Loss of Consortium Demand Letter
Loss of Consortium Demand Letter
Before you use this: Select the law for the incident and claim. Establish that this claimant may bring the identified relationship claim, that the underlying injury claim supports it, and that the demand does not duplicate another person's damages. Share only personal or medical detail needed and authorized for this demand.
[LAW FIRM NAME AND ADDRESS]
[ATTORNEY NAME AND CONTACT]
[__/__/____]
Delivery method: [METHOD AND ADDRESS]
[INSURER, DEFENDANT, OR COUNSEL NAME]
[CLAIM OR CASE NUMBER]
Re: [CONSORTIUM CLAIMANT] and [INJURED PERSON]; incident on [__/__/____]
Dear [NAME]:
Our firm represents [CONSORTIUM CLAIMANT] regarding the effect of [INJURED PERSON]'s injuries on their [IDENTIFIED RELATIONSHIP]. We also represent [INJURED PERSON] in the underlying claim [YES/NO]; if no, counsel and contact for that claim are [NAME]. This is a settlement proposal concerning only the consortium claim identified below unless both claimants expressly authorize a combined resolution.
Legal and factual basis. The controlling law is [STATE OR OTHER JURISDICTION, CURRENT AUTHORITY AND PINPOINT]. It recognizes a claim by [RELATIONSHIP TYPE] in these circumstances because [ELIGIBILITY FACTS, INCLUDING DATE RELATIONSHIP BEGAN AND ANY REQUIRED STATUS]. The underlying claim is [CLAIM TYPE, ACTOR, DUTY, BREACH OR OTHER BASIS, CAUSATION, AND CURRENT STATUS]. We contend the incident affected this claimant's relationship as described below. Any limitation, defense, allocation, or derivative-claim condition is [IDENTIFIED AUTHORITY AND FACTS].
| Period or event | Relationship activity or service before incident | Documented change after incident | Record or witness |
|---|---|---|---|
| [DATES] | [SPECIFIC FACT] | [SPECIFIC FACT] | [SOURCE] |
| [DATES] | [SPECIFIC FACT] | [SPECIFIC FACT] | [SOURCE] |
The injured person's condition relevant to this claim is [MINIMUM FACTS NEEDED, WITH CONSENT AND SOURCE]. The claimed effect on companionship, shared activity, services, or other legally recognized interest is [PRECISE FACTS]. The duration supported by current evidence is [DATE RANGE]; any future projection is [EVIDENCE AND UNCERTAINTY / "NONE CLAIMED"]. We do not seek the injured person's own medical expenses, lost wages, or suffering in this claimant's demand unless the identified law separately permits and the item is not duplicated.
Settlement proposal: [CONSORTIUM CLAIMANT] offers to resolve [EXACT CLAIMS AND DATE RANGE] for $[AMOUNT], supported by [FACTUAL VALUATION AND ANY ITEMIZED ECONOMIC COMPONENT]. The proposed release would name [RELEASING PARTY AND RELEASED PERSONS] and take effect upon [SIGNED AGREEMENT AND CLEARED PAYMENT / OTHER AGREED EVENT]. Claims of [INJURED PERSON] and any other family member are [NOT INCLUDED / INCLUDED ONLY UNDER SEPARATE WRITTEN AUTHORITY AND ALLOCATION]. Any lien or third-party interest is [IDENTIFIED STATUS OR "NONE KNOWN"].
Please respond by [__/__/____] at [TIME AND TIME ZONE] to [CONTACT]. This is a proposed negotiation date, subject to any separate legal or court deadline. If you dispute eligibility, the underlying claim, causation, or the amount, please identify the basis and any records you would like us to review. We are available to discuss a supported resolution.
Sincerely,
Signature: ______________________________
[ATTORNEY NAME AND ROLE]
For [CONSORTIUM CLAIMANT]
Enclosures: [AUTHORIZED DECLARATION, RECORDS OR SUPPORTING SCHEDULE / "NONE"]
Delivery record: Sent [__/__/____] by [METHOD] to [DESTINATION]; proof [TRACKING OR RECEIPT].
About this template
- Last updated
- September 27, 2026
- Last reviewed
- September 30, 2026
- Jurisdiction
- All states
- Category
- Personal Injury
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 September 30, 2026.
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