Templates Personal Injury Loss of Consortium Demand Letter

Loss of Consortium Demand Letter

Ready to Edit

RELATIONSHIP-LOSS / CONSORTIUM DEMAND PREPARATION PACKET

1. Claim activation record

Do not send this packet. Confirm that the jurisdiction recognizes the selected claimant and theory.

Required item Verified information
Governing jurisdiction [________________________________]
Primary injured person and claim [________________________________]
Proposed consortium / relationship-loss claimant [________________________________]
Relationship and legally relevant dates [________________________________]
Authority recognizing this claimant and claim [________________________________]
Derivative, independent, or other classification [________________________________]
Required primary liability and injury findings [________________________________]
Defenses imputed from primary claim [________________________________]
Claim-specific defenses [________________________________]
Recognized damages elements [________________________________]
Excluded, overlapping, or duplicative damages [________________________________]
Proof and causation standard [________________________________]
Accrual, limitation, notice, and pre-suit rules [________________________________]
Joinder, pleading, and party requirements [________________________________]
Survival, death, divorce, separation, or relationship-change effect [________________________________]
Insurance coverage, limits, and allocation issue [________________________________]
Settlement, release, lien, fee, and tax review [________________________________]
Counsel [________________________________]

This packet supplies no default eligible relationship, damages category, claim status, response period, or settlement value.

2. Matter and claimant information

Field Entry
Primary claimant [________________________________]
Consortium / relationship claimant [________________________________]
Relationship [________________________________]
Relationship began / marriage or other legal date [________________________________]
Relationship status at incident and now [________________________________]
Incident / loss date [__/__/____]
Insured / responsible party [________________________________]
Insurer / administrator [________________________________]
Claim number(s) [________________________________]
Litigation status [________________________________]
Separate representation / conflict review [________________________________]

3. Primary claim dependency map

Primary issue Current status Evidence Effect on relationship claim
Duty / legal responsibility [________________] [________________] [________________]
Breach / wrongful conduct [________________] [________________] [________________]
Causation [________________] [________________] [________________]
Primary injuries [________________] [________________] [________________]
Comparative / contributory fault [________________] [________________] [________________]
Releases, waivers, settlements, or adjudications [________________] [________________] [________________]
Policy limits / collectability [________________] [________________] [________________]

Do not make admissions in the relationship claim that narrow or contradict the primary claim.

4. Governing element and damages matrix

Copy only elements and damages categories recognized for this claimant and jurisdiction.

Element / damages category Authority Required showing Supporting facts Evidence Overlap / objection risk Include?
[________________] [________________] [________________] [________________] [________________] [________________] [____]
[________________] [________________] [________________] [________________] [________________] [________________] [____]
[________________] [________________] [________________] [________________] [________________] [________________] [____]

Potential fact domains, if authorized, may include companionship, society, affection, services, care, assistance, intimacy, support, household contributions, or another specifically recognized interest. Do not treat the claimant's own emotional distress, medical condition, financial loss, children, or extended-family impact as part of the claim without authority.

5. Pre-incident baseline

Relationship activity or contribution Frequency / pattern before incident Source / witness Privacy concern
[________________] [________________] [________________] [________________]
[________________] [________________] [________________] [________________]
[________________] [________________] [________________] [________________]

Describe ordinary facts, not idealized or exaggerated conclusions. Identify preexisting limitations, relationship changes, caregiving duties, separations, or other facts that affect causation and credibility.

6. Post-incident change record

Period Specific change Primary injury causing change Frequency / duration Corroboration Current status
[________] [________________] [________________] [________________] [________________] [________________]
[________] [________________] [________________] [________________] [________________] [________________]
[________] [________________] [________________] [________________] [________________] [________________]

7. Services and economic-value analysis

Use only if the jurisdiction recognizes the category and avoid duplicating primary-claim economic damages.

Service / contribution Pre-incident frequency Lost / reduced period Replacement source Actual cost Valuation method Claimed by whom
[________________] [________________] [________________] [________________] [________] [________________] [________________]
[________________] [________________] [________________] [________________] [________] [________________] [________________]

Potential duplication with attendant care, household services, wage loss, medical expense, or primary claimant damages: [________________________________]

8. Duration and prognosis

Item Verified information / source
Primary injury prognosis [________________________________]
Functional limitations affecting relationship [________________________________]
Past loss period [________________________________]
Future loss period and evidentiary basis [________________________________]
Contingencies and uncertainty [________________________________]
Life-expectancy or present-value evidence, if authorized [________________________________]

Do not select a future number of years from a generic table without admissible evidence and jurisdiction-specific review.

9. Evidence and privacy plan

Evidence Fact supported Source / custodian Admissibility / foundation Privacy / privilege treatment Include in demand?
Claimant statement [________________] [________________] [________________] [________________] [____]
Primary claimant statement [________________] [________________] [________________] [________________] [____]
Family / friend witness [________________] [________________] [________________] [________________] [____]
Household / service records [________________] [________________] [________________] [________________] [____]
Photograph / calendar / activity record [________________] [________________] [________________] [________________] [____]
Expert or valuation evidence [________________] [________________] [________________] [________________] [____]
Medical or treatment evidence [________________] [________________] [________________] [________________] [____]

Avoid unnecessary intimate, medical, mental-health, child, or third-party information. Use factual summaries, redactions, or separate confidential transmission when appropriate.

10. Valuation and settlement allocation

Item Primary claim Relationship claim Combined / shared Notes
Past economic $[________] $[________] $[________] [________________]
Future economic $[________] $[________] $[________] [________________]
Non-economic $[________] $[________] $[________] [________________]
Other authorized category $[________] $[________] $[________] [________________]

Valuation method and authority: [________________________________]

Policy-limit and allocation issue: [________________________________]

Separate versus combined demand decision: [________________________________]

Settlement allocation can affect releases, liens, fees, taxes, allocation among claimants, and court approval. Obtain separate advice before using nominal or strategic allocations.

11. Release and conflict control

Issue Approved treatment
Separate client and engagement [________________________________]
Conflict between primary and relationship claimant [________________________________]
Authority to negotiate and accept [________________________________]
Separate settlement consent [________________________________]
Release scope for each claimant [________________________________]
Derivative-claim release effect [________________________________]
Indemnity / hold-harmless [________________________________]
Confidentiality / non-disparagement [________________________________]
Minor, estate, guardian, probate, bankruptcy, or court approval [________________________________]
Fee and cost allocation [________________________________]

12. Demand letter shell

[DATE]

VIA: [APPROVED METHOD]

[RECIPIENT]

Re: [PRIMARY CLAIMANT], [RELATIONSHIP CLAIMANT], [CLAIM NUMBER], [LOSS DATE]

Dear [________________________________]:

We represent [relationship claimant] concerning the relationship-loss claim recognized by [exact authority: ________________________________] arising from the injuries alleged by [primary claimant]. The claimant is eligible because [facts tied to authority: ________________________________].

Governing claim and elements

[________________________________]

Primary injury and causation

[________________________________]

Pre-incident relationship baseline

[________________________________]

Specific post-incident losses

[________________________________]

Duration and evidence

[________________________________]

Valuation and demand

Relationship claim demand: $[________________]

Combined resolution proposal, if authorized: $[________________]

Basis and allocation:

[________________________________]

Response

Please respond by [date selected for case reasons: ________________________________]. This date is not represented as a statutory deadline unless the activated authority record states otherwise.

This demand reserves only rights and claims available under the governing law and does not alter any applicable deadline.

Sincerely,

[COUNSEL]

13. Supporting-document index

ID Document Supports Date / pages Redaction / confidentiality Sent
[____] [________________] [________________] [________________] [________________] [____]
[____] [________________] [________________] [________________] [________________] [____]

14. Final checklist

☐ Claimant eligibility and relationship verified

☐ Claim classification and dependency on primary claim confirmed

☐ Each damages category supported by current authority

☐ Pre- and post-incident facts are specific and credible

☐ Duplicate damages and claimant allocations reconciled

☐ Sensitive evidence minimized and protected

☐ Conflicts, separate consent, releases, fees, liens, and tax issues reviewed

☐ Limitations, notice, joinder, and litigation deadlines calendared

☐ Response date presented accurately

☐ Complete sent copy and delivery proof retained

This packet must be reactivated for every claimant and jurisdiction. Never carry an eligible relationship, damages category, derivative-claim rule, response period, valuation, or release effect from another case without current official authority.

Ezel AI
Hi! Want this done for you? Tell me your situation and I'll fill in every section and tailor it to your state.
You get the finished Word & PDF in about 5 minutes. $99 one time for this document, or $249/mo for access to every document and every Ezel app. Want me to start?
AI Legal Assistant
Ezel AI
Hi! Want this done for you? Tell me your situation and I'll fill in every section and tailor it to your state.
You get the finished Word & PDF in about 5 minutes. $99 one time for this document, or $249/mo for access to every document and every Ezel app. Want me to start?

Insert Image

Insert Table

Watch Ezel in action (sample case)

All changes saved
Save
Export
Export as DOCX
Export as PDF
Generating PDF...
loss_of_consortium_demand_universal.pdf
Ready to export as PDF or Word
AI is editing...
Chat
Review

Get your finished document

Filled in for your situation. Drafting from scratch takes hours; finish yours in about 5 minutes for $99 one time.

  • Deep Legal Knowledge
    Understands case law, statutes, and legal doctrine.
  • Court-Ready Formatting
    Proper captions and local-rule compliance.
  • AI-Powered Editing
    Tailor every section to your case.
  • Export as PDF & Word
    Ready to file or send.
Secure checkout via Stripe
Need to customize this document?

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.

Checked against the law it cites

A reviewer verified this template's legal citations against the official source on 2026-08-15.

Legal authority: Applicable consortium or relationship-loss authorities, claimant-eligibility law, primary-claim law, damages and evidence authorities, limitations rules, settlement and release law, and court rules: [INSERT CURRENT OFFICIAL SOURCES BEFORE USE]

Last updated: 2026-08-15

Get your Loss of Consortium Demand Letter, done and ready to use

Fill it in for your situation, adjust it for your state, and download the finished Word and PDF. Let the AI do it in about 5 minutes, or finish it yourself in the editor. $99 one time, or go Pro for access to every document and every Ezel app.