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Sample Complaint in Interpleader

{LAW FIRM NAME}
{Address}
{City}, {State} {ZIP}
{Telephone:}
{Facsimile: }

{Lawyer Name (Bar No.)}
Email: {}

Attorney for Plaintiff

In the Superior Court of the state of Arizona
In and for the County of Maricopa

[Insurance Company of At-Fault Driver],

Plaintiff,

v.

[Individuals and Entities Including Lienholders Who May Have A Right to Policy Limit Proceeds],

Defendants.

Case No.: ____________________________

 

COMPLAINT IN INTERPLEADER

 

     (Interpleader – Automobile Only)

 

Tier [1, 2 or 3]

 

 

For its Complaint in Interpleader and pursuant to Rule 22, Arizona Rules of Civil Procedure, Plaintiff [Insurance Company] alleges as follows:

  1. The events giving rise to this cause of action occurred within Maricopa County, Arizona.
  2. This Court has jurisdiction over the subject matter and parties to this action and the amount in controversy exceeds the minimal jurisdictional requirements of this Court.
  3. Venue is proper with this Court.
  4. The amount of Plaintiff’s damages qualifies this matter as a Tier [1, 2 or 3] case in accordance with Rule 8(b)(2) of the Arizona Rules of Civil Procedure.
  5. Plaintiff [Insurance Company] (“Plaintiff”) is an insurance company properly licensed and authorized to do business in the State of Arizona.
  6. Defendant [#1 – Name of Driver of the Other Vehicle Hit by At-Fault Driver] was at all relevant times herein a resident of Maricopa County, Arizona.
  7. Defendant [#2 – Name of Minor Daughter Passenger in the Vehicle of Defendant #1] is a minor and the daughter of Defendant [#1] and was at all relevant times herein a resident of Maricopa County, Arizona.
  8. Defendant [#3 – Name of Adult Passenger in the Vehicle of in Defendant #1] was at all relevant times herein a resident to Maricopa County, Arizona.
  9. Defendant [#4 – Name of Adult Passenger in the Same Vehicle of At-Fault Driver] was at all relevant times herein a resident of Maricopa County, Arizona.
  10. Defendant [City of Phoenix Ambulance Company] is a governmental entity operating in the State of Arizona.
  11. Defendant [Hospital] dba [] Medical Center is an Arizona corporation which is licensed and does business in the State of Arizona.
  12. Defendant #5 [Hospital Physician Group] dba [] is an Arizona corporation which is licensed and does business in the State of Arizona.
  13. Defendant #6 [Hospital Clinic] dba [] is an Arizona corporation which is licensed and does business in the State of Arizona.
  14. Defendant #7 [Diagnostic Imaging Company] is an Arizona corporation which is licensed and does business in the State of Arizona.
  15. Defendant #8 [Orthopedic Physician Group] is an Arizona corporation which is licensed and does business in the State of Arizona.
  16. Defendant #9 [Radiology Company] is a foreign corporation which does business in the State of Arizona.
  17. Defendant #10 [Arizona Health Care Cost Containment System] is a governmental entity operating in the State of Arizona.
  18. Defendants John Does I-V, Jane Does I-V, ABC Corporations I-V and ABC Partnerships I-V are persons, corporations, or other legal entities whose true names are unknown to Plaintiff who may have claims in this Interpleader action. At such time the identity of these Defendants become known, Plaintiff will seek leave of the Court to amend its Complaint and identify them as same.
  19. On [Date of Accident], [Defendants #1 through #3] were involved in an automobile accident involving two vehicles that occurred on [Street Name] at the intersection of [] in Phoenix, Maricopa County, Arizona (“Accident”).
  20. Plaintiff [Insurance Company] does not wish to contest the issue of liability for the Accident for purposes of this Interpleader action.
  21. At the time of the Accident, Defendants [Defendants #2 and #3] were passengers in a vehicle driven by Defendant [#1].
  22. At the time of the Accident, Defendant [Defendant #4] was a passenger in a vehicle driven by [List Name of At-Fault Driver], which was insured by [Insurance Company, Policy No. [] (“Policy”).
  23. The Policy has bodily injury liability limits of $[] per person and $[] per accident.
  24. The Policy was effective on the date of the Accident.
  25. At the time of the Accident, passenger [List Name of Defendant Minor #2] was a minor.
  26. At the time of the filing of this Interpleader action, Defendant [Defendant Minor #2] is the only remaining minor.
  27. Upon information and belief, [Defendant #3] was a minor at the time of the accident but no longer a minor at the time of the filing of this Interpleader Complaint.
  28. Upon information and belief, [Defendants #4] was not a minor at the time of the accident and has not filed a lawsuit within the applicable statute of limitations period.
  29. The statute of limitations has expired for any claim which may be asserted by [Defendant #4]. As such, [Defendant #4] is not permitted to recover for any damages as a result of the Accident and not entitled to any portion of the available bodily injury liability policy limits provided by Plaintiff.
  30. [Defendant #1] has made a claim for bodily injury sustained in the Accident and has filed a separate lawsuit in Maricopa County Superior Court Case No. CV________-_________ against [Name of At-Fault Driver] for the Accident.
  31. [Defendant #1] asserted claim of injury and damages arising from the Accident that exceeds the available liability limits of $[] per person and $[] per accident for bodily injury.
  32. Upon information and belief, [Defendant #2] may also have a claim of injury and damages arising from the Accident.
  33. Upon information and belief, [Defendant #3] may also have a claim of injury and damages arising from the Accident.
  34. It is unknown to Plaintiff what healthcare providers or entities may have provided treatment to [Defendants #2 and #3] as a result of the Accident and whether such healthcare providers or entities have an interest in the Interpleader action.
  35. Defendants #5 through #10 [List All Ambulance, Hospital and Other Health Care Provider Entities] provided medical care to [Defendants #1 and #2] and may have an interest in this Interpleader action.
  36. Defendant Arizona Health Care Cost Containment System (“AHCCCS”) filed a lien notice for benefits paid on behalf of [Defendants #1 and #2] for treatment received on the date of the Accident that may have an interest in this Interpleader action.
  37. [Defendant #1]’s claim alone notwithstanding any other claims that may asserted by [Defendants #2 and #3] exceeds the available liability policy limits of $[] per person / $[] per accident provided by Plaintiff, which would apply to the subject accident.
  38. Plaintiff is unable to determine how to apportion the liability coverage between the Defendants.
  39. Plaintiff cannot safely settle any of the claims being made by Defendants until it is determined to whom and what amounts must be paid.
  40. Plaintiff acknowledges that it is obligated to pay its limits to resolve any and all claims against its covered insured, driver, under the Policy.
  41. The current claim by [Defendant #1] and potential claims of all other [Defendants #2 and #3] are such that Plaintiff may be exposed to the risk of multiple liability, and Plaintiff is in great doubt as to which Defendants are entitled to be paid from the available liability insurance proceeds and how to allocate funds in a fair and just manner.
  42. Pursuant to Rule 22(b) of the Arizona Rules of Civil Procedure, upon Order of this Court, Plaintiff will deposit the entire $[per accident policy limits] of the available per accident bodily injury coverage with the Clerk of the Court to be retained by the Clerk in an interest bearing account for the benefit of the proper and lawful beneficiaries of such policy proceeds, with no single Defendant collecting more than $[50% of the per accident policy limits] out of the total available policy limits.
  43. As Plaintiff is not contesting the issue of liability for the Accident for purposes of this Interpleader action, Plaintiff requests this Court’s judicial determination of the claims and to enter an Order discharging Plaintiff from liability upon deposit of the applicable remaining limits with this Court.

WHEREFORE, Plaintiff requests the following relief:

  1. That this Court Order Plaintiff to pay into the custody of the Clerk of the Court, or such other persons or entities designated by the Court, its bodily injury liability insurance proceeds in the amount of $[] per person and $[] per accident with no single Defendant being entitled to receive more than $[50% of the per accident policy limits] out of the total available policy limits;
  2. That this Court settle and adjust the respective claims involving Defendants, the sum total of the settlement and adjustment within the aforementioned available coverage;
  3. That Defendants be enjoined and restrained from instituting any separate actions against Plaintiff for the recovery of such insurance policy, or any part thereof;
  4. Upon payment to the Court of the policy proceeds, Plaintiff be discharged from any further liability to Defendants resulting from the [date of accident] automobile accident; and
  5. For such other and further relief as the Court deems proper under the circumstances.

 

DATED this ____ day of _____________, _____.

 

 

 

Respectfully submitted,

{law firm name}

By

{NAME OF ATTORNEY}

{Law Firm Address}

{City} {Arizona}, {Zip}

Attorney for Plaintiff