Maryland Personal Injury Demand Letter

PERSONAL INJURY DEMAND LETTER

STATE OF MARYLAND

Before you use this: Identify the actual claim-handling rule and response period. Md. Code, Ins. § 27-1001 applies only to actions under Cts. & Jud. Proc. § 3-1701; it does not supply this third-party settlement demand's response clock.

SETTLEMENT COMMUNICATION

For settlement discussion; admissibility depends on applicable evidence law

SENDER INFORMATION

Law Firm/Attorney: [________________________________]

Bar Number: [________________________________]

Address: [________________________________]

City, State, ZIP: [________________________________]

Telephone: [________________________________]

Facsimile: [________________________________]

Email: [________________________________]

RECIPIENT INFORMATION

Date: [__/__/____]

Insurance Company: [________________________________]

Claims Department Address: [________________________________]

City, State, ZIP: [________________________________]

Adjuster Name: [________________________________]

Claim Number: [________________________________]

Policy Number: [________________________________]

Insured Name: [________________________________]

Date of Loss: [__/__/____]

RE: DEMAND FOR SETTLEMENT

Claimant: [________________________________]

Date of Birth: [__/__/____]

Date of Incident: [__/__/____]

Location of Incident: [________________________________]

Type of Claim: ☐ Motor Vehicle Accident ☐ Premises Liability ☐ Other negligence-based injury claim: [________________________________]

I. INTRODUCTION AND PURPOSE

This letter constitutes a formal demand for settlement on behalf of [________________________________] ("Claimant") for personal injuries, economic losses, and non-economic damages sustained as a direct and proximate result of the negligence of your insured, [________________________________], on [__/__/____].

This demand supplies the incident, injury, loss, and supporting information identified below so you can evaluate a proposed settlement. The requested response date appears in Section XIV.

II. STATEMENT OF FACTS

A. Pre-Incident Background

Prior to the incident, Claimant was a [____]-year-old [________________________________] (occupation). Relevant pre-incident conditions or injuries, if any, and Claimant's physical condition can be described as follows:

[________________________________]
[________________________________]
[________________________________]

B. Detailed Description of the Incident

Date: [__/__/____]

Time: [____:____] ☐ AM ☐ PM

Location: [________________________________]

County: [________________________________], Maryland

Weather Conditions: [________________________________]

Road/Surface Conditions: [________________________________]

Narrative of Events:

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

C. Emergency Response

911 Called: ☐ Yes ☐ No

Time of Call: [____:____] ☐ AM ☐ PM

Responding Agency: [________________________________]

Report Number: [________________________________]

Emergency Medical Services: ☐ Yes ☐ No

EMS Provider: [________________________________]

Transport Destination: [________________________________]

D. Witnesses

III. LIABILITY ANALYSIS

A. Negligence of Your Insured

Your insured, [________________________________], was negligent in the following respects:

☐ Failed to maintain a proper lookout
☐ Failed to yield the right of way
☐ Operated a vehicle at an excessive rate of speed
☐ Violated Maryland Transportation Article § [________________________________]
☐ Failed to maintain premises in a reasonably safe condition
☐ Failed to warn of known dangerous conditions
☐ Violated applicable building codes or safety regulations
☐ Other: [________________________________]

Specific Acts of Negligence:

1. [________________________________]
2. [________________________________]
3. [________________________________]
4. [________________________________]

B. Claimant Conduct and Defenses

Assess the claimant's conduct and any asserted defense under the current law governing this claim. Determine whether contributory negligence, assumption of risk, or another doctrine applies to the pleaded theory and evidence.

Evidence concerning claimant conduct:

The following evidence addresses Claimant's conduct and the defenses raised or reasonably anticipated:

1. [________________________________]
2. [________________________________]
3. [________________________________]
4. [________________________________]

Supporting Evidence:

☐ Police report confirms your insured was solely at fault
☐ Traffic citation issued to your insured for: [________________________________]
☐ Witness statements confirm Claimant's proper conduct
☐ Video/photographic evidence establishes Claimant's actions were reasonable
☐ Expert analysis confirms Claimant could not have avoided the incident
☐ Other: [________________________________]

C. Additional Defense Response, If Supported

Identify any additional response to an asserted defense only after confirming the governing rule and its elements under current controlling authority.

Facts supporting that response, if any:

[________________________________]
[________________________________]
[________________________________]

IV. DETAILED DESCRIPTION OF INJURIES

A. Initial Injuries Sustained

Immediately following the incident, Claimant sustained the following injuries:

Primary Injuries:

1. [________________________________]
2. [________________________________]
3. [________________________________]
4. [________________________________]

Secondary/Associated Injuries:

1. [________________________________]
2. [________________________________]
3. [________________________________]

B. Diagnosis Codes (ICD-10)

C. Detailed Injury Narrative

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

D. Permanent Conditions/Residual Effects

If supported by the medical record, the following residual conditions are claimed:

☐ Chronic pain in [________________________________]
☐ Limited range of motion in [________________________________]
☐ Scarring/disfigurement to [________________________________]
☐ Nerve damage affecting [________________________________]
☐ Cognitive impairment including [________________________________]
☐ Post-traumatic stress affecting [________________________________]
☐ Other permanent conditions: [________________________________]

V. MEDICAL TREATMENT HISTORY

A. List of Medical Providers

B. Treatment Timeline

Emergency/Acute Phase ([__/__/____] - [__/__/____])

Date: [__/__/____]
Provider: [________________________________]
Type of Visit: ☐ Emergency Room ☐ Urgent Care ☐ Ambulance Transport
Treatment Rendered: [________________________________]
Findings: [________________________________]
Recommendations: [________________________________]

Date: [__/__/____]
Provider: [________________________________]
Type of Visit: [________________________________]
Treatment Rendered: [________________________________]
Findings: [________________________________]
Recommendations: [________________________________]

Active Treatment Phase ([__/__/____] - [__/__/____])

Primary Care/Specialist Visits:

Physical Therapy/Rehabilitation:

Diagnostic Imaging/Testing:

Surgical Procedures (if applicable):

Maintenance/Ongoing Phase ([__/__/____] - Present)

Current Treatment Status:

☐ Treatment completed; discharged to self-care
☐ Treatment completed with permanent restrictions
☐ Ongoing maintenance care required
☐ Additional treatment recommended: [________________________________]

Prognosis:

[________________________________]
[________________________________]
[________________________________]

VI. MEDICAL EXPENSE BREAKDOWN

A. Itemized Medical Expenses

B. Summary of Medical Expenses by Category

C. Health Insurance/Subrogation Information

Health Insurance Carrier: [________________________________]

Policy Number: [________________________________]

Amount Paid by Health Insurance: $[________]

Subrogation/Lien Amount: $[________]

Medicare/Medicaid Involvement: ☐ Yes ☐ No

If Yes, Conditional Payment Amount: $[________]

VII. LOST WAGES AND LOSS OF EARNING CAPACITY

A. Employment Information

Employer: [________________________________]

Position/Title: [________________________________]

Employment Start Date: [__/__/____]

Employment Status at Time of Incident: ☐ Full-Time ☐ Part-Time ☐ Self-Employed

Work Schedule: [____] hours per week

B. Income Documentation

Hourly Rate: $[________] OR Annual Salary: $[________]

Average Weekly Gross Income: $[________]

Average Weekly Net Income: $[________]

Additional Compensation (bonuses, commissions, overtime): $[________]

C. Lost Time Calculation

TOTAL PAST LOST WAGES: $[________]

D. Verification

☐ Employer verification letter attached
☐ Pay stubs for 6 months prior to incident attached
☐ Tax returns for [____] year(s) attached
☐ Self-employment income documentation attached

E. Loss of Earning Capacity (if applicable)

Pre-Incident Earning Capacity: $[________] per year

Post-Incident Earning Capacity: $[________] per year

Annual Reduction: $[________]

Work Life Expectancy: [____] years

Present Value Calculation: $[________]

Basis for Calculation:

[________________________________]
[________________________________]
[________________________________]

VIII. PAIN AND SUFFERING NARRATIVE

A. Physical Pain and Discomfort

The injuries sustained by Claimant have caused and continue to cause significant physical pain and suffering. In Claimant's own words:

[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]
[________________________________]

Pain Level Assessment:

• Initial pain level (0-10 scale): [____]
• Peak pain level during treatment: [____]
• Current pain level: [____]
• Activities that aggravate pain: [________________________________]

B. Emotional and Psychological Impact

The incident and resulting injuries have had a profound emotional and psychological impact on Claimant:

☐ Anxiety, particularly related to [________________________________]
☐ Depression symptoms including [________________________________]
☐ Post-traumatic stress symptoms including [________________________________]
☐ Sleep disturbances including [________________________________]
☐ Fear of [________________________________]
☐ Mood changes affecting [________________________________]
☐ Other psychological effects: [________________________________]

Narrative:

[________________________________]
[________________________________]
[________________________________]
[________________________________]

C. Impact on Daily Living Activities

The injuries have significantly impacted Claimant's ability to perform normal daily activities:

D. Impact on Recreational Activities and Hobbies

Prior to this incident, Claimant regularly engaged in the following activities that have been curtailed or eliminated:

E. Impact on Family and Social Relationships

[________________________________]
[________________________________]
[________________________________]
[________________________________]

F. Loss of Consortium (if applicable)

Spouse Name: [________________________________]

The injuries have adversely affected the marital relationship in the following ways:

[________________________________]
[________________________________]
[________________________________]

IX. PROPERTY DAMAGE

A. Vehicle Damage (if applicable)

Year/Make/Model: [________________________________]

VIN: [________________________________]

Fair Market Value (Pre-Incident): $[________]

Damage Assessment:

☐ Repairable – Estimated Repair Cost: $[________]
☐ Total Loss – Actual Cash Value: $[________]

Body Shop/Appraiser: [________________________________]

Estimate Number: [________________________________]

B. Other Property Damage

C. Loss of Use

Rental Vehicle Cost: $[________] for [____] days

Other Transportation Expenses: $[________]

TOTAL PROPERTY DAMAGE: $[________]

X. FUTURE MEDICAL CARE AND EXPENSES

A. Recommended Future Treatment

Based on the opinions of Claimant's treating physicians, the following future medical care is reasonably anticipated:

B. Future Surgical Procedures (if anticipated)

C. Life Care Plan Summary (if applicable)

A life care plan has been prepared by [________________________________], which projects lifetime medical costs of $[________]. Key components include:

[________________________________]
[________________________________]
[________________________________]

D. Future Medical Expense Summary

XI. MARYLAND-SPECIFIC DAMAGES CONSIDERATIONS

A. Non-Economic Damages Cap

Pursuant to Md. Code, Cts. & Jud. Proc. § 11-108, Maryland imposes a statutory cap on non-economic damages in personal injury actions. The cap increases by $15,000 each year on October 1st.

Cap for a covered cause arising October 1, 2026 through September 30, 2027: $980,000 per direct victim and persons claiming through that victim.

Use the date the cause arose under § 11-108 to select the cap period. Section 11-108 does not supply the cap for a covered post-2005 health-claims verdict; use the separate medical-malpractice workflow for that claim.

Date of Incident: [__/__/____]

Applicable Non-Economic Damages Cap: $[________]

B. Multiple Defendants

If multiple defendants are involved, identify each person's alleged conduct, causation, and the current authority for the requested allocation of liability.

C. Payments and Adjustments

Document billed charges, adjustments, amounts paid, outstanding balances, and any liens or reimbursement claims. Determine the recoverable medical-expense amount and treatment of third-party payments under current controlling authority.

XII. SUMMARY OF DAMAGES

A. Economic Damages (Special Damages)

B. Non-Economic Damages (General Damages)

Note: Non-economic damages are subject to the statutory cap under Md. Code, Cts. & Jud. Proc. § 11-108.

C. Total Demand

XIII. SETTLEMENT DEMAND

Based upon the foregoing, we hereby demand payment in the amount of:

$[________________________________]

to fully and finally settle all claims arising from this incident.

This demand represents fair compensation for Claimant's injuries, economic losses, and non-economic damages, and takes into account:

☐ The clear liability of your insured
☐ Claimant's complete freedom from contributory negligence
☐ The severity and permanence of Claimant's injuries
☐ The substantial economic losses incurred
☐ The significant impact on Claimant's quality of life
☐ The applicable statutory cap on non-economic damages
☐ Potential verdict exposure at trial

XIV. RESPONSE DEADLINE AND CONSEQUENCES

A. Response Required

Please provide a written response to this demand by [__/__/____]. This is [a chosen negotiation date / a period required by the identified policy or verified law: ________].

B. Claim Handling

Please identify any additional information needed to evaluate the documented claim and the policy provision or other basis for any coverage position.

C. Statute of Limitations Notice

Md. Code, Cts. & Jud. Proc. § 5-101 generally measures three (3) years from the date the civil action at law accrues, unless another Code provision supplies a different period. Determine the claim-specific accrual rule, any special period, and tolling before calculating the deadline.

Date of Incident: [__/__/____]

Statute of Limitations Expiration: [__/__/____]

We reserve all rights to file suit prior to the expiration of the statute of limitations if a fair settlement cannot be reached.

D. Preservation of Evidence

This letter serves as formal notice to preserve all evidence related to this incident, including but not limited to:

• All documents, photographs, and video recordings
• All communications related to this claim
• All claim notes and investigation materials
• Vehicle(s) involved in the incident
• Electronic data and metadata

If evidence is lost, any remedy must be evaluated under current controlling authority and the actual record.

XV. DOCUMENTATION CHECKLIST

The following documents are enclosed with this demand:

Medical Records and Bills

☐ Emergency room records and bills
☐ Hospital admission/discharge records
☐ Primary care physician records
☐ Specialist consultation records
☐ Physical therapy records
☐ Chiropractic treatment records
☐ Diagnostic imaging reports (X-ray, MRI, CT)
☐ Surgical operative reports
☐ Prescription records
☐ Itemized medical bills from all providers
☐ Explanation of Benefits (EOBs)
☐ Health insurance lien/subrogation letter

Liability Documentation

☐ Police/incident report
☐ Photographs of accident scene
☐ Photographs of vehicle damage
☐ Photographs of injuries
☐ Witness statements
☐ Traffic citation(s)
☐ Surveillance/dashcam footage
☐ Expert reports (accident reconstruction, etc.)

Employment and Income Documentation

☐ Employer verification letter
☐ Pay stubs (6 months prior to incident)
☐ Tax returns ([____] years)
☐ W-2 forms
☐ Documentation of lost benefits

Property Damage Documentation

☐ Vehicle repair estimate
☐ Total loss valuation
☐ Rental car receipts
☐ Photographs of damaged property
☐ Receipts for damaged personal property

Other Documentation

☐ Claimant's affidavit/declaration
☐ Day-in-the-life documentation
☐ Correspondence with your company
☐ Prior demand letters (if any)
☐ Life care plan (if applicable)
☐ Vocational expert report (if applicable)
☐ Economic loss report (if applicable)

XVI. CONCLUSION

The enclosed evidence supports the liability and damages positions stated above, subject to the specific facts and defenses identified in this letter.

We trust that you will evaluate this claim in good faith and respond with a fair settlement offer within the time specified. We remain available to discuss this matter and to provide any additional information you may reasonably require.

If the matter cannot be resolved, Claimant may file an action in a court with jurisdiction.

Respectfully submitted,

Signature: [________________________________]

Printed Name: [________________________________]

Title: [________________________________]

Date: [__/__/____]

XVII. CLAIMANT AUTHORIZATION

I, [________________________________], hereby authorize my attorney to submit this demand on my behalf. I have reviewed the contents of this letter and confirm that the information provided is true and accurate to the best of my knowledge.

Claimant Signature: [________________________________]

Date: [__/__/____]

This letter is offered for settlement discussion. Its admissibility for any purpose is governed by applicable evidence law. The letter is not a complete statement of all facts and claims; all rights are reserved.