Hawaii Personal Injury Demand Letter
PERSONAL INJURY DEMAND LETTER
State of Hawaii
PRIVILEGED AND CONFIDENTIAL – SETTLEMENT COMMUNICATION
Protected Under Hawaii Rules of Evidence Rule 408
DATE: [__/__/____]
VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
[________________________________]
[Insurance Company Name]
[________________________________]
[Street Address]
[________________________________]
[City, State, ZIP Code]
RE:
| | |
|---|---|
| Claimant: | [________________________________] |
| Your Insured: | [________________________________] |
| Claim Number: | [________________________________] |
| Date of Loss: | [__/__/____] |
| Policy Number: | [________________________________] |
Dear Claims Representative:
This office represents [________________________________] ("Claimant") for injuries and damages sustained in a motor vehicle collision that occurred on [__/__/____] in [________________________________], Hawaii. This letter constitutes a formal demand for compensation arising from the negligent conduct of your insured, [________________________________].
PLEASE NOTE: The two-year statute of limitations under HRS § 657-7 will expire on [__/__/____]. Claimant reserves all rights to file suit prior to that date if this matter is not resolved.
I. STATEMENT OF FACTS
A. Pre-Accident Background
[________________________________]
[________________________________]
[________________________________]
B. Incident Description
On [__/__/____] at approximately [____] [☐ a.m. / ☐ p.m.], Claimant was [________________________________] [describe activity, e.g., "operating a motor vehicle," "a pedestrian," "a passenger"] at or near [________________________________] [location/intersection] in [________________________________], Hawaii.
[________________________________]
[________________________________]
[________________________________]
[Provide detailed narrative of the incident, including road conditions, weather, traffic signals, witness observations, and sequence of events]
C. Emergency Response and Immediate Aftermath
☐ Police responded to the scene
- Report Number: [________________________________]
- Investigating Officer: [________________________________]
- Department: [________________________________]
☐ Emergency Medical Services responded
- Claimant was transported by ambulance to [________________________________]
- Claimant refused transport but sought medical care within [____] hours
☐ Photographs were taken at the scene
☐ Witness statements were obtained
II. LIABILITY ANALYSIS
A. Negligence of Your Insured
Your insured breached the duty of reasonable care owed to Claimant by engaging in the following negligent conduct:
☐ Failure to maintain proper lookout
☐ Failure to yield the right-of-way
☐ Following too closely in violation of HRS § 291C-50
☐ Excessive speed for conditions in violation of HRS § 291C-101
☐ Distracted driving (cell phone use, etc.)
☐ Running a red light/stop sign in violation of HRS § 291C-32/33
☐ Improper lane change in violation of HRS § 291C-49
☐ Driving under the influence in violation of HRS § 291E-61
☐ Failure to maintain vehicle in safe operating condition
☐ Other: [________________________________]
B. Evidence Supporting Liability
| Evidence Type | Description | Status |
|---|---|---|
| Police Report | [________________________________] | ☐ Attached |
| Witness Statements | [________________________________] | ☐ Attached |
| Photographs/Video | [________________________________] | ☐ Attached |
| Expert Analysis | [________________________________] | ☐ Attached |
| Traffic Camera Footage | [________________________________] | ☐ Requested |
| Cell Phone Records | [________________________________] | ☐ Subpoenaed |
C. Hawaii Comparative Fault Analysis (HRS § 663-31)
Hawaii follows a modified comparative negligence system under HRS § 663-31. Under this statute:
- 51% Bar Rule: A plaintiff who is found to be 51% or more at fault is completely barred from recovery
- Damage Reduction: If plaintiff is 50% or less at fault, damages are reduced by plaintiff's percentage of fault
- 50/50 Split: Even in cases of equal fault (50/50), the plaintiff may still recover, reduced by 50%
Application to This Case:
Based on the facts and evidence, Claimant bears [____]% fault (if any) for the following reason(s):
☐ Claimant bears no comparative fault whatsoever
☐ Claimant may bear minimal fault ([____]%) for: [________________________________]
Your insured bears [____]% fault based on:
[________________________________]
[________________________________]
Conclusion: Claimant's recovery is [☐ not subject to reduction / ☐ subject to a [____]% reduction] under Hawaii's comparative fault statute.
D. Joint and Several Liability (HRS § 663-10.9)
☐ This case involves a single tortfeasor
☐ This case involves multiple tortfeasors
If multiple tortfeasors are involved, Hawaii law provides:
- Economic Damages: Joint tortfeasors remain jointly and severally liable
- Noneconomic Damages: Joint and several liability applies only to tortfeasors whose negligence is 25% or more; tortfeasors with less than 25% negligence are liable only for their proportionate share
III. HAWAII NO-FAULT PIP CONSIDERATIONS
A. Personal Injury Protection Benefits (HRS § 431:10C)
Hawaii is a no-fault insurance state. Claimant's PIP carrier has paid or is obligated to pay personal injury protection benefits as follows:
| PIP Coverage | Carrier | Policy Limits | Amount Paid | Remaining |
|---|---|---|---|---|
| Medical Expenses | [________________] | $[________] | $[________] | $[________] |
| Wage Loss (Optional) | [________________] | $[________] | $[________] | $[________] |
Minimum PIP Coverage: Hawaii requires minimum PIP coverage of $10,000 per person (HRS § 431:10C-103.5).
B. Threshold to Pursue Tort Claim (HRS § 431:10C-306)
Under Hawaii's no-fault system, Claimant may pursue a tort claim against your insured because:
☐ Monetary Threshold Exceeded: Medical expenses exceed $5,000
- Total medical expenses to date: $[________________________________]
☐ Serious Injury Threshold Met: Claimant sustained a "serious injury" as defined by HRS § 431:10C-306, including:
☐ Death
☐ Significant permanent loss of use of a part or function of the body
☐ Permanent loss of use of a body organ, member, function, or system
☐ Significant permanent disfigurement
☐ Other serious injury: [________________________________]
C. PIP Lien/Subrogation
☐ PIP carrier has asserted a subrogation interest of $[________________________________]
☐ PIP carrier has waived subrogation
☐ Subrogation resolution pending
IV. MEDICAL TREATMENT CHRONOLOGY
A. Emergency and Initial Treatment
| Date | Provider | Treatment | Diagnosis | Charges |
|---|---|---|---|---|
| [__/__/____] | [________________________________] | Emergency Department | [________________________________] | $[________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________] |
B. Diagnostic Studies
| Date | Facility | Study Type | Findings | Charges |
|---|---|---|---|---|
| [__/__/____] | [________________________________] | ☐ X-ray ☐ MRI ☐ CT ☐ EMG | [________________________________] | $[________] |
| [__/__/____] | [________________________________] | ☐ X-ray ☐ MRI ☐ CT ☐ EMG | [________________________________] | $[________] |
| [__/__/____] | [________________________________] | ☐ X-ray ☐ MRI ☐ CT ☐ EMG | [________________________________] | $[________] |
C. Specialist Consultations
| Date | Specialist | Specialty | Findings/Recommendations | Charges |
|---|---|---|---|---|
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________] |
D. Physical Therapy/Rehabilitation
| Date Range | Provider | Sessions | Treatment Focus | Charges |
|---|---|---|---|---|
| [__/__/____] to [__/__/____] | [________________________________] | [____] | [________________________________] | $[________] |
| [__/__/____] to [__/__/____] | [________________________________] | [____] | [________________________________] | $[________] |
E. Surgical Procedures (If Applicable)
| Date | Surgeon | Facility | Procedure | Charges |
|---|---|---|---|---|
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________] |
F. Ongoing/Future Treatment
| Recommended Treatment | Provider | Estimated Duration | Estimated Cost |
|---|---|---|---|
| [________________________________] | [________________________________] | [________________________________] | $[________] |
| [________________________________] | [________________________________] | [________________________________] | $[________] |
G. Injuries Sustained
Primary Diagnoses:
- [________________________________]
- [________________________________]
- [________________________________]
- [________________________________]
ICD-10 Codes:
- [________________________________]
- [________________________________]
- [________________________________]
Prognosis: [________________________________]
[________________________________]
[________________________________]
V. SPECIAL DAMAGES ITEMIZATION
A. Past Medical Expenses
| Category | Provider | Amount Billed | Amount Paid | Balance Due |
|---|---|---|---|---|
| Emergency Services | [________________________________] | $[________] | $[________] | $[________] |
| Hospital/Facility | [________________________________] | $[________] | $[________] | $[________] |
| Primary Care | [________________________________] | $[________] | $[________] | $[________] |
| Specialist Care | [________________________________] | $[________] | $[________] | $[________] |
| Physical Therapy | [________________________________] | $[________] | $[________] | $[________] |
| Chiropractic | [________________________________] | $[________] | $[________] | $[________] |
| Diagnostic Imaging | [________________________________] | $[________] | $[________] | $[________] |
| Prescription Medications | [________________________________] | $[________] | $[________] | $[________] |
| Medical Equipment/DME | [________________________________] | $[________] | $[________] | $[________] |
| Ambulance/Transport | [________________________________] | $[________] | $[________] | $[________] |
| SUBTOTAL - PAST MEDICAL | $[________] | $[________] | $[________] |
B. Future Medical Expenses
| Treatment/Service | Provider | Duration | Estimated Cost |
|---|---|---|---|
| [________________________________] | [________________________________] | [________________________________] | $[________] |
| [________________________________] | [________________________________] | [________________________________] | $[________] |
| [________________________________] | [________________________________] | [________________________________] | $[________] |
| SUBTOTAL - FUTURE MEDICAL | $[________] |
C. Lost Wages and Income
Employment Information:
- Employer: [________________________________]
- Position: [________________________________]
- Hourly Rate/Salary: $[________________________________]
- Average Weekly Earnings: $[________________________________]
| Period | Dates | Days/Hours Missed | Amount |
|---|---|---|---|
| Initial Recovery | [__/__/____] to [__/__/____] | [____] days | $[________] |
| Follow-up Appointments | Various | [____] hours | $[________] |
| Physical Therapy | Various | [____] hours | $[________] |
| Surgery Recovery | [__/__/____] to [__/__/____] | [____] days | $[________] |
| SUBTOTAL - PAST LOST WAGES | $[________] |
Future Lost Earning Capacity:
☐ Not applicable
☐ Applicable - Claimant's injuries have resulted in diminished earning capacity
| Description | Duration | Annual Loss | Total |
|---|---|---|---|
| [________________________________] | [____] years | $[________] | $[________] |
| SUBTOTAL - FUTURE LOST EARNINGS | $[________] |
D. Property Damage
| Item | Description | Fair Market Value | Repair Cost | Claim |
|---|---|---|---|---|
| Vehicle | [____] [Make] [Model] | $[________] | $[________] | $[________] |
| Personal Property | [________________________________] | $[________] | N/A | $[________] |
| Rental Vehicle | [____] days @ $[____]/day | N/A | N/A | $[________] |
| Diminished Value | [________________________________] | N/A | N/A | $[________] |
| SUBTOTAL - PROPERTY DAMAGE | $[________] |
E. Out-of-Pocket Expenses
| Expense | Description | Amount |
|---|---|---|
| Mileage to Medical Appointments | [____] miles @ $0.67/mile | $[________] |
| Parking Fees | [________________________________] | $[________] |
| Home Care Assistance | [________________________________] | $[________] |
| Household Services | [________________________________] | $[________] |
| Medical Equipment Purchases | [________________________________] | $[________] |
| Other | [________________________________] | $[________] |
| SUBTOTAL - OUT-OF-POCKET | $[________] |
TOTAL SPECIAL DAMAGES SUMMARY
| Category | Amount |
|---|---|
| Past Medical Expenses | $[________________________________] |
| Future Medical Expenses | $[________________________________] |
| Past Lost Wages | $[________________________________] |
| Future Lost Earning Capacity | $[________________________________] |
| Property Damage | $[________________________________] |
| Out-of-Pocket Expenses | $[________________________________] |
| TOTAL SPECIAL DAMAGES | $[________________________________] |
VI. GENERAL DAMAGES (NONECONOMIC DAMAGES)
A. Hawaii Law on Noneconomic Damages
Under HRS § 663-8.5, noneconomic damages include compensation for:
- Pain and suffering
- Mental anguish
- Disfigurement
- Loss of enjoyment of life
- Loss of consortium
- All other nonpecuniary losses
IMPORTANT - NO CAP ON NONECONOMIC DAMAGES IN MOTOR VEHICLE CASES:
While Hawaii has a $375,000 cap on "pain and suffering" damages in certain tort actions under HRS § 663-8.7, this cap does NOT apply to motor vehicle personal injury cases. Claimant is entitled to full compensation for all noneconomic damages without statutory limitation.
B. Pain and Suffering
[________________________________]
[________________________________]
[________________________________]
[Describe the physical pain experienced, including intensity, duration, and impact on daily activities]
C. Emotional Distress and Mental Anguish
[________________________________]
[________________________________]
[________________________________]
[Describe anxiety, depression, PTSD symptoms, sleep disturbances, fear of driving, etc.]
D. Loss of Enjoyment of Life
Prior to the accident, Claimant regularly engaged in the following activities that have been affected:
| Activity | Pre-Accident Frequency | Current Status | Impact |
|---|---|---|---|
| [________________________________] | [________________________________] | ☐ Unable ☐ Limited | [________________________________] |
| [________________________________] | [________________________________] | ☐ Unable ☐ Limited | [________________________________] |
| [________________________________] | [________________________________] | ☐ Unable ☐ Limited | [________________________________] |
E. Scarring and Disfigurement
☐ Not applicable
☐ Applicable
| Location | Size/Description | Permanence | Visibility |
|---|---|---|---|
| [________________________________] | [________________________________] | ☐ Permanent ☐ Fading | ☐ Visible ☐ Concealable |
F. Loss of Consortium (If Applicable)
☐ Not applicable
☐ Applicable - Spouse: [________________________________]
[________________________________]
[________________________________]
G. Noneconomic Damages Valuation
Based on the nature, severity, and duration of Claimant's injuries, the reasonable value of noneconomic damages is:
$[________________________________]
VII. DEMAND AND SETTLEMENT PROPOSAL
A. Damages Summary
| Category | Amount |
|---|---|
| TOTAL SPECIAL DAMAGES | $[________________________________] |
| TOTAL GENERAL DAMAGES | $[________________________________] |
| GROSS DAMAGES | $[________________________________] |
| Less: Comparative Fault Reduction ([____]%) | ($[________________________________]) |
| Less: PIP Benefits Paid (if applicable) | ($[________________________________]) |
| NET DAMAGES | $[________________________________] |
B. Settlement Demand
Based on the foregoing, Claimant demands the sum of:
$[________________________________]
to fully and finally resolve all claims arising from this incident.
C. Policy Limits Demand (If Applicable)
☐ This is a policy limits demand
☐ Claimant is willing to accept the policy limits of $[________________________________] in full satisfaction of all claims against your insured
If this is a policy limits demand and limits are insufficient to fully compensate Claimant, please:
- Confirm the applicable policy limits in writing
- Provide a certified copy of the declarations page
- Advise of any excess/umbrella coverage
D. Response Deadline
Please respond to this demand in writing within thirty (30) days of the date of this letter, no later than [__/__/____].
Failure to respond or make a reasonable offer may result in the filing of a lawsuit and a claim for bad faith against the insurer under Hawaii law.
VIII. SUPPORTING DOCUMENTATION CHECKLIST
The following documents are enclosed or available upon request:
Medical Records and Bills
☐ Emergency Department records and bills
☐ Hospital admission/discharge records
☐ Primary care physician records
☐ Specialist consultation records
☐ Physical therapy records
☐ Chiropractic records
☐ Diagnostic imaging reports and films
☐ Prescription records
☐ Medical equipment invoices
☐ Future medical cost estimate/life care plan
Liability Evidence
☐ Police accident report
☐ Witness statements
☐ Scene photographs
☐ Vehicle photographs
☐ Traffic camera footage
☐ Expert accident reconstruction report
☐ Weather/road condition reports
Income/Employment Documentation
☐ Employer verification letter
☐ Pay stubs (pre-accident)
☐ Tax returns ([____] years)
☐ Lost wage statement from employer
☐ Vocational rehabilitation report
☐ Economic loss expert report
Property Damage
☐ Vehicle repair estimate
☐ Total loss valuation
☐ Rental car receipts
☐ Diminished value appraisal
☐ Personal property inventory
Other Documentation
☐ Claimant's declaration/statement
☐ Photographs of injuries (dated)
☐ Day-in-the-life video
☐ Letters from family/friends regarding impact
☐ PIP benefits paid confirmation
IX. HAWAII-SPECIFIC LEGAL NOTES
Statute of Limitations
- General Personal Injury: 2 years from date of injury (HRS § 657-7)
- Medical Malpractice: 2 years from discovery, maximum 6 years (HRS § 657-7.3)
- Claims Against State: 2 years (HRS § 662-4)
- Discovery Rule: Statute begins when plaintiff discovers or should have discovered the injury
Comparative Negligence (HRS § 663-31)
- Type: Modified Comparative Negligence with 51% Bar
- Effect: Plaintiff barred from recovery if 51% or more at fault
- Reduction: Damages reduced by plaintiff's percentage of fault if 50% or less
Joint and Several Liability (HRS § 663-10.9)
- Economic Damages: Joint tortfeasors remain jointly and severally liable
- Noneconomic Damages: Joint and several liability only for tortfeasors 25% or more at fault
No-Fault Insurance (HRS Chapter 431:10C)
- Minimum PIP: $10,000 per person
- Tort Threshold: $5,000 medical expenses OR serious injury
- Serious Injury: Permanent loss of use of body part/function, significant permanent disfigurement
Damage Caps
- Noneconomic Damages: No cap for motor vehicle personal injury cases
- Medical Malpractice: $375,000 cap on pain and suffering (HRS § 663-8.7)
- Punitive Damages: No statutory cap
Prejudgment Interest
- Available under Hawaii law from date of demand or filing of complaint
X. RESERVATION OF RIGHTS
Claimant expressly reserves the right to:
- Amend this demand based on additional discovery or medical treatment
- Seek punitive damages if evidence supports willful or wanton conduct
- File suit prior to the expiration of the statute of limitations
- Add additional parties or claims as investigation continues
- Seek attorneys' fees and costs as permitted by law
- Pursue bad faith claims against the insurer for unreasonable delay or denial
Please direct all correspondence regarding this matter to the undersigned. Do not contact Claimant directly.
We look forward to your prompt response and a good faith effort to resolve this matter without litigation.
Respectfully submitted,
[________________________________]
Attorney for Claimant
[________________________________]
[Firm Name]
[________________________________]
[Street Address]
[________________________________]
[City, State, ZIP Code]
[________________________________]
[Telephone]
[________________________________]
[Facsimile]
[________________________________]
[Email]
Hawaii Bar No.: [________________________________]
ENCLOSURES:
☐ Medical records and bills
☐ Police report
☐ Photographs
☐ Wage documentation
☐ Other: [________________________________]
cc: [________________________________] (Claimant)
[________________________________] (File)
This demand letter is submitted for settlement purposes only and is protected under Hawaii Rules of Evidence Rule 408. Nothing contained herein shall be construed as an admission of any fact or liability.
About This Template
Personal injury cases are brought by people who were hurt because of someone else's carelessness: car crashes, slip and falls, defective products, and more. Demand letters, settlement agreements, and court filings in these cases have to document the injuries, the medical treatment, the lost income, and the exact legal basis for holding the other side responsible. Well-prepared paperwork is what drives higher settlements and forces insurers to take the claim seriously.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Last updated: February 2026