    6.3 Count III – Loss of Consortium (optional)
7. Comparative Negligence Allegations
8. Damages
9. Prayer for Relief
10. Jury Demand
11. Optional Arbitration Election Statement
12. Attorneys’ Fees & Costs
13. Verification (Hawai‘i R. Civ. P. 11 & 23(b))
14. Certificate of Service

1. DOCUMENT HEADER

1.1 Plaintiff ☐[PLAINTIFF FULL NAME] (“Plaintiff”) brings this Complaint against Defendant ☐[DEFENDANT FULL NAME] (“Defendant”) arising out of a motor-vehicle collision that occurred on ☐[DATE] at or near ☐[LOCATION] (the “Subject Accident”).
1.2 This action seeks recovery of special, general, and, where authorized, punitive damages, together with costs and such other relief as the Court deems just and equitable.

2. DEFINITIONS

For purposes of this Complaint:
(a) “Subject Vehicle” means the ☐[year/make/model] operated by Defendant at the time of the Subject Accident.
(b) “Plaintiff Vehicle” means the ☐[year/make/model] owned/operated by Plaintiff.
(c) “Serious Injury Threshold” refers to the statutory prerequisites to maintain a tort action under Hawai‘i’s Motor Vehicle Insurance Law, Haw. Rev. Stat. ch. 431:10C.
[// GUIDANCE: Add additional defined terms (e.g., “PIP Benefits”) as needed for your fact pattern.]

3. JURISDICTION & VENUE

3.1 This Court has subject-matter jurisdiction pursuant to Haw. Rev. Stat. § 603-21.5.
3.2 Venue is proper in this Circuit under Haw. Rev. Stat. § 603-36 because (a) the Subject Accident occurred within this Circuit and/or (b) Defendant resides or can be served here.
3.3 The amount in controversy exceeds the jurisdictional minimum of the District Court of the State of Hawai‘i.

4. COMPLIANCE WITH HAWAI‘I NO-FAULT STATUTE

4.1 Plaintiff has exhausted all no-fault personal injury protection (“PIP”) benefits available under Plaintiff’s motor-vehicle insurance policy, or Plaintiff’s damages exceed the monetary threshold, thereby satisfying the Serious Injury Threshold.
4.2 Plaintiff has complied with all notice and claim requirements under Haw. Rev. Stat. ch. 431:10C.
4.3 Accordingly, Plaintiff is legally entitled to pursue tort remedies against Defendant.

5. FACTUAL ALLEGATIONS

5.1 On ☐[DATE] at approximately ☐[TIME], Defendant operated the Subject Vehicle on ☐[STREET/ROUTE].
5.2 Defendant negligently ☐[describe specific act—e.g., failed to yield, exceeded the speed limit, drove while distracted], causing the Subject Vehicle to collide with the Plaintiff Vehicle.
5.3 As a direct and proximate result, Plaintiff sustained severe bodily injuries including, without limitation, ☐[list injuries], incurred medical expenses in excess of ☐[$____], and suffered pain, mental anguish, loss of enjoyment of life, and other damages.
5.4 At all relevant times, Plaintiff exercised reasonable care and was lawfully operating the Plaintiff Vehicle.

6. CAUSES OF ACTION

6.1 COUNT I – NEGLIGENCE

6.1.1 Plaintiff re-alleges and incorporates Paragraphs 1 through 5 as though fully set forth herein.
6.1.2 Defendant owed Plaintiff a duty to operate the Subject Vehicle with reasonable care, obey traffic laws, and avoid foreseeable risk of harm.
6.1.3 Defendant breached that duty by ☐[insert specific breaches].
6.1.4 Defendant’s breach was the actual and proximate cause of Plaintiff’s injuries and damages.
6.1.5 WHEREFORE, Plaintiff prays for judgment as set forth in Section 9 below.

6.2 COUNT II – NEGLIGENCE PER SE (optional)

[// GUIDANCE: Include only if you have clear statutory/regulatory violations (e.g., speeding, DUI).]
6.2.1 Defendant violated ☐[identify traffic statute/regulation] intended to protect persons such as Plaintiff.
6.2.2 Such violation constitutes negligence per se, entitling Plaintiff to damages as alleged.

6.3 COUNT III – LOSS OF CONSORTIUM (optional)

6.3.1 ☐[SPOUSE/PARTNER NAME] (“Consortium Plaintiff”) is the lawful spouse/domestic partner of Plaintiff.
6.3.2 As a direct result of Defendant’s negligence, Consortium Plaintiff has been deprived of Plaintiff’s companionship, services, society, and consortium.

7. COMPARATIVE NEGLIGENCE ALLEGATIONS

7.1 Should Defendant assert comparative negligence, Plaintiff affirmatively alleges that Plaintiff’s comparative fault, if any, is less than 51 percent, such that recovery is not barred under Hawai‘i’s modified comparative negligence rule.
7.2 Plaintiff further alleges that any alleged comparative negligence is de minimis relative to Defendant’s misconduct.

8. DAMAGES

8.1 Special Damages (economic):
 (a) Past medical expenses: ☐[$_]
 (b) Future medical care: ☐[$]
 (c) Past wage loss: ☐[$_]
 (d) Future loss of earning capacity: ☐[$]
8.2 General Damages (non-economic): Pain and suffering, mental anguish, loss of enjoyment of life, and other intangible harms in an amount to be proven at trial, subject to any applicable statutory caps.
8.3 Property Damage: ☐[$____] (repair/replacement of Plaintiff Vehicle and personal property).
8.4 Punitive Damages: Plaintiff reserves the right to seek punitive damages upon a showing of Defendant’s willful or wanton conduct, subject to Hawai‘i law.
[// GUIDANCE: Hawai‘i generally imposes no cap on auto-accident non-economic damages unless medical malpractice is implicated. Confirm factual applicability.]

9. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully prays for:
(a) Judgment against Defendant for all special and general damages in amounts to be proven at trial;
(b) Punitive damages where authorized;
(c) Pre- and post-judgment interest as permitted by law;
(d) Reasonable attorneys’ fees and costs pursuant to any applicable statute or rule;
(e) Such other and further relief as the Court deems just and proper.

10. JURY DEMAND

Pursuant to Article I, Section 13 of the Hawai‘i Constitution and Hawai‘i Rules of Civil Procedure Rule 38, Plaintiff hereby demands a trial by jury on all issues so triable.

11. OPTIONAL ARBITRATION ELECTION STATEMENT

[// GUIDANCE: Under Hawai‘i’s Court-Annexed Arbitration Program (H.R.S.A. § 601-20), tort claims under $150,000 are subject to mandatory arbitration unless exempted. If you wish to bypass arbitration, assert that the claim exceeds the threshold or file a 10-day “Request for Exemption.”]

12. ATTORNEYS’ FEES & COSTS

Plaintiff seeks recovery of attorneys’ fees and costs to the fullest extent allowed by Haw. Rev. Stat. §§ 607-14, 431:10C-211, and any other applicable authority.

13. VERIFICATION

I, ☐[PLAINTIFF NAME], declare under penalty of perjury that I am the Plaintiff in the above-entitled action; I have read the foregoing Complaint and know its contents; and the same is true of my own knowledge except as to those matters stated on information and belief, and as to those matters I believe them to be true.

DATED: ☐[City], Hawai‘i, ☐[DATE].

☐[PLAINTIFF NAME]

14. CERTIFICATE OF SERVICE

I hereby certify that on the ☐[DATE] a true and correct copy of the foregoing was duly served on all parties or their counsel in the manner indicated:

• ☐[Name, address, method of service]

DATED: ☐[City], Hawai‘i, ☐[DATE].

☐[ATTORNEY NAME]
Attorney for Plaintiff

SIGNATURE BLOCK

Respectfully submitted,

☐[LAW FIRM NAME]
By: _____
☐[ATTORNEY NAME]
Hawai‘i Bar No. ☐[_]
☐[Firm Address]
Tel: ☐[--_] | Fax: ☐[--____]
Email: ☐[[email protected]]
Attorneys for Plaintiff

[// GUIDANCE:

1. Pleading Format.
   • Use 14-point Times New Roman and double-space per Hawai‘i Rules of the Circuit Courts Rule 7.
   • Set 1-inch margins and include footers with page numbers.

2. Filing Sequence.
   • File Complaint, Summons, and Civil Information Sheet together.
   • Present originals and two endorsed copies to the clerk; arrange for sheriff or private service.

3. Comparative Negligence Discovery.
   • Propound early interrogatories on speed, distraction, impairment, and seat-belt use to preserve evidence supporting your < 51 percent defense.

4. Mediation/ADR.
   • Confirm with client whether to opt-in to private mediation before discovery to leverage Hawai‘i’s settlement culture.

End GUIDANCE]