DEMAND FOR SETTLEMENT - MEDICAL MALPRACTICE

[FIRM NAME]
Attorneys at Law
[Street Address]
[City, State ZIP]
Telephone: [Phone]
Facsimile: [Fax]
Email: [Email]

DATE: [Date]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND FIRST-CLASS MAIL

[Risk Management / Claims Administrator / Insurance Carrier]
[Hospital / Medical Group / Insurance Company Name]
[Street Address]
[City, State ZIP]

RE: MEDICAL MALPRACTICE CLAIM - SETTLEMENT DEMAND
Patient/Claimant: [Client Full Name]
Date(s) of Negligent Care: [Date or Date Range]
Healthcare Provider(s): [Provider Name(s)]
Facility: [Hospital/Clinic Name]
Claim Number: [If assigned]

Dear [Recipient Name]:

This firm represents [Client Name] in connection with the medical malpractice that occurred during [his/her] care and treatment at [Facility Name] by [Healthcare Provider Name(s)]. This letter constitutes formal notice of our client's claim and our demand for settlement.

[STATE-SPECIFIC NOTICE: INSERT APPLICABLE PRE-SUIT NOTICE LANGUAGE]

[For states requiring pre-suit notice - e.g., Florida:]
"This letter constitutes notice of intent to initiate litigation as required by [State] Statutes Section [Number]. This notice initiates the [90-day] presuit screening period."

I. PRE-SUIT COMPLIANCE NOTICE

[CRITICAL: CUSTOMIZE THIS SECTION FOR STATE-SPECIFIC REQUIREMENTS]

We hereby certify the following pre-suit requirements have been met:

☐ Certificate of Merit: An appropriately qualified medical expert has reviewed the relevant medical records and has provided a written opinion that the applicable standard of care was breached and that such breach caused injury to our client.

☐ Pre-Suit Notice: This letter serves as the required pre-suit notice under [State statute]. The statutory waiting period of [number] days will begin upon receipt of this notice.

☐ Expert Affidavit: An affidavit of merit executed by a qualified medical expert [is attached / will be filed with the complaint / has been filed as required].

☐ Medical Review Panel: [If applicable] A claim has been filed with the medical review panel as required by [State] law.

Expert Certification:

Pursuant to [State] law, we certify that we have consulted with a qualified medical expert who has reviewed the medical records and other relevant materials in this matter. Based on this review, the expert has concluded that there is a reasonable basis to believe:

1. The healthcare provider(s) named herein failed to comply with the applicable standard of care; and
2. Such failure was a proximate cause of the injuries sustained by our client.

II. PRESERVATION OF EVIDENCE - LITIGATION HOLD

YOU ARE HEREBY DIRECTED TO PRESERVE ALL EVIDENCE relating to the care and treatment of [Client Name], including but not limited to:

☐ Complete medical records (paper and electronic)
☐ All versions of electronic medical records (including audit trails showing modifications)
☐ Nursing notes, medication administration records, and flow sheets
☐ All diagnostic imaging studies (X-rays, CT scans, MRIs, ultrasounds) and reports
☐ Laboratory results and pathology reports
☐ Operative reports and anesthesia records
☐ Consultation notes
☐ Informed consent documents
☐ Patient correspondence and communications
☐ Incident/occurrence reports
☐ Peer review and quality assurance records (to the extent discoverable)
☐ Policies, procedures, and protocols in effect at the time of treatment
☐ Credentialing files for involved healthcare providers
☐ Staffing records and schedules
☐ Equipment maintenance and calibration records
☐ Training records for involved personnel
☐ Any recorded statements or interviews
☐ Insurance policies and communications with insurers

Modification, destruction, or concealment of any records will result in claims of spoliation, sanctions, and adverse inference instructions.

III. FACTUAL BACKGROUND

A. Patient History and Presentation

[Client Name], a [age]-year-old [male/female], presented to [Facility/Provider] on [Date] with [chief complaint / reason for visit]:

Relevant Medical History:
☐ [Relevant past medical history]
☐ [Relevant surgical history]
☐ [Current medications]
☐ [Allergies]
☐ [Relevant family history]
☐ [Relevant social history]

Presenting Symptoms:
☐ [Symptom 1]
☐ [Symptom 2]
☐ [Symptom 3]

B. Chronology of Negligent Care

[Provide detailed chronological account of the medical care at issue]

[Date/Time]: [Describe what occurred]

[Date/Time]: [Describe what occurred]

[Date/Time]: [Describe what occurred]

[Continue with detailed chronology]

C. The Medical Error(s)

[Describe specifically what the healthcare provider(s) did wrong]:

[CUSTOMIZE BASED ON TYPE OF MALPRACTICE:]

☐ Misdiagnosis / Failure to Diagnose:
[Describe the correct diagnosis that was missed, the signs and symptoms that should have led to the correct diagnosis, and the delay or failure that occurred]

☐ Surgical Error:
[Describe the surgical error - wrong site, retained foreign object, organ damage, etc.]

☐ Medication Error:
[Describe the medication error - wrong drug, wrong dose, drug interaction, allergy ignored, etc.]

☐ Failure to Treat:
[Describe the condition that required treatment and the failure to provide appropriate treatment]

☐ Delayed Treatment:
[Describe the delay and the consequences of that delay]

☐ Birth Injury:
[Describe the obstetric or neonatal error and resulting injury]

☐ Anesthesia Error:
[Describe the anesthesia complication and how it occurred]

☐ Hospital Negligence:
[Describe institutional failures - staffing, infection control, falls, etc.]

☐ Failure to Obtain Informed Consent:
[Describe the lack of adequate informed consent]

D. Discovery of Malpractice

[Describe when and how the malpractice was discovered - important for statute of limitations]

Our client [did not discover / could not have reasonably discovered] the malpractice until [Date], when [describe discovery circumstances]. Prior to this time, [describe why earlier discovery was not possible - the injury was latent, the medical records were not available, the providers concealed the error, etc.].

IV. STANDARD OF CARE ANALYSIS

A. Applicable Standard of Care

The standard of care applicable to [Defendant Healthcare Provider] is that degree of care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably competent [specialty] physicians/healthcare providers.

Based on our expert's analysis, the applicable standard of care required [Defendant] to:

☐ [Standard 1 - e.g., "Obtain a complete patient history including allergies before prescribing medication"]
☐ [Standard 2 - e.g., "Order appropriate diagnostic tests when presented with symptoms of [condition]"]
☐ [Standard 3 - e.g., "Timely refer the patient to a specialist when [condition] was suspected"]
☐ [Standard 4 - e.g., "Follow established protocols for [procedure/treatment]"]
☐ [Standard 5]

B. Breaches of the Standard of Care

[Defendant Healthcare Provider] breached the applicable standard of care in the following specific ways:

Breach 1: [Detailed description of breach]
- What the standard required: [Describe]
- What the provider did or failed to do: [Describe]
- How this deviated from the standard: [Describe]

Breach 2: [Detailed description of breach]
- What the standard required: [Describe]
- What the provider did or failed to do: [Describe]
- How this deviated from the standard: [Describe]

Breach 3: [Continue as needed]

C. Expert Opinion Summary

We have retained [Expert Name, M.D.], a board-certified [Specialty] physician with [number] years of experience in [relevant area], to review this matter. [Dr./Expert Name] has concluded, to a reasonable degree of medical certainty/probability, that:

1. [Defendant Provider] breached the applicable standard of care by [summarize breaches];

2. These breaches were a direct and proximate cause of [describe injuries/damages];

3. Had appropriate care been rendered, [describe what would have happened - e.g., "the patient's condition would have been diagnosed and treated in time to prevent the resulting injury," "the surgical complication would have been avoided," etc.].

[Note: Full expert report available upon request / will be provided as required by applicable rules]

V. CAUSATION

A. Factual Causation

But for the defendant's breach of the standard of care, our client would not have suffered the injuries described herein. Specifically:

☐ Had [Defendant] properly [diagnosed / treated / monitored / etc.] the patient, [describe what would have occurred differently]
☐ The [delay / error / omission] directly caused [describe causal chain]
☐ The injuries sustained were the direct, foreseeable result of the defendant's negligence

B. Proximate Causation

The injuries sustained by our client were foreseeable consequences of the defendant's negligence. It is well-established in the medical literature that [describe how the type of negligence leads to the type of injury].

C. Loss of Chance (If Applicable)

[For cases where negligence reduced chances of better outcome:]

Even if the defendant's negligence did not, with certainty, cause our client's ultimate injury, it substantially reduced [his/her] chance of a better outcome. Prior to the negligent care, our client had a [percentage]% chance of [survival / recovery / avoiding the adverse outcome]. As a direct result of the defendant's negligence, that chance was reduced to [percentage]%.

[Note: Some jurisdictions recognize loss of chance as a separate theory of recovery]

VI. INJURIES AND DAMAGES

A. Physical Injuries Caused by Malpractice

As a direct and proximate result of the defendant's medical negligence, our client has suffered:

Primary Injuries:
☐ [Injury 1 - e.g., "Advancement of cancer from Stage II to Stage IV due to delayed diagnosis"]
☐ [Injury 2 - e.g., "Permanent nerve damage requiring below-knee amputation"]
☐ [Injury 3 - e.g., "Hypoxic brain injury resulting in permanent cognitive impairment"]
☐ [Injury 4]

Secondary Complications:
☐ [Complication 1]
☐ [Complication 2]
☐ [Complication 3]

Current Medical Status:
[Describe client's current condition, ongoing treatment needs, and prognosis]

B. Medical Expenses

Past Medical Expenses (Attributable to Malpractice):

Future Medical Expenses:

Based on our client's life expectancy and the opinions of treating physicians and life care planning experts:

C. Lost Earnings and Earning Capacity

Past Lost Wages:
| Period | Amount |
|--------|--------|
| [Date range] | $[Amount] |
| TOTAL PAST LOST WAGES | $[Total] |

Future Lost Earning Capacity:

[Describe impact on ability to work]

Based on vocational and economic analysis:
| Category | Amount |
|----------|--------|
| Lost Future Earnings | $[Amount] |
| Lost Benefits (Health, Retirement) | $[Amount] |
| Lost Career Advancement | $[Amount] |
| TOTAL FUTURE LOST EARNINGS | $[Total] |

D. Non-Economic Damages

[NOTE: Check for state damage caps on non-economic damages in medical malpractice cases]

Physical Pain and Suffering:
- [Describe the pain caused by the malpractice and subsequent treatment]
- [Describe ongoing pain and discomfort]

Emotional Distress:
- [Describe psychological impact - anxiety, depression, PTSD]
- [Describe impact of dealing with preventable medical crisis]
- [Describe loss of trust in medical profession]

Loss of Enjoyment of Life:
- [Describe activities and life experiences lost]
- [Describe impact on family relationships]
- [Describe impact on daily activities]

Disfigurement/Physical Impairment:
- [Describe any permanent disfigurement]
- [Describe permanent physical limitations]

Loss of Consortium (Spouse's Claim):
- [Describe impact on marital relationship]

E. Summary of Damages

[IF STATE HAS DAMAGE CAP:]

Note: [State] imposes a cap of $[Amount] on non-economic damages in medical malpractice cases pursuant to [Statute Citation]. However, [describe any exceptions - e.g., "this cap does not apply in cases of death or catastrophic injury," "the cap is unconstitutional under [case name]," etc.].

VII. SETTLEMENT DEMAND

A. Demand Amount

Based upon the clear breach of the standard of care, the severity of our client's injuries, and the substantial economic and non-economic damages, we hereby demand:

$[DEMAND AMOUNT]

[OR - Policy Limits Demand:]

TENDER OF FULL POLICY LIMITS OF $[AMOUNT]

B. Allocation (If Multiple Defendants)

[If multiple defendants:]

We demand the following allocation of liability:

C. Time for Response

This demand will remain open for [30/45/60/90] days from the date of this letter, through and including [Expiration Date].

[For states with pre-suit investigation periods:]

This letter initiates the [number]-day pre-suit investigation period pursuant to [State statute]. We expect a substantive response, including access to medical records, within this period.

D. Pre-Suit Conference (If Required/Requested)

[For states requiring pre-suit conferences - e.g., Florida:]

We request a pre-suit conference to discuss this claim and explore settlement possibilities. We are available for such conference during the statutory pre-suit period.

VIII. INSURANCE AND INDEMNIFICATION

We demand disclosure of:

☐ All professional liability insurance policies applicable to this claim
☐ Policy limits for each applicable policy
☐ Hospital/institutional liability coverage
☐ Any self-insured retention amounts
☐ Excess/umbrella coverage
☐ Any indemnification agreements between defendants

IX. DOCUMENTATION ENCLOSED

☐ Medical records (relevant portions supporting claim)
☐ Medical bills and itemized statements
☐ Expert affidavit/certificate of merit (as required by state law)
☐ Employment and wage records
☐ Life care plan (if prepared)
☐ Economic loss analysis (if prepared)
☐ Photographs documenting injuries/condition
☐ HIPAA authorizations

X. ADDITIONAL NOTICES

A. Statute of Limitations

The statute of limitations for medical malpractice in [State] is [number] years from [date of injury / date of discovery / date of termination of treatment]. Based on our analysis:

• Date of negligent care: [Date]
• Date of discovery: [Date]
• Applicable limitations period expires: [Date]

We reserve all rights regarding tolling, the discovery rule, and other doctrines that may extend the limitations period.

B. Punitive Damages (If Applicable)

[If conduct warrants:]

The conduct of [Defendant] in this matter rises to the level of [gross negligence / recklessness / willful and wanton conduct / intentional misconduct] warranting punitive damages. Specifically, [describe egregious conduct - e.g., "the defendant falsified medical records," "the defendant was impaired while treating the patient," "the defendant ignored multiple obvious warning signs," etc.].

C. Peer Review / National Practitioner Data Bank

Be advised that we intend to report this matter to the National Practitioner Data Bank and applicable state medical boards as required by law following any settlement or judgment.

XI. CONCLUSION

This case involves clear medical negligence that caused catastrophic, life-altering injuries to our client. The breach of the standard of care is supported by expert opinion, and the causal connection between the negligence and our client's injuries is direct and undeniable.

Medical malpractice cases are expensive and time-consuming to litigate for all parties. We believe early resolution serves everyone's interests. However, we are fully prepared to litigate this matter through trial if necessary.

We urge you to give this matter serious attention and to respond promptly.

Respectfully submitted,

[FIRM NAME]

By: _________________________________
[Attorney Name]
[State Bar Number]
Attorney for [Client Name]

ENCLOSURES: [List]

cc: [Client Name]
[File]
[State Medical Board - if required]

PRE-SUBMISSION CHECKLIST

Pre-Suit Requirements (CRITICAL - Verify for Your State):
☐ Identified all pre-suit requirements for jurisdiction
☐ Certificate of merit obtained from qualified expert
☐ Expert affidavit prepared (if required)
☐ Pre-suit notice requirements satisfied
☐ Medical review panel filing completed (if required)
☐ Waiting period calculated and noted

Substantive Preparation:
☐ All medical records obtained and reviewed
☐ Expert has provided written opinion
☐ Causation analysis complete
☐ Damages fully documented
☐ Economic/life care planning expert retained (if needed)
☐ Damage caps researched and applied (if applicable)

Procedural Items:
☐ Statute of limitations verified (including discovery rule)
☐ All potentially liable parties identified
☐ Correct entities named (physician vs. group vs. hospital)
☐ Insurance coverage information obtained
☐ Liens identified (Medicare, Medicaid, ERISA, etc.)

STATE-SPECIFIC REQUIREMENTS QUICK REFERENCE

[VERIFY CURRENT LAW - This is a general reference only]

[ALWAYS VERIFY CURRENT LAW BEFORE RELYING ON THIS CHART]

Medical malpractice claims have the most complex procedural requirements of any personal injury case. This template must be extensively customized for your jurisdiction. Failure to comply with pre-suit requirements can result in dismissal. Always verify current law and consult with experienced medical malpractice counsel.