PRE-SUIT DEMAND LETTER
AUTOMOBILE ACCIDENT - PERSONAL INJURY CLAIM
LETTER HEADER
[LAW FIRM LETTERHEAD]
SENT VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND FIRST-CLASS MAIL
Date: _______________________
CLAIMS REPRESENTATIVE:
| Field | Information |
|---|---|
| Name | _________________________________ |
| Title | _________________________________ |
| Insurance Company | _________________________________ |
| Address | _________________________________ |
| City, State, ZIP | _________________________________ |
RE: DEMAND FOR SETTLEMENT
| Claim Information |
|---|
| Our Client: _________________________________ |
| Date of Loss: _________________________________ |
| Claim Number: _________________________________ |
| Policy Number: _________________________________ |
| Insured: _________________________________ |
| Policy Limits: $_________________________________ |
SECTION 1: INTRODUCTION AND REPRESENTATION
Dear Claims Representative:
This firm represents _________________________________ ("Claimant") for injuries and damages sustained in an automobile accident that occurred on _____________ at approximately _____________ [time] at or near _________________________________ [location].
This letter constitutes a formal demand for settlement of our client's personal injury claim. We have enclosed supporting documentation and request that you respond within thirty (30) days of receipt of this demand.
Time-Sensitive Notice:
☐ This demand expires on _____________ [date 30 days from sending]
☐ Failure to respond may result in filing of litigation without further notice
☐ All rights are reserved including the right to amend this demand
SECTION 2: LIABILITY ANALYSIS
A. Facts of the Accident
On _____________, our client was operating/riding in a _____________ [year/make/model] traveling _____________ [direction] on _____________ [street/highway] in _____________ [city], _____________ [state].
Accident Narrative:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
B. Police Report Summary
| Field | Information |
|---|---|
| Responding Agency | _________________________________ |
| Report Number | _________________________________ |
| Investigating Officer | _________________________________ |
| Citations Issued | _________________________________ |
| Fault Determination | _________________________________ |
Police Report Findings:
☐ Your insured was cited for: _________________________________
☐ Your insured admitted fault at the scene
☐ Independent witnesses confirmed your insured's negligence
☐ Physical evidence supports our client's account
C. Negligence of Your Insured
Your insured, _________________________________, was negligent in one or more of the following ways:
☐ Failed to maintain proper lookout
☐ Failed to yield the right of way
☐ Followed too closely
☐ Exceeded safe speed for conditions
☐ Ran red light/stop sign
☐ Made improper lane change
☐ Operated vehicle while distracted (cell phone, texting)
☐ Operated vehicle while impaired
☐ Failed to obey traffic control device
☐ Other: _________________________________
D. Comparative/Contributory Fault Analysis
Applicable Standard:
☐ Pure Comparative Fault (recovery reduced by percentage of fault)
☐ Modified Comparative Fault - 50% Bar
☐ Modified Comparative Fault - 51% Bar
☐ Contributory Negligence (complete bar to recovery)
Our Position: Your insured bears ____% responsibility for this accident. Our client's conduct in no way contributed to the collision.
SECTION 3: INJURY DESCRIPTION AND MEDICAL TREATMENT
A. Injuries Sustained
Our client sustained the following injuries as a direct and proximate result of this collision:
Primary Injuries:
| Body Part/System | Diagnosis | ICD-10 Code (if known) |
|---|---|---|
| _________________ | _________________ | _________________ |
| _________________ | _________________ | _________________ |
| _________________ | _________________ | _________________ |
| _________________ | _________________ | _________________ |
Diagnostic Studies:
☐ X-rays performed: _________________________________
☐ MRI performed: _________________________________
☐ CT scan performed: _________________________________
☐ EMG/Nerve conduction study: _________________________________
☐ Other diagnostic tests: _________________________________
B. Medical Treatment Timeline
Emergency/Initial Treatment:
| Date | Provider | Treatment | Cost |
|---|---|---|---|
| _______ | _________________________________ | _________________________________ | $_______ |
Follow-Up Treatment:
| Date | Provider | Treatment | Cost |
|---|---|---|---|
| _______ | _________________________________ | _________________________________ | $_______ |
| _______ | _________________________________ | _________________________________ | $_______ |
| _______ | _________________________________ | _________________________________ | $_______ |
Physical Therapy/Rehabilitation:
| Date Range | Provider | Sessions | Total Cost |
|---|---|---|---|
| _______ to _______ | _________________________________ | _______ | $_______ |
Specialist Consultations:
| Date | Specialist | Specialty | Cost |
|---|---|---|---|
| _______ | _________________________________ | _________________________________ | $_______ |
C. Treatment Summary
| Treatment Category | Provider Count | Visit Count | Total Charges |
|---|---|---|---|
| Emergency Room | _______ | _______ | $_____________ |
| Hospital (Inpatient) | _______ | _______ days | $_____________ |
| Primary Care | _______ | _______ | $_____________ |
| Orthopedic | _______ | _______ | $_____________ |
| Chiropractic | _______ | _______ | $_____________ |
| Physical Therapy | _______ | _______ | $_____________ |
| Pain Management | _______ | _______ | $_____________ |
| Diagnostic Imaging | _______ | _______ | $_____________ |
| Other | _______ | _______ | $_____________ |
| TOTAL MEDICAL EXPENSES | $_____________ |
D. Current Medical Status
Maximum Medical Improvement (MMI):
☐ Claimant has reached MMI as of _____________
☐ Treating physician has released claimant from care
☐ Claimant continues to treat with expected discharge date of _____________
Permanent Impairment:
☐ Permanent impairment rating: _____% whole person
☐ Permanent restrictions: _________________________________
☐ No permanent impairment anticipated
Future Medical Needs:
☐ Future surgery anticipated: _________________________________
☐ Ongoing physical therapy: _________________________________
☐ Chronic pain management: _________________________________
☐ Future medical costs estimated at: $_____________
SECTION 4: ECONOMIC DAMAGES (SPECIAL DAMAGES)
A. Medical Expenses
| Category | Amount |
|---|---|
| Past Medical Expenses (itemized above) | $_____________ |
| Future Medical Expenses (if applicable) | $_____________ |
| TOTAL MEDICAL EXPENSES | $_____________ |
B. Lost Wages/Income
Employment Information:
| Field | Information |
|---|---|
| Employer | _________________________________ |
| Position | _________________________________ |
| Hourly Rate / Annual Salary | $_________________________________ |
| Hours Worked per Week | _________________________________ |
Lost Time Calculation:
| Period | Days/Hours Missed | Amount Lost |
|---|---|---|
| _______ to _______ | _______ | $_____________ |
| _______ to _______ | _______ | $_____________ |
| TOTAL PAST LOST WAGES | $_____________ |
Documentation Attached:
☐ Verification of employment letter
☐ Pay stubs for period prior to accident
☐ Tax returns (if self-employed)
☐ Physician's disability/work restriction notes
C. Loss of Earning Capacity (If Applicable)
☐ Our client's earning capacity has been permanently diminished
☐ Economic expert report attached estimating future loss at: $_____________
D. Property Damage
| Item | Amount |
|---|---|
| Vehicle repair costs | $_____________ |
| Vehicle total loss value | $_____________ |
| Rental car expenses | $_____________ |
| Personal property damaged | $_____________ |
| TOTAL PROPERTY DAMAGE | $_____________ |
☐ Property damage claim resolved separately
☐ Property damage included in this demand
E. Out-of-Pocket Expenses
| Expense | Amount |
|---|---|
| Prescription medications | $_____________ |
| Medical equipment (crutches, brace, etc.) | $_____________ |
| Mileage to medical appointments (_____ miles × $0.67) | $_____________ |
| Parking fees for medical visits | $_____________ |
| Home health assistance | $_____________ |
| Other: _________________________________ | $_____________ |
| TOTAL OUT-OF-POCKET EXPENSES | $_____________ |
F. Summary of Economic Damages
| Category | Amount |
|---|---|
| Past Medical Expenses | $_____________ |
| Future Medical Expenses | $_____________ |
| Past Lost Wages | $_____________ |
| Future Lost Wages/Earning Capacity | $_____________ |
| Property Damage (if included) | $_____________ |
| Out-of-Pocket Expenses | $_____________ |
| TOTAL ECONOMIC DAMAGES | $_____________ |
SECTION 5: NON-ECONOMIC DAMAGES (GENERAL DAMAGES)
A. Pain and Suffering
Our client has endured and continues to endure significant pain and suffering as a result of this collision:
Physical Pain:
______________________________________________________________________________
______________________________________________________________________________
Duration and Intensity:
☐ Acute pain lasting _____________ weeks/months
☐ Chronic pain continuing to present
☐ Pain rating at worst: _____/10
☐ Current pain rating: _____/10
B. Mental and Emotional Distress
☐ Anxiety, especially when driving or riding in vehicles
☐ Depression related to injuries and limitations
☐ Post-traumatic stress symptoms
☐ Sleep disturbances
☐ Psychological treatment sought: _________________________________
C. Loss of Enjoyment of Life
Our client has been deprived of activities and enjoyments that were part of daily life before this accident:
☐ Unable to participate in _________________________________ [sports/hobbies]
☐ Limited ability to care for children/family members
☐ Cannot perform household chores without assistance
☐ Social activities significantly curtailed
☐ Other: _________________________________
D. Inconvenience and Disruption
☐ Time spent at medical appointments: approximately _______ hours
☐ Assistance required for daily activities: _________________________________
☐ Inability to work caused significant financial stress
☐ Recovery process disrupted normal life for _____________ months
E. Scarring and Disfigurement (If Applicable)
☐ Location of scar(s): _________________________________
☐ Size: _________________________________
☐ Permanent: ☐ Yes ☐ No
SECTION 6: DAMAGES CALCULATION AND DEMAND
A. Multiplier Method Calculation
| Component | Amount |
|---|---|
| Total Economic Damages | $_____________ |
| Multiplier Applied | × _____ |
| Non-Economic Damages (calculated) | $_____________ |
| TOTAL DAMAGES | $_____________ |
Multiplier Justification:
The multiplier of _____ is appropriate based on:
☐ Severity of injuries (moderate to severe)
☐ Length of recovery period
☐ Permanent nature of injuries
☐ Impact on daily life and activities
☐ Clear liability of your insured
☐ Credibility of our client
B. Itemized Damages Summary
| Damage Category | Amount |
|---|---|
| ECONOMIC DAMAGES | |
| Medical Expenses (past and future) | $_____________ |
| Lost Wages (past and future) | $_____________ |
| Out-of-Pocket Expenses | $_____________ |
| Subtotal - Economic | $_____________ |
| NON-ECONOMIC DAMAGES | |
| Pain and Suffering | $_____________ |
| Mental/Emotional Distress | $_____________ |
| Loss of Enjoyment of Life | $_____________ |
| Inconvenience | $_____________ |
| Subtotal - Non-Economic | $_____________ |
| TOTAL DAMAGES | $_____________ |
C. Formal Demand
Based on the foregoing, we hereby demand the sum of:
$_____________
in full and final settlement of all claims arising from this accident.
SECTION 7: POLICY LIMITS DEMAND (IF APPLICABLE)
☐ This section applies if damages exceed policy limits
We understand the applicable policy limits are $_____________.
Given that our client's damages significantly exceed available coverage, we demand payment of the full policy limits of $_____________ within thirty (30) days to resolve this claim.
Notice of Potential Bad Faith:
Please be advised that we are aware of your insured's exposure in excess of policy limits. Failure to tender policy limits within a reasonable time may expose your insured to personal liability and your company to claims of bad faith.
We reserve all rights to pursue recovery against your insured personally for any excess judgment.
SECTION 8: LIEN INFORMATION
The following liens or subrogation interests may apply to any settlement:
| Lienholder | Type | Amount |
|---|---|---|
| _________________________________ | Health Insurance Subrogation | $_____________ |
| _________________________________ | Medicare Conditional Payment | $_____________ |
| _________________________________ | Medicaid Lien | $_____________ |
| _________________________________ | Medical Provider Lien | $_____________ |
| _________________________________ | Attorney's Lien | $_____________ |
Total Known Liens: $______________
We will address all liens from settlement proceeds. Final allocation will be provided with settlement documents.
SECTION 9: ENCLOSED DOCUMENTATION
The following documents are enclosed in support of this demand:
Liability Documentation:
☐ Police accident report
☐ Photographs of accident scene
☐ Photographs of vehicle damage
☐ Witness statements
☐ Traffic citation(s)
Medical Documentation:
☐ Medical records from all treating providers
☐ Medical bills from all treating providers
☐ Diagnostic imaging reports
☐ Physician narrative report
☐ Disability/work restriction notes
Wage Loss Documentation:
☐ Employment verification letter
☐ Pay stubs (pre-accident)
☐ Tax returns (if self-employed)
Other Documentation:
☐ Photographs of injuries
☐ Property damage estimates/photos
☐ Out-of-pocket expense receipts
☐ _________________________________
SECTION 10: SETTLEMENT TERMS AND CONDITIONS
Upon receipt of the demanded amount, we will provide:
☐ Full release of all claims against your insured
☐ Dismissal of any pending litigation (if applicable)
☐ Satisfaction of all applicable liens
☐ Hold harmless agreement regarding liens (if required)
Settlement Contingencies:
☐ Offer must remain open for _______ days after acceptance
☐ Settlement funds must be paid within _______ days of acceptance
☐ Medicare/Medicaid final lien amounts must be obtained before release execution
SECTION 11: RESPONSE REQUESTED
Please respond to this demand within thirty (30) days with one of the following:
☐ Acceptance of our demand in full
☐ Counteroffer with detailed explanation
☐ Request for additional documentation (specify)
☐ Denial with stated reasons
Failure to respond will be considered a rejection of this demand, and we will proceed with litigation without further notice.
CLOSING
We trust that upon review of the enclosed documentation, you will agree that our demand is fair and reasonable given the clear liability of your insured and the nature and extent of our client's injuries.
We look forward to resolving this matter amicably and without the need for litigation.
Very truly yours,
_________________________________
[Attorney Name]
[Bar Number]
[Firm Name]
[Address]
[Phone]
[Email]
Enclosures: As noted above
cc: Client file
STATE-SPECIFIC VARIATIONS
Comparative Fault States
- California, New York, Florida: Pure comparative fault
- Texas, Illinois: Modified (51% bar)
- Adjust demand strategy based on any potential contributory fault
No-Fault/PIP States
- Florida, Michigan, New York, others: Address PIP benefits exhaustion
- Threshold requirements for tort claims must be met
Bad Faith Considerations
- Some states allow direct bad faith claims
- Document all communications with insurer
- Time-limit demands may trigger bad faith exposure
Pre-Suit Requirements
- Florida: Pre-suit demand letter requirements for certain claims
- California: Civil Code § 1542 waiver required in releases
- Check state-specific statutory notice requirements
PRACTICE NOTES FOR ATTORNEYS
Timing Considerations
☐ Wait for MMI before sending demand
☐ Consider statute of limitations
☐ Allow adequate response time (30-45 days typical)
☐ Account for lien resolution time in settlement timeline
Demand Amount Strategy
☐ Research jury verdicts in jurisdiction
☐ Consider insurance coverage limits
☐ Leave room for negotiation
☐ Support multiplier with case-specific factors
Documentation Best Practices
☐ Organize records chronologically
☐ Highlight key medical findings
☐ Include photographs of injuries at various stages
☐ Provide clear damages calculation spreadsheet
This template provides guidance for pre-suit demand letters in auto accident cases. Modify based on specific facts, jurisdiction, and applicable law. Always verify current statutes of limitations and procedural requirements before sending.
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