PERSONAL INJURY DEMAND LETTER — WISCONSIN
FOR SETTLEMENT PURPOSES ONLY — WIS. STAT. § 904.08 PROTECTED
HEADER INFORMATION
SENT VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
Date: [__/__/____]
FROM:
[________________________________]
Attorney at Law
[________________________________]
[________________________________]
[________________________________]
Telephone: [________________________________]
Facsimile: [________________________________]
Email: [________________________________]
Wisconsin State Bar No.: [________________________________]
TO:
[________________________________]
Claims Adjuster / Claims Department
[________________________________] Insurance Company
[________________________________]
[________________________________]
RE: PERSONAL INJURY DEMAND
| Field | Detail |
|---|---|
| Claimant: | [________________________________] |
| Claimant DOB: | [__/__/____] |
| Date of Loss: | [__/__/____] |
| Claim Number: | [________________________________] |
| Policy Number: | [________________________________] |
| Insured/Tortfeasor: | [________________________________] |
| Location of Incident: | [________________________________], Wisconsin |
| Police Report No.: | [________________________________] |
| Investigating Agency: | [________________________________] |
I. INTRODUCTION AND PURPOSE
This letter constitutes a formal demand for compensation on behalf of our client, [________________________________] ("Claimant"), for personal injuries and damages sustained as a direct and proximate result of the negligence of your insured, [________________________________] ("Tortfeasor"), on [__/__/____] in [________________________________], Wisconsin.
This firm represents Claimant in all claims arising from this incident. All communications should be directed exclusively to this office.
This demand is protected under Wis. Stat. § 904.08 (settlement communications).
WISCONSIN COMPARATIVE FAULT: Under Wis. Stat. § 895.045, Wisconsin applies modified comparative negligence with a 51% bar. A plaintiff is barred if the plaintiff's negligence is "greater than" the negligence of the defendant — i.e., barred if more than 50% at fault. If 50% or less, recovery is reduced proportionally. Wisconsin also has a unique joint and several liability threshold at 51%: defendants found 51% or more at fault are jointly and severally liable.
II. FACTUAL BACKGROUND
A. Pre-Incident Conditions
On [__/__/____], at approximately [____] [a.m./p.m.], Claimant was [________________________________] at or near [________________________________], Wisconsin.
Weather: [________________________________]
Road conditions: [________________________________]
Lighting: [________________________________]
Traffic: [________________________________]
B. The Incident
[________________________________]
[________________________________]
[________________________________]
[________________________________]
C. Emergency Response
☐ Police called — Report No.: [________________________________]
☐ EMS responded — Report No.: [________________________________]
☐ Claimant transported by ambulance to [________________________________]
☐ Claimant sought treatment at [________________________________]
☐ Fire department responded
☐ Photographs taken at scene
☐ Witness statements obtained
D. Witnesses
| Witness | Contact | Observations |
|---|---|---|
| [________________________________] | [________________________________] | [________________________________] |
| [________________________________] | [________________________________] | [________________________________] |
| [________________________________] | [________________________________] | [________________________________] |
E. Police Report
Officer [________________________________], [________________________________]:
- [________________________________]
- [________________________________]
☐ Citations to tortfeasor: [________________________________]
☐ No citations to Claimant
III. LIABILITY ANALYSIS UNDER WISCONSIN LAW
A. Negligence Standard
Wisconsin negligence elements:
- Duty of care owed by the tortfeasor
- Breach of the standard of care
- Cause-in-fact — "but for" the breach, injury would not have occurred
- Proximate cause — foreseeable consequences
- Damages — actual, compensable injuries
Note: Wisconsin uses a "substantial factor" test for cause-in-fact in some cases, rather than the strict "but for" test.
B. Tortfeasor's Acts of Negligence
☐ Failure to maintain proper lookout
☐ Failure to yield right of way
☐ Following too closely (Wis. Stat. § 346.14)
☐ Distracted driving / handheld device (Wis. Stat. § 346.89(4m))
☐ Excessive speed (Wis. Stat. § 346.57)
☐ Failure to obey traffic signals (Wis. Stat. § 346.37)
☐ Improper lane change
☐ OWI / DUI (Wis. Stat. § 346.63)
☐ Reckless driving (Wis. Stat. § 346.62)
☐ Failure to maintain vehicle
☐ Other: [________________________________]
C. Modified Comparative Negligence (Wis. Stat. § 895.045)
Wisconsin's statute provides:
"Contributory negligence does not bar recovery in an action by any person... to recover damages for negligence resulting in death or in injury to person or property, if that negligence was not greater than the negligence of the person against whom recovery is sought."
Key Principles:
- Plaintiff is barred if more than 50% at fault
- If 50% or less, recovery reduced by plaintiff's percentage of negligence
- When multiple defendants: plaintiff's negligence is compared to each defendant separately for purposes of the bar
Claimant bears NO fault. The tortfeasor is 100% responsible.
D. Joint and Several Liability (Wis. Stat. § 895.045(3))
Wisconsin has a two-tier liability system:
- Defendant 51% or more at fault: Jointly and severally liable for all damages
- Defendant less than 51% at fault: Severally liable only — responsible for only that defendant's proportionate share
Practical Significance: If the tortfeasor is found 51%+ at fault, the tortfeasor (and the insurer) is liable for the entire damages award, even if other parties share some fault.
E. Collateral Source Rule
Wisconsin follows the collateral source rule. Evidence of benefits received from collateral sources (health insurance, disability, etc.) is generally inadmissible to reduce the plaintiff's damages. The tortfeasor must compensate the plaintiff for the full amount of medical expenses incurred.
F. Negligence Per Se
Statutory violations:
- Wis. Stat. § [________________________________]: [________________________________]
- Wis. Stat. § [________________________________]: [________________________________]
IV. INJURIES AND MEDICAL TREATMENT
A. Summary of Injuries
Primary Diagnoses:
- [________________________________]
- [________________________________]
- [________________________________]
Secondary/Associated Conditions:
- [________________________________]
- [________________________________]
B. Injury Checklist
☐ Traumatic brain injury / Concussion
☐ Cervical spine injury (herniation / bulge / fracture)
☐ Thoracic spine injury
☐ Lumbar spine injury
☐ Shoulder injury (rotator cuff / labral)
☐ Knee injury (ACL / MCL / meniscus)
☐ Hip injury / fracture
☐ Rib fractures
☐ Extremity fractures
☐ Facial lacerations / scarring
☐ Soft tissue injuries
☐ Nerve damage / radiculopathy
☐ PTSD / anxiety / depression
☐ TMJ dysfunction
☐ Other: [________________________________]
C. Chronological Treatment History
| Date(s) | Provider / Facility | Treatment | Notes | Cost |
|---|---|---|---|---|
| [__/__/____] | [________________________________] | Emergency department | [________________________________] | $[________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
D. Diagnostic Imaging
| Date | Study | Facility | Findings |
|---|---|---|---|
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] |
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] |
E. Surgical Procedures
| Date | Procedure | Surgeon | Facility | Cost |
|---|---|---|---|---|
| [__/__/____] | [________________________________] | [________________________________] | [________________________________] | $[________________________________] |
F. Prognosis
Treating physician [________________________________]:
- [________________________________]
- MMI: ☐ Reached [__/__/____] ☐ Not yet reached
- Impairment rating: [____]%
- Future treatment: [________________________________]
- Future medical costs: $[________________________________]
V. DAMAGES CALCULATION
A. Economic Damages (No Cap)
| Category | Amount |
|---|---|
| Past Medical Expenses | |
| Emergency / hospital | $[________________________________] |
| Ambulance | $[________________________________] |
| Primary care | $[________________________________] |
| Specialists | $[________________________________] |
| Surgery | $[________________________________] |
| Physical therapy | $[________________________________] |
| Chiropractic | $[________________________________] |
| Imaging | $[________________________________] |
| Medications | $[________________________________] |
| DME | $[________________________________] |
| Mental health | $[________________________________] |
| Subtotal — Past Medical | $[________________________________] |
| Future Medical | $[________________________________] |
| Past Lost Wages | $[________________________________] |
| Future Lost Earning Capacity | $[________________________________] |
| Property Damage | $[________________________________] |
| Other Economic | $[________________________________] |
| TOTAL ECONOMIC DAMAGES | $[________________________________] |
B. Non-Economic Damages
Wisconsin Non-Economic Damages Cap: The $750,000 cap on non-economic damages under Wis. Stat. § 893.55(4)(d)(1) applies only to medical malpractice cases. In general personal injury cases, there is no cap on non-economic damages. (The Wisconsin Supreme Court struck down a prior general PI non-economic cap in Ferdon ex rel. Petrucelli v. Wisconsin Patients Comp. Fund, 2005 WI 125, 284 Wis. 2d 573.)
| Category | Amount |
|---|---|
| Physical pain and suffering (past and future) | $[________________________________] |
| Mental anguish / emotional distress | $[________________________________] |
| Loss of enjoyment of life | $[________________________________] |
| Loss of society and companionship | $[________________________________] |
| Inconvenience | $[________________________________] |
| Disfigurement / scarring | $[________________________________] |
| Physical impairment | $[________________________________] |
| Loss of consortium | $[________________________________] |
| TOTAL NON-ECONOMIC DAMAGES | $[________________________________] |
C. Total Damages Summary
| Component | Amount |
|---|---|
| Economic Damages | $[________________________________] |
| Non-Economic Damages | $[________________________________] |
| TOTAL DAMAGES | $[________________________________] |
VI. INSURANCE COVERAGE ANALYSIS
A. Tortfeasor's Liability Coverage
| Coverage | Limits |
|---|---|
| Insurer | [________________________________] |
| Policy Number | [________________________________] |
| BI — Per Person | $[________________________________] |
| BI — Per Accident | $[________________________________] |
| Property Damage | $[________________________________] |
| Umbrella / Excess | $[________________________________] |
Wisconsin Auto Insurance Minimums (Wis. Stat. § 344.33):
- $25,000/$50,000 bodily injury; $10,000 property damage (25/50/10)
B. UM/UIM Coverage
Wisconsin requires UM coverage (Wis. Stat. § 632.32). UIM must be offered.
| Coverage | Limits |
|---|---|
| Insurer | [________________________________] |
| UM — Per Person | $[________________________________] |
| UM — Per Accident | $[________________________________] |
| UIM — Per Person | $[________________________________] |
| UIM — Per Accident | $[________________________________] |
C. MedPay
| Coverage | Limits |
|---|---|
| MedPay available | $[________________________________] |
| MedPay utilized | $[________________________________] |
VII. PREJUDGMENT INTEREST
A. Insurance Claim Interest (Wis. Stat. § 628.46(1))
Overdue insurance claim payments bear simple interest at 7.5% per annum. A claim payment is overdue if not paid within 30 days after the insurer receives a properly supported proof of loss.
B. Offer of Settlement Interest (Wis. Stat. § 807.01(4))
If the claimant makes a formal offer of settlement that is rejected and subsequently obtains a judgment more favorable than the rejected offer, the claimant may be entitled to prejudgment interest on the amount of the judgment.
| Component | Value |
|---|---|
| Damages subject to interest | $[________________________________] |
| Interest rate | 7.5% per annum |
| Estimated prejudgment interest | $[________________________________] |
VIII. PUNITIVE DAMAGES
Applicability (Wis. Stat. § 895.043)
Punitive damages in Wisconsin require proof by clear and convincing evidence that the defendant acted:
- Maliciously; or
- In intentional disregard of the rights of the plaintiff
Statutory Cap (Wis. Stat. § 895.043(6))
Punitive damages are capped at the greater of:
- Two (2) times the amount of compensatory damages; or
- $200,000
☐ Punitive damages sought: [________________________________]
☐ Punitive damages not sought at this time
IX. SETTLEMENT DEMAND
SETTLEMENT DEMAND: $[________________________________]
Terms:
- Payment within thirty (30) days of receipt
- Certified funds to [________________________________], Attorney Trust Account
- Full and final release upon payment
- Inclusive of all claims from the incident
- Excludes first-party insurance claims (MedPay, UM/UIM)
Note: This demand also constitutes a formal offer of settlement for purposes of Wis. Stat. § 807.01(4). If rejected and Claimant obtains a more favorable judgment at trial, prejudgment interest will apply.
X. STATUTE OF LIMITATIONS AND RESERVATION OF RIGHTS
Statute of Limitations
Under Wis. Stat. § 893.54, the SOL for personal injury is three (3) years.
| Item | Date |
|---|---|
| Date of Incident | [__/__/____] |
| SOL Expiration | [__/__/____] |
| Days Remaining | [____] days |
Reservation of Rights
Claimant reserves all rights, including filing suit, amending damages, pursuing punitive damages, pursuing UM/UIM claims, seeking prejudgment interest, and all other remedies under Wisconsin law.
WARNING: If this demand is not accepted, Claimant will file suit. Wisconsin's joint and several liability rule means that a defendant found 51% or more at fault is liable for the entire damages award. Additionally, prejudgment interest at 7.5% will accrue on overdue claim payments. The collateral source rule ensures full medical expense recovery.
XI. MEDICAL RECORDS AND EXHIBITS INDEX
☐ Emergency department records
☐ Ambulance / EMS report
☐ Hospital records
☐ Primary care records
☐ Specialist records
☐ Physical therapy records
☐ Chiropractic records
☐ Mental health records
☐ Surgical records
☐ Imaging reports
☐ Prescription records
☐ Medical narrative report
☐ Itemized bills
☐ EOBs
☐ Employer wage verification
☐ Tax returns
☐ Police report
☐ Photographs (scene, vehicle, injuries)
☐ Witness statements
☐ Property damage documentation
XII. SIGNATURE
Respectfully submitted,
[________________________________]
Attorney for Claimant
Wisconsin State Bar No.: [________________________________]
[________________________________]
Firm Name
[________________________________]
Address
Telephone: [________________________________]
Email: [________________________________]
Date: [__/__/____]
XIII. SOURCES AND REFERENCES
Wisconsin Statutes
- Wis. Stat. § 895.045 — Modified comparative negligence (51% bar)
- Wis. Stat. § 895.045(3) — Joint and several liability (51%+ at fault)
- Wis. Stat. § 893.54 — Statute of limitations (3 years)
- Wis. Stat. § 893.55(4)(d)(1) — Med mal non-economic cap ($750,000)
- Wis. Stat. § 895.043 — Punitive damages (2x compensatory or $200K)
- Wis. Stat. § 628.46(1) — Insurance claim interest (7.5%)
- Wis. Stat. § 807.01(4) — Offer of settlement prejudgment interest
- Wis. Stat. § 344.33 — Auto insurance minimums (25/50/10)
- Wis. Stat. § 632.32 — UM/UIM coverage
- Wis. Stat. § 895.04 — Wrongful death
- Wis. Stat. § 346.63 — OWI/DUI
- Wis. Stat. § 346.62 — Reckless driving
Key Wisconsin Cases
- Ferdon ex rel. Petrucelli v. Wisconsin Patients Comp. Fund, 2005 WI 125 — Struck down general PI non-economic cap
Key Wisconsin Principles
- Modified comparative fault with 51% bar
- Joint and several liability for defendants 51%+ at fault; several only below 51%
- No cap on non-economic damages in general PI (cap applies only in med mal at $750K)
- Punitive damages capped at greater of 2x compensatory or $200K
- Collateral source rule applies
- Prejudgment interest at 7.5% on overdue insurance payments
- Auto minimums: 25/50/10
- 3-year statute of limitations
- Wisconsin is a fault-based tort state
This template does not constitute legal advice and must be reviewed by a licensed Wisconsin attorney before use.
About This Template
Jurisdiction-Specific
This template is drafted specifically for Wisconsin, incorporating applicable state statutes, local court rules, and jurisdiction-specific compliance requirements.
How It's Made
Drafted using current statutory databases and legal standards for personal injury. Each template includes proper legal citations, defined terms, and standard protective clauses.
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: March 2026