36.10 [1980 Revision] Form of Verdict-Plaintiff vs. Defendant Insurance Company-Interest-Vexatious Refusal Penalty-Attorney Fees

Instruction No 1 36.10 [1980 Revision] Form of Verdict--Plaintiff vs. Defendant Insurance Company--Interest--Vexatious Refusal Penalty--Attorney Fees VERDICT Note: Complete this form by writing in the name required by your verdict. On the claim of plaintiff (state the name ) for insurance benefits, interest, penalties and attorney fees against defendant, we, the undersigned jurors, find in favor of: (Plaintiff (state the name)) or (Defendant (state the name)) Note: Complete the following paragraph only if your verdict is in favor of plaintiff (state the name ). We, the undersigned jurors, assess the damages of plaintiff (state the name ) as follows: On the policy $ For interest $ For penalty $ (stating the amount ). (stating the amount or, if none, write the word, "none" ). (stating the amount or, if none, write the word, "none" ). (stating the amount or, if none, write the word "none" ). For attorney fees $ Note: All jurors who agree to the above findings must sign below.