Illinois Personal Injury Demand Letter
PERSONAL INJURY DEMAND LETTER — STATE OF ILLINOIS
SETTLEMENT COMMUNICATION — FOR COMPROMISE PURPOSES
ATTORNEY INFORMATION
Law Firm: [________________________________]
Attorney Name: [________________________________]
Illinois ARDC No.: [________________________________]
Address: [________________________________]
City, State, ZIP: [____________________], Illinois [________]
Telephone: [________________________________]
Facsimile: [________________________________]
Email: [________________________________]
CLAIM INFORMATION
Date of Letter: [__/__/____]
Sent Via: ☐ Certified Mail, Return Receipt Requested ☐ Regular U.S. Mail ☐ Email ☐ Facsimile
To:
Insurance Company: [________________________________]
Claims Adjuster: [________________________________]
Adjuster Address: [________________________________]
City, State, ZIP: [________________________________]
Claim Number: [________________________________]
Policy Number: [________________________________]
Insured (Defendant): [________________________________]
Claimant: [________________________________]
Date of Loss: [__/__/____]
Date of Birth (Claimant): [__/__/____]
Type of Claim: ☐ Bodily Injury ☐ Wrongful Death ☐ Property Damage ☐ Uninsured Motorist ☐ Underinsured Motorist
I. INTRODUCTION AND PURPOSE
This letter constitutes a formal demand for settlement on behalf of our client, [________________________________] ("Claimant"), for personal injuries, damages, and losses sustained as a direct and proximate result of the negligence of your insured, [________________________________] ("Defendant"), arising from an incident that occurred on [__/__/____] in [________________________________], Illinois.
This firm has been retained to represent Claimant in connection with all claims arising from this incident. Please direct all future communications regarding this matter to our office.
The purpose of this demand is to present the facts, applicable Illinois law, Claimant's injuries and damages, and to make a specific settlement demand. Our investigation confirms that your insured is fully liable for Claimant's injuries and damages.
II. FACTUAL BACKGROUND
A. Incident Description
On [__/__/____], at approximately [____] ☐ a.m. ☐ p.m., the following incident occurred:
Location: [________________________________]
City/County: [________________________________], Illinois
Weather Conditions: [________________________________]
Road/Surface Conditions: [________________________________]
Lighting Conditions: ☐ Daylight ☐ Dusk ☐ Dawn ☐ Darkness ☐ Artificial Lighting
Type of Incident:
☐ Motor vehicle collision
☐ Rear-end collision
☐ Intersection collision
☐ Head-on collision
☐ Side-impact / T-bone collision
☐ Pedestrian accident
☐ Bicycle accident
☐ Motorcycle accident
☐ Trucking / commercial vehicle accident
☐ Slip and fall / Premises liability
☐ Dog bite / Animal attack
☐ Product liability
☐ Medical malpractice
☐ Other: [________________________________]
B. Narrative of Events
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
C. Police Report / Incident Documentation
Responding Agency: [________________________________]
Report Number: [________________________________]
Investigating Officer: [________________________________]
Badge Number: [________________________________]
The official report documents the following:
- [________________________________]
- [________________________________]
- [________________________________]
Citations Issued to Defendant: ☐ Yes ☐ No
If yes, specify: [________________________________]
D. Witnesses
| # | Witness Name | Contact Information | Summary of Testimony |
|---|---|---|---|
| 1 | [________________] | [________________] | [________________] |
| 2 | [________________] | [________________] | [________________] |
| 3 | [________________] | [________________] | [________________] |
E. Photographic and Video Evidence
☐ Photographs of accident scene
☐ Photographs of vehicle damage / hazardous condition
☐ Photographs of Claimant's visible injuries
☐ Surveillance camera footage
☐ Dashcam / bodycam footage
☐ Cell phone photographs or video
☐ Other: [________________________________]
III. LIABILITY ANALYSIS UNDER ILLINOIS LAW
A. Liability Position
Claimant contends that Defendant owed an applicable duty of care, breached that duty, caused the occurrence and resulting injuries, and is responsible for the damages documented below. Counsel must tailor these allegations to the claim type, facts, and available proof.
B. Defendant's Breach of Duty
Your insured breached the applicable duty of care in the following respects:
☐ Failure to exercise due care and caution
☐ Failure to yield the right-of-way
☐ Following too closely
☐ Excessive speed / violation of speed limits
☐ Violation of traffic control device
☐ Distracted driving / use of electronic device
☐ Driving under the influence
☐ Failure to maintain reasonably safe premises
☐ Violation of local building code or safety ordinance
☐ Negligent entrustment
☐ Respondeat superior / vicarious liability
☐ Other: [________________________________]
Specific breaches:
[________________________________]
[________________________________]
C. Illinois Modified Comparative Negligence (51% Bar Rule)
735 ILCS 5/2-1116 provides:
"In all actions on account of bodily injury or death or physical damage to property... the plaintiff shall be barred from recovering damages if the trier of fact finds that the contributory fault on the part of the plaintiff is more than 50% of the proximate cause of the injury or damage for which recovery is sought."
For claims within the statute, Illinois's modified comparative-fault rule provides:
- The plaintiff is barred from any recovery if found more than 50% at fault
- If the plaintiff is 50% or less at fault, damages are reduced by the plaintiff's fault percentage
Application to This Case: Claimant contends that your insured bears [____]% of the fault for this incident. Claimant was [not at fault / minimally at fault] because [________________________________].
D. Joint and Several Liability (735 ILCS 5/2-1117)
For negligence and strict-product-liability claims within the statute:
- All defendants found liable are jointly and severally liable for the plaintiff's past and future medical and medically related expenses
- A defendant allocated 25% or more of the total fault described in the statute is jointly and severally liable for all other damages
- A defendant allocated less than 25% of that total fault is severally liable for all other damages
Application to This Case: Claimant contends that your insured's statutory fault allocation is [____]%. Counsel should apply Section 2-1117 only after identifying every relevant party, third-party defendant, claim theory, and statutory exception.
E. Statutory or Ordinance Violation
☐ This case involves a potentially relevant statutory or ordinance violation: [________________________________]
Provision, protected class, facts, and proposed legal effect: [________________________________]
IV. INJURIES AND MEDICAL TREATMENT
A. Summary of Injuries
As a direct and proximate result of this incident, Claimant sustained the following injuries:
☐ Traumatic brain injury (TBI) / Concussion
☐ Cervical spine injury (herniation, bulge, fracture)
☐ Thoracic spine injury
☐ Lumbar spine injury (herniation, bulge, fracture)
☐ Shoulder injury (rotator cuff tear, labral tear)
☐ Knee injury (meniscus tear, ligament tear, fracture)
☐ Hip injury (fracture, labral tear)
☐ Rib fractures
☐ Facial lacerations / scarring / disfigurement
☐ Dental injuries
☐ Wrist / hand / finger fractures or sprains
☐ Ankle / foot fractures or sprains
☐ Internal organ injury
☐ Soft tissue injuries (sprains, strains, contusions)
☐ Post-traumatic stress disorder (PTSD)
☐ Anxiety / Depression
☐ Chronic pain syndrome
☐ Other: [________________________________]
Primary Diagnoses (ICD-10 Codes):
- [________________________________] — [________]
- [________________________________] — [________]
- [________________________________] — [________]
- [________________________________] — [________]
- [________________________________] — [________]
B. Chronological Treatment History
Emergency / Initial Treatment
Date: [__/__/____]
Provider: [________________________________]
Facility: [________________________________]
Arrived Via: ☐ Ambulance ☐ Self ☐ Other
Treatment: [________________________________]
Findings: [________________________________]
Primary Care / Follow-Up Treatment
| Date | Provider | Treatment | Notes |
|---|---|---|---|
| [__/__/____] | [________________] | [________________] | [________________] |
| [__/__/____] | [________________] | [________________] | [________________] |
| [__/__/____] | [________________] | [________________] | [________________] |
| [__/__/____] | [________________] | [________________] | [________________] |
Specialist Treatment
Specialist: [________________________________]
Specialty: [________________________________]
Treatment Period: [__/__/____] through [__/__/____]
Treatment Provided: [________________________________]
Findings/Recommendations: [________________________________]
Diagnostic Imaging
| Date | Type | Facility | Findings |
|---|---|---|---|
| [__/__/____] | ☐ X-ray ☐ MRI ☐ CT ☐ EMG/NCS ☐ Other | [________________] | [________________] |
| [__/__/____] | ☐ X-ray ☐ MRI ☐ CT ☐ EMG/NCS ☐ Other | [________________] | [________________] |
| [__/__/____] | ☐ X-ray ☐ MRI ☐ CT ☐ EMG/NCS ☐ Other | [________________] | [________________] |
Physical Therapy / Rehabilitation
Provider: [________________________________]
Treatment Period: [__/__/____] through [__/__/____]
Number of Sessions: [____]
Treatment Modalities: [________________________________]
Progress / Outcome: [________________________________]
Surgical Treatment (if applicable)
Date: [__/__/____]
Surgeon: [________________________________]
Facility: [________________________________]
Procedure: [________________________________]
Outcome: [________________________________]
Pain Management (if applicable)
Provider: [________________________________]
Treatment Period: [__/__/____] through [__/__/____]
Treatment Modalities:
☐ Epidural steroid injections
☐ Facet joint injections
☐ Nerve blocks
☐ Trigger point injections
☐ Radiofrequency ablation
☐ Medication management
☐ Other: [________________________________]
C. Current Condition and Prognosis
Claimant's current condition:
[________________________________]
[________________________________]
Treating Physician's Prognosis:
[________________________________]
☐ Claimant has reached Maximum Medical Improvement (MMI)
☐ Claimant continues active treatment
☐ Future surgery is recommended: [________________________________]
☐ Permanent impairment rating assigned: [____]% whole person
D. Future Medical Treatment
| Treatment | Provider | Estimated Duration | Estimated Cost |
|---|---|---|---|
| [________________] | [________________] | [________________] | $[________] |
| [________________] | [________________] | [________________] | $[________] |
| [________________] | [________________] | [________________] | $[________] |
☐ A life care plan has been prepared by [________________________________] and is enclosed.
V. DAMAGES CALCULATION
A. Past Medical Expenses (Itemized)
| # | Provider | Description | Dates of Service | Amount Billed |
|---|---|---|---|---|
| 1 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| 2 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| 3 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| 4 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| 5 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| 6 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| 7 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| 8 | [________________] | [________________] | [__/__/____] – [__/__/____] | $[________] |
| TOTAL PAST MEDICAL EXPENSES | $[________] |
B. Future Medical Expenses
| # | Treatment/Provider | Estimated Duration | Annual Cost | Total Estimated Cost |
|---|---|---|---|---|
| 1 | [________________] | [________________] | $[________] | $[________] |
| 2 | [________________] | [________________] | $[________] | $[________] |
| 3 | [________________] | [________________] | $[________] | $[________] |
| TOTAL FUTURE MEDICAL EXPENSES | $[________] |
C. Past Lost Wages / Income
Employer: [________________________________]
Position/Title: [________________________________]
Rate of Pay: $[________] per ☐ hour ☐ week ☐ month ☐ year
Period of Absence: [__/__/____] through [__/__/____]
Total Days Missed: [____]
Verification: ☐ Employer letter ☐ Tax returns ☐ Pay stubs
| Description | Amount |
|---|---|
| Lost Wages / Salary | $[________] |
| Lost Overtime | $[________] |
| Lost Bonuses / Commissions | $[________] |
| Lost Benefits (health insurance, retirement) | $[________] |
| Used Paid Time Off / Sick Leave | $[________] |
| TOTAL PAST LOST WAGES | $[________] |
D. Future Lost Earning Capacity
Basis for Claim: [________________________________]
Vocational Expert: [________________________________]
Economist: [________________________________]
Projected Loss Period: [____] years
Present Value of Future Lost Earnings: $[________]
E. Noneconomic Damages (Pain and Suffering)
Claimant has suffered and continues to suffer:
☐ Physical pain and suffering (past and ongoing)
☐ Mental and emotional distress
☐ Anxiety, depression, and PTSD
☐ Loss of enjoyment of life
☐ Loss of normal life
☐ Scarring and disfigurement
☐ Physical limitations and disability
☐ Loss of independence
☐ Interference with marital relationship
☐ Other: [________________________________]
Narrative of Impact on Daily Life:
[________________________________]
[________________________________]
[________________________________]
Noneconomic Damages Claimed: $[________]
F. Loss of Consortium (if applicable)
Spouse/Partner Name: [________________________________]
Description of Impact: [________________________________]
Amount Claimed: $[________]
G. Property Damage
| Item | Description | Amount |
|---|---|---|
| Vehicle damage / Total loss | [________________] | $[________] |
| Diminished value | [________________] | $[________] |
| Rental vehicle / Loss of use | [________________] | $[________] |
| Personal property | [________________] | $[________] |
| TOTAL PROPERTY DAMAGE | $[________] |
H. Out-of-Pocket Expenses
| Item | Amount |
|---|---|
| Prescription medications | $[________] |
| Medical devices / equipment | $[________] |
| Mileage to/from medical appointments | $[________] |
| Home modifications | $[________] |
| Household help / assistance | $[________] |
| Other: [________________] | $[________] |
| TOTAL OUT-OF-POCKET | $[________] |
I. Summary of All Damages
| Category | Amount |
|---|---|
| Past Medical Expenses | $[________] |
| Future Medical Expenses | $[________] |
| Past Lost Wages / Income | $[________] |
| Future Lost Earning Capacity | $[________] |
| Noneconomic Damages (Pain & Suffering) | $[________] |
| Loss of Consortium | $[________] |
| Property Damage | $[________] |
| Out-of-Pocket Expenses | $[________] |
| TOTAL DAMAGES | $[________] |
VI. INSURANCE COVERAGE ANALYSIS
A. Defendant's Liability Coverage
Carrier: [________________________________]
Policy Number: [________________________________]
Bodily Injury Limits: $[________] / $[________] (per person / per accident)
Property Damage Limits: $[________]
Umbrella / Excess Policy: ☐ Yes ☐ No ☐ Unknown — Limits: $[________]
Motor-vehicle note: For a vehicle subject to 625 ILCS 5/7-601, the liability policy must meet the Section 7-203 minimums: $25,000 for bodily injury or death of one person, $50,000 for two or more persons in one crash, and $20,000 for property damage in one crash. Confirm the policy, vehicle, and any statutory exception.
B. Claimant's Coverage
Carrier: [________________________________]
Policy Number: [________________________________]
☐ Uninsured Motorist (UM): $[________] / $[________]
☐ Underinsured Motorist (UIM): $[________] / $[________]
☐ Medical Payments (MedPay): $[________]
☐ Collision Coverage: $[________] (deductible: $[________])
UM/UIM note: Section 143a requires bodily-injury uninsured-motorist coverage at least at the Section 7-203 minimums. Section 143a-2 generally includes additional UM coverage equal to the insured's bodily-injury liability limits unless the insured makes the written lower-limit election or rejection described there. When UM limits exceed the statutory minimums, Section 143a-2(4) requires UIM coverage equal to the UM limits. Confirm the policy, elections, covered vehicle, insured status, offsets, notice, consent, and other conditions.
C. Other Potential Coverage
☐ Homeowner's / Renter's insurance
☐ Commercial general liability
☐ Workers' compensation
☐ Health insurance subrogation / lien: $[________]
☐ Medicare / Medicaid lien: $[________]
☐ ERISA lien: $[________]
VII. PREJUDGMENT INTEREST
Under 735 ILCS 5/2-1303(c), Illinois provides for prejudgment interest in personal injury and wrongful death actions:
"In all actions brought to recover damages for personal injury or wrongful death... the plaintiff shall recover prejudgment interest on all damages, except punitive damages, sanctions, statutory attorney's fees, and statutory costs, set forth in the judgment."
Key Provisions:
- Rate: 6% per annum
- Accrual: Begins on the date the action is filed
- Maximum Period: 5 years
- Voluntary dismissal: Accrual is tolled from voluntary dismissal until refiling
- Timely defense offer: A qualifying written offer can reduce the principal on which interest is calculated or eliminate prejudgment interest if the judgment does not exceed the offer
- Government defendants: The State and other governmental entities listed in subsection (c) are not liable for this prejudgment interest
Calculation (if suit has been filed):
- Total compensatory damages: $[________]
- Date suit filed: [__/__/____]
- Rate: 6% per annum
- Accrued prejudgment interest to date: $[________]
Interest notice: If suit has been filed and subsection (c) applies, prejudgment interest will be determined from the judgment, exclusions, accrual period, and any qualifying written defense settlement offer. This demand does not itself determine the statutory calculation.
VIII. PUNITIVE DAMAGES
☐ This case does involve conduct warranting punitive damages.
☐ This case does not currently involve a claim for punitive damages.
Punitive damages are claim- and defendant-specific. Do not include them without confirming that the governing cause of action permits them and that the facts and procedure support them.
For a wrongful-death action filed on or after August 11, 2023, 740 ILCS 180/2 permits punitive damages when otherwise applicable, but excludes healing-art malpractice, legal malpractice, and actions against the State, a unit of local government, or covered government employees in the capacities specified by the statute. The section also preserves the applicability of the limits identified in its text.
If applicable, punitive damages are warranted because:
[________________________________]
[________________________________]
IX. SETTLEMENT DEMAND
Based on the foregoing analysis of liability, injuries, damages, and applicable Illinois law, Claimant hereby demands the total sum of:
$[________________________________]
This demand is made in good faith and represents the full value of Claimant's damages under Illinois law. This amount includes all economic damages, noneconomic damages, and applicable prejudgment interest.
Response Deadline: This demand shall remain open for [____] days from the date of this letter, specifically until [__/__/____].
Method of Response: Please respond in writing to the undersigned at the address listed above.
X. STATUTE OF LIMITATIONS WARNING
IMPORTANT: 735 ILCS 5/13-202 generally requires an action for damages for injury to the person to be commenced within two years after the cause of action accrued. Accrual is not stated as invariably identical to the incident date, and other statutes can create different periods, repose rules, notice requirements, tolling rules, or exceptions for particular claims, defendants, and claimants.
Incident date: [__/__/____]
Attorney-calculated accrual date: [__/__/____]
Attorney-calculated filing deadline: [__/__/____]
Different period, notice rule, tolling provision, or exception considered: [________________________________]
If this matter is not resolved prior to the statute of limitations deadline, Claimant will file suit without further notice.
XI. RESERVATION OF RIGHTS AND LITIGATION WARNING
Claimant expressly reserves the right to:
- File suit in the appropriate Illinois Circuit Court if this matter is not resolved by the stated deadline
- Seek all damages available under Illinois law, including economic damages, noneconomic damages, prejudgment interest (735 ILCS 5/2-1303), costs, and attorney's fees where applicable
- Seek punitive damages where the evidence supports such a claim
- Pursue additional parties whose negligence contributed to Claimant's injuries, invoking joint and several liability under 735 ILCS 5/2-1117
- Pursue UM/UIM benefits if the tortfeasor's coverage is insufficient
- Assert any separately verified insurance remedy supported by the policy, facts, and governing law
- Claim additional damages discovered after the date of this letter
This demand letter is a settlement communication and is not a complete statement of all facts, injuries, or damages. Investigation is ongoing.
XII. MEDICAL RECORDS AND EXHIBITS INDEX
Medical Records and Bills
☐ Emergency room records and bills — [________________________________]
☐ Hospital records and bills — [________________________________]
☐ Primary care physician records — [________________________________]
☐ Specialist records and bills — [________________________________]
☐ Physical therapy records and bills — [________________________________]
☐ Chiropractic records and bills — [________________________________]
☐ Pain management records and bills — [________________________________]
☐ Surgical records — [________________________________]
☐ Diagnostic imaging reports — [________________________________]
☐ Pharmacy records — [________________________________]
☐ Mental health treatment records — [________________________________]
☐ Medical narrative / causation letter — [________________________________]
☐ Life care plan — [________________________________]
Employment and Income Documentation
☐ Employer verification of lost wages letter
☐ Pay stubs / earnings statements
☐ Tax returns (prior 3 years)
☐ Vocational expert report
☐ Economist report
Incident Documentation
☐ Police report / incident report
☐ Photographs of accident scene
☐ Photographs of injuries
☐ Photographs of property damage
☐ Witness statements
☐ Surveillance / dashcam footage
☐ Expert reports (accident reconstruction, etc.)
Insurance Documentation
☐ Defendant's declarations page
☐ Claimant's declarations page
☐ UM/UIM information
☐ Health insurance lien documentation
☐ Medicare / Medicaid conditional payment information
Other
☐ Prior demand correspondence
☐ [________________________________]
☐ [________________________________]
XIII. SIGNATURE BLOCK
Respectfully submitted,
[________________________________]
Attorney for Claimant
Illinois ARDC No.: [________________________________]
[________________________________]
[Law Firm Name]
[Address]
[City], Illinois [ZIP]
Tel: [________________________________]
Fax: [________________________________]
Email: [________________________________]
Date: [__/__/____]
XIV. SOURCES AND REFERENCES
Illinois Statutes
- Illinois General Assembly, 735 ILCS 5/2-1116 — limitation on recovery in tort actions.
- Illinois General Assembly, 735 ILCS 5/2-1117 — joint liability.
- Illinois General Assembly, 735 ILCS 5/2-1303 — judgment and prejudgment interest.
- Illinois General Assembly, 735 ILCS 5/13-202 — personal-injury limitations period.
- Illinois General Assembly, 740 ILCS 180/2 — wrongful-death damages and limitations.
- Illinois General Assembly, 625 ILCS 5/7-203 — minimum policy or bond limits.
- Illinois General Assembly, 625 ILCS 5/7-601 — required liability insurance policy.
- Illinois General Assembly, 215 ILCS 5/143a — uninsured-motorist coverage.
- Illinois General Assembly, 215 ILCS 5/143a-2 — additional UM and UIM coverage.
Current official text verified August 3, 2026. Official ILGA text was fetched this session, and legislative-index results were screened for recent bills referencing the cited sections. Public Act 104-0120, effective January 1, 2026, references Section 2-1303 but does not amend its prejudgment-interest subsection.
This template is designed for use by licensed Illinois attorneys. It must be customized to the specific facts and circumstances of each case. All statutory citations should be verified as current before use. This document does not constitute legal advice.
About this template
- Last updated
- August 3, 2026
- Citations checked
- August 3, 2026
- Jurisdiction
- Illinois
- Category
- Personal Injury
Legal authority
- 735 ILCS 5/2-1116 (Modified Comparative Negligence — 51% Bar)
- 735 ILCS 5/2-1117 (Joint and Several Liability)
- 735 ILCS 5/2-1303 (Prejudgment Interest — 6% Per Annum)
- 735 ILCS 5/13-202 (Personal-Injury Limitations Period — 2 Years After Accrual)
- 740 ILCS 180/2 (Wrongful-Death Damages; Limited Punitive-Damages Amendment)
- 625 ILCS 5/7-601 (Mandatory Auto Liability Insurance)
- 625 ILCS 5/7-203 (Minimum Insurance Coverage Amounts)
- 215 ILCS 5/143a (Minimum Uninsured-Motorist Coverage)
- 215 ILCS 5/143a-2 (Additional UM and Underinsured-Motorist Coverage)
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.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on August 3, 2026.
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