TIME-LIMITED DEMAND LETTER
Statutory/Common Law Time-Limit Settlement Demand
[LAW FIRM LETTERHEAD]
DATE: [________________________________]
VIA: ☐ Certified Mail, Return Receipt Requested
AND: ☐ Email to [________________________________]
URGENT: TIME-LIMITED SETTLEMENT DEMAND
TO:
Insurance Company:
[INSURANCE COMPANY NAME]
[ADDRESS]
[CITY, STATE ZIP]
Adjuster: [________________________________]
Email: [________________________________]
Fax: [________________________________]
Claim Number: [________________________________]
Insured:
[INSURED NAME]
[ADDRESS]
[CITY, STATE ZIP]
NOTICE: THIS IS A TIME-LIMITED DEMAND
PURSUANT TO [CALIFORNIA CODE OF CIVIL PROCEDURE SECTIONS 999-999.5 / APPLICABLE STATE LAW / COMMON LAW], THIS LETTER CONSTITUTES A TIME-LIMITED DEMAND TO SETTLE THE BODILY INJURY CLAIM OF [CLIENT NAME].
I. DEMAND SUMMARY
| Field | Information |
|---|---|
| Claimant | [________________________________] |
| Date of Incident | [________________________________] |
| Insured | [________________________________] |
| Claim Number | [________________________________] |
| Policy Number | [________________________________] |
| Policy Limits | $[________________________________] |
| DEMAND AMOUNT | $[________________________] |
| DEADLINE | [DATE] at 5:00 PM [TIMEZONE] |
II. STATUTORY REQUIREMENTS (California CCP 999-999.5)
This time-limited demand complies with California Code of Civil Procedure Sections 999 through 999.5:
☐ This demand is in writing
☐ This demand is expressly identified as a "time-limited demand"
☐ This demand provides at least 30 days to respond (email) / 33 days (mail)
☐ This demand includes a description of all known injuries
☐ This demand includes reasonable proof of claim and damages
Under CCP 999.5, you may:
- Request clarification of this demand
- Request additional information reasonably needed to evaluate the claim
- Request an extension of time (which we may grant or deny)
Any such request must:
- Be made in writing within the response period
- Not constitute a counteroffer or rejection
- Specify the clarification or information needed
III. THE DEMAND
A. Settlement Amount
We demand $[DEMAND AMOUNT] to fully and finally settle all claims of [CLIENT NAME] against your insured arising from the incident of [DATE].
☐ This demand is for the full policy limits of $[LIMITS]
☐ This demand is for less than policy limits: $[AMOUNT]
B. Response Deadline
This demand expires on [DATE] at [TIME] [TIMEZONE].
C. Acceptance Method
To accept this demand, you must provide written acceptance before the deadline that:
- States you accept the demand amount of $[AMOUNT]
- Is unconditional
- Includes no counteroffer
- Confirms payment will be made within [___] days
D. Form of Payment
☐ Single draft payable to "[CLIENT NAME] and [LAW FIRM NAME]"
☐ Mailed to our office at [ADDRESS]
☐ OR wire transfer (instructions upon request)
IV. CONDITIONS OF SETTLEMENT
A. Release Terms
Upon receipt of payment, we will provide a release that:
☐ Releases only your insured (not the insurance company, unless limits paid)
☐ Releases all claims arising from the [DATE] incident
☐ Contains standard release language
☐ Does NOT contain:
- Confidentiality provisions
- Admission of liability by claimant
- Indemnification by claimant
- Non-disparagement clauses
- Other unusual terms
B. Dismissal (if suit filed)
☐ If suit has been filed, we will file a Request for Dismissal with prejudice within [___] days of payment
C. Other Conditions
[List any other specific conditions:]
☐ [________________________________]
☐ [________________________________]
All conditions stated herein are reasonable and capable of performance.
V. DESCRIPTION OF INCIDENT
[Provide clear description of the incident:]
On [DATE], at approximately [TIME], at [LOCATION], your insured [describe negligent conduct resulting in injury to claimant].
[________________________________]
[________________________________]
[________________________________]
VI. LIABILITY ANALYSIS
A. Evidence of Liability
☐ Police report finding insured at fault
☐ Citation(s) issued: [________________________________]
☐ Witness statements
☐ Physical evidence
☐ Video evidence
☐ Insured's admission
☐ Other: [________________________________]
B. Liability Conclusion
Liability against your insured is:
☐ Clear and undisputed
☐ Strongly supported by the evidence
☐ Sufficient to warrant settlement at this amount
VII. DESCRIPTION OF INJURIES
A. Injuries Sustained
[CLIENT NAME] sustained the following injuries as a direct result of the incident:
| Injury | ICD-10 Code |
|---|---|
| [________________________________] | [________] |
| [________________________________] | [________] |
| [________________________________] | [________] |
| [________________________________] | [________] |
B. Symptoms and Limitations
Current symptoms include:
- [________________________________]
- [________________________________]
- [________________________________]
Functional limitations:
- [________________________________]
- [________________________________]
C. Permanency
☐ Injuries have fully resolved
☐ Injuries are permanent
☐ Long-term prognosis uncertain
VIII. TREATMENT SUMMARY
A. Emergency Treatment
[________________________________]
B. Ongoing Treatment
| Provider | Specialty | Dates | Treatment |
|---|---|---|---|
| [________] | [________] | [________] | [________] |
| [________] | [________] | [________] | [________] |
| [________] | [________] | [________] | [________] |
C. Current Treatment Status
☐ Treatment completed
☐ Treatment ongoing
☐ Maximum Medical Improvement reached: [DATE]
IX. PROOF OF DAMAGES
A. Medical Expenses
| Provider | Amount |
|---|---|
| [________________________________] | $[________] |
| [________________________________] | $[________] |
| [________________________________] | $[________] |
| [________________________________] | $[________] |
| TOTAL MEDICAL EXPENSES | $[________] |
B. Lost Wages
| Category | Amount |
|---|---|
| Past Lost Wages | $[________] |
| Future Lost Wages/Earning Capacity | $[________] |
| TOTAL LOST WAGES | $[________] |
C. Other Special Damages
| Category | Amount |
|---|---|
| Out-of-pocket expenses | $[________] |
| Property damage | $[________] |
| Other | $[________] |
| TOTAL OTHER SPECIALS | $[________] |
D. Total Special Damages
TOTAL SPECIAL DAMAGES: $[________________________________]
X. ENCLOSED DOCUMENTATION
The following documentation is provided as reasonable proof of claim:
☐ Police/Incident Report
☐ Medical Records (summary or complete)
☐ Medical Bills (itemized)
☐ Photographs of Injuries
☐ Photographs of Property Damage
☐ Lost Wage Verification
☐ Other: [________________________________]
Additional records available upon reasonable request.
XI. RESPONSE OPTIONS
Under applicable law, you have the following response options:
A. Accept the Demand
Provide written, unconditional acceptance before the deadline.
B. Reject the Demand
You may reject this demand, but be advised that unreasonable rejection may:
- Subject your insured to excess judgment
- Expose you to bad faith liability
- Result in recovery of punitive damages
C. Request Clarification or Information
You may request clarification or additional information in writing. Such request:
- Will not be deemed a counteroffer or rejection
- Should specify what is needed
- May result in extension of the deadline at our discretion
D. Request Extension
You may request an extension of the deadline in writing, stating good cause. We will consider such requests but are not obligated to grant them.
E. Make Counteroffer
A counteroffer will be deemed a rejection of this demand. This demand will not be reinstated if rejected.
XII. EFFECT OF DEADLINE EXPIRATION
IF THIS DEMAND EXPIRES WITHOUT ACCEPTANCE:
- This offer is permanently withdrawn
- We are under no obligation to renew or extend the offer
- We will not remind you of the approaching deadline
- We will not contact you regarding the status of your evaluation
- A belated offer of the same or greater amount will NOT settle this case
- We will proceed to litigation
- Your insured will be exposed to excess judgment
- You may be exposed to bad faith liability
XIII. NOTICE TO INSURED
A copy of this demand is being provided to your insured at the address above.
[INSURED NAME]: You are being notified of this settlement demand because you have a personal stake in its resolution. If this demand is unreasonably rejected and a judgment is entered against you in excess of your policy limits, you may have claims against your insurance company. You may wish to consult with independent counsel.
XIV. MULTIPLE CLAIMANTS (if applicable)
☐ Not applicable
☐ Applicable: We are aware that there are [NUMBER] claimants. This demand is made without regard to other claims, and we assert that our client is entitled to the full [per-person limits / demanded amount].
XV. BAD FAITH NOTICE
This demand is made in good faith to provide your insured's insurance carrier a fair opportunity to resolve this claim within policy limits.
We put you on notice that:
- Liability is [clear / well-supported]
- Damages [meet or exceed / substantially exceed] policy limits
- The demand amount is reasonable
- All conditions are capable of performance
- Adequate time has been provided for evaluation
Unreasonable failure to accept this demand may constitute bad faith and expose you to:
- Liability for excess judgment
- Compensatory damages
- Punitive damages
- Attorney fees and costs
XVI. CONTACT INFORMATION
Direct all communications to:
[ATTORNEY NAME]
[LAW FIRM NAME]
[ADDRESS]
[CITY, STATE ZIP]
Phone: [________________________________]
Fax: [________________________________]
Email: [________________________________]
XVII. DEADLINE REMINDER
THIS DEMAND EXPIRES ON:
[DATE]
AT [TIME] [TIMEZONE]
We will NOT contact you to remind you of this deadline.
Very truly yours,
[SIGNATURE]
[ATTORNEY NAME]
Attorney for [CLIENT NAME]
[STATE BAR NUMBER]
Enclosures: As listed above
cc via Certified Mail:
- [INSURED NAME] at [ADDRESS]
- [CLIENT NAME]
- File
RESPONSE TRACKING
| Action | Date | Notes |
|---|---|---|
| Demand sent | [________] | |
| Deadline | [________] | |
| Response received | [________] | ☐ Accept ☐ Reject ☐ Info Request |
| Extension requested | [________] | ☐ Granted ☐ Denied |
| Final disposition | [________] |
| Field | Entry |
|---|---|
| File Number | [________________] |
| Demand Amount | $[________________] |
| Deadline | [________________] |
| CCP 999 Compliant | ☐ Yes ☐ N/A |
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About This Template
Jurisdiction-Specific
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Last updated: February 2026