[// GUIDANCE: Replace every bracketed and ALL-CAPS placeholder before filing.
Verify all factual allegations, dates, and amounts. ]

IN THE DISTRICT COURT OF [COUNTY] COUNTY, NEBRASKA

[PLAINTIFF NAME], ) Case No. __
Plaintiff, )
)
v. ) COMPLAINT AND
) JURY DEMAND
[DEFENDANT NAME], )
Defendant. )

TABLE OF CONTENTS
1. Parties, Jurisdiction, and Venue .................................. ¶¶1-5
2. Factual Allegations ............................................... ¶¶6-22
3. Causes of Action
3.1 Negligence .................................................... ¶¶23-32
3.2 Negligence Per Se ............................................. ¶¶33-37
4. Comparative Negligence Allegations ................................ ¶¶38-40
5. Damages ........................................................... ¶¶41-47
6. Reservation & Preservation Matters ................................ ¶¶48-52
7. Prayer for Relief ................................................. ¶¶53-56
8. Jury Demand ....................................................... ¶57
9. Verification & Signature Block .................................... p. 11

COMPLAINT FOR DAMAGES
Plaintiff [PLAINTIFF NAME] (“Plaintiff”), through undersigned counsel, for his/her Complaint
against Defendant [DEFENDANT NAME] (“Defendant”), alleges as follows:

1. PARTIES, JURISDICTION, AND VENUE
2. Plaintiff is a resident of [CITY], [COUNTY] County, Nebraska, and was at all relevant
   times the owner/operator of the vehicle involved in the collision described herein.
3. Defendant is a resident of [CITY/STATE] and may be served at [SERVICE ADDRESS].
   [// GUIDANCE: For corporate defendants, insert state of incorporation & registered agent.]
4. This Court has subject-matter jurisdiction over this action pursuant to Neb. Rev. Stat.
   § 25-207 (personal-injury actions) and applicable common-law tort principles.
5. Venue is proper in this Court under Neb. Rev. Stat. § 25-403.01 because the collision
   occurred in [COUNTY] County and Defendant resides and/or does business here.

6. The amount in controversy exceeds the jurisdictional minimum of this Court.

7. FACTUAL ALLEGATIONS

8. On [DATE] at approximately [TIME], Plaintiff was operating a [YEAR/MAKE/MODEL]
   westbound on [STREET/ROAD] near its intersection with [CROSS-STREET] in
   [CITY], Nebraska (“Subject Collision”).
9. Weather and roadway conditions were [CLEAR/DRY/etc.]; traffic was [LIGHT/MOD.].
10. Defendant, driving a [YEAR/MAKE/MODEL/PLATE], was traveling [DIRECTION]
    on [STREET] approaching the same intersection.
11. Defendant failed to yield the right of way and violently collided with the driver-side of
    Plaintiff’s vehicle. Impact speeds are estimated at [--] mph.
12. The investigating law-enforcement officer cited Defendant for violation of
    [SPECIFY STATUTE/REGULATION] (failure to yield / speeding / etc.).
13. Plaintiff was wearing a seat belt and otherwise acting prudently.

14. As a direct and proximate result of Defendant’s conduct, Plaintiff suffered:
    a. Physical injuries including [LIST];
    b. Medical expenses to date of approximately $[AMT];
    c. Anticipated future medical expenses of $[AMT];
    d. Lost wages of $[AMT] and loss of future earning capacity;
    e. Property damage to Plaintiff’s vehicle totaling $[AMT]; and
    f. Past and future non-economic damages, including pain, suffering, mental anguish,
    and loss of enjoyment of life.
    13-22. [Insert additional, case-specific facts, witness identities, medical treatment timeline,
    insurance claim history, etc.]

15. CAUSES OF ACTION
    3.1 Count I – Negligence

16. Plaintiff incorporates ¶¶1-22 as if fully set forth herein.
17. Defendant owed Plaintiff a duty to operate his/her vehicle with reasonable care and to
    obey all applicable traffic laws.
18. Defendant breached that duty by, inter alia:
    a. Failing to keep a proper lookout;
    b. Driving at a speed greater than was reasonable and prudent;
    c. Failing to yield the right of way; and
    d. Operating a motor vehicle while distracted and/or fatigued.
    26-31. [Detail additional acts/omissions as supported by evidence.]
19. Defendant’s breaches were the direct and proximate cause of Plaintiff’s injuries and
    damages described herein.

3.2 Count II – Negligence Per Se
33. Plaintiff incorporates ¶¶1-32.
34. At the time of the Subject Collision, Defendant was in violation of
[INSERT SPECIFIC TRAFFIC CODE SECTION], a safety statute enacted to
protect motorists such as Plaintiff.
35. Such statutory violation constitutes negligence per se under Nebraska law.
36. Plaintiff belongs to the class of persons the statute is designed to protect, and the type
of harm suffered is the type the statute seeks to prevent.
37. Accordingly, Defendant is liable to Plaintiff for all damages proximately caused thereby.

4. COMPARATIVE NEGLIGENCE ALLEGATIONS
5. Nebraska follows modified comparative negligence (≤ 50% bar).
6. Plaintiff denies any negligence; however, to the extent comparative fault is asserted,
   Plaintiff’s recovery shall be reduced only in accordance with Neb. Rev. Stat.
   § 25-21,185.09 and shall be barred solely if Plaintiff’s negligence is found to exceed
   fifty percent (50%).

7. Plaintiff affirmatively pleads such statutory scheme by way of anticipation of defenses.

8. DAMAGES

9. Economic Damages: past and future medical expenses, lost wages,
   loss of earning capacity, and property damage (¶12).
10. Non-Economic Damages: past and future physical pain, suffering, emotional distress,
    and loss of enjoyment of life.
11. Pre- and post-judgment interest as allowed by law.
12. Costs of this action under Neb. Rev. Stat. § 25-1708.
13. No punitive or exemplary damages are sought, as such damages are not available under
    Nebraska law.
14. Plaintiff presently estimates damages in excess of $[AMT] but will amend in
    accordance with Neb. Ct. R. Pldg. § 6-111 as discovery progresses.

15. Plaintiff reserves the right to assert additional categories of damages permitted by law.

16. RESERVATION & PRESERVATION MATTERS

17. Plaintiff demands preservation of all physical evidence and electronically stored
    information (ESI) related to the collision, including without limitation event-data
    recorder (EDR) downloads, dash-cam footage, cell-phone records, and vehicle repair
    invoices.
18. Plaintiff gives notice that failure to preserve such evidence may give rise to sanctions
    for spoliation.
19. Plaintiff reserves the right to pursue underinsured or uninsured motorist benefits should
    such coverage apply.
20. Pursuant to Neb. Rev. Stat. § 25-3303 (med-pay subrogation), Plaintiff will address
    any statutory liens and subrogation interests at the appropriate time.

21. Plaintiff expressly reserves the right to amend this Complaint to join additional parties
    or claims as discovery dictates.

22. PRAYER FOR RELIEF
    WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in his/her favor
    and against Defendant as follows:

23. For compensatory damages in an amount to be proven at trial;
24. For pre- and post-judgment interest as allowed by law;
25. For Plaintiff’s taxable costs herein; and

26. For such other and further relief as the Court deems just and proper.

27. JURY DEMAND

28. Plaintiff demands trial by jury on all issues so triable as a matter of right.

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

Date: ___, 20_ _________
[PLAINTIFF NAME]

RESPECTFULLY SUBMITTED,

[LAW FIRM NAME]
By: _____
[ATTORNEY NAME] (# Bar No.)
[Street Address]
[City, State ZIP]
Tel: [] -_ | Fax: [] -
Email: [[email protected]]

ATTORNEYS FOR PLAINTIFF

[// GUIDANCE: Filing Checklist (Nebraska State Court)]
• Civil Case Cover Sheet (Neb. Ct. R. § 2-111)
• Summons & Praecipe for Summons
• Filing fee per Dist. Ct. schedule
• Confidential PI Worksheet (if seeking protection of medical records)
• Service via sheriff or certified mail per Neb. Rev. Stat. § 25-505.1

[// GUIDANCE: Consider Early Settlement Demand]
Under Neb. Rev. Stat. § 25-901, Plaintiff may submit a written settlement
offer; rejected offers can impact post-judgment costs if Plaintiff
ultimately recovers more at trial.