UM/UIM (Uninsured/Underinsured Motorist) Demand Letter - Universal
UM/UIM CLAIM AND DEMAND — PREPARATION PACKET
Do not send this packet. Complete the policy, coverage, jurisdiction,
tortfeasor-settlement, damages, lien, deadline, and procedural registers.
Prepare each required notice, consent request, proof, demand, arbitration
filing, complaint, release, or settlement document separately.
1. Matter control
| Item | Verified entry |
|---|---|
| Claimant and contact | [________________________________] |
| Counsel | [________________________________] |
| Accident date, time, and location | [________________________________] |
| Claimant vehicle and role | [________________________________] |
| Other vehicle / tortfeasor | [________________________________] |
| UM/UIM insurer and claim number | [________________________________] |
| Other insurers and claim numbers | [________________________________] |
| Pending court, arbitration, or agency matter | [________________________________] |
| Proposed communication date | [__/__/____] |
| Earliest independent deadline | [________________________________] |
2. Policy and endorsement inventory
Obtain complete policies, declarations, endorsements, amendments, applications,
renewals, notices, and claim correspondence. Do not rely on a declarations page
or coverage label alone.
| Policy / coverage | Issuer | Named insured | Covered vehicle / person | Limit | Endorsement / form | Effective dates |
|---|---|---|---|---|---|---|
| [____] | [____] | [____] | [____] | $[____] | [____] | [____] |
| [____] | [____] | [____] | [____] | $[____] | [____] | [____] |
Policy provisions requiring verbatim review: [________________________________]
Choice-of-law, territory, arbitration, appraisal, suit, notice, cooperation,
consent, subrogation, exhaustion, offset, setoff, reduction, priority, other
insurance, anti-stacking, and settlement provisions: [________________________________]
3. Current-authority and coverage register
Complete a separate row for every jurisdiction and coverage issue.
| Issue | Policy text | Current authority | Facts | Counsel conclusion |
|---|---|---|---|---|
| Person qualifies for coverage | [____] | [____] | [____] | [____] |
| Vehicle and accident qualify | [____] | [____] | [____] | [____] |
| Uninsured or underinsured classification | [____] | [____] | [____] | [____] |
| Trigger and exhaustion | [____] | [____] | [____] | [____] |
| Limit, priority, and other insurance | [____] | [____] | [____] | [____] |
| Stacking or aggregation | [____] | [____] | [____] | [____] |
| Offset, setoff, credit, or reduction | [____] | [____] | [____] | [____] |
| Notice and proof | [____] | [____] | [____] | [____] |
| Cooperation and examination | [____] | [____] | [____] | [____] |
| Consent to settle and subrogation | [____] | [____] | [____] | [____] |
| Arbitration or litigation | [____] | [____] | [____] | [____] |
| Limitations and accrual | [____] | [____] | [____] | [____] |
| Fees, interest, penalties, or extra-contractual claim | [____] | [____] | [____] | [____] |
No consent-by-silence, mandatory arbitration, stacking, offset, exhaustion,
response period, penalty, interest, or bad-faith conclusion is supplied here.
4. Notice and deadline calendar
| Notice, filing, or event | Trigger | Trigger date / proof | Due date and time | Recipient / method | Authority |
|---|---|---|---|---|---|
| Initial claim notice | [____] | [____] | [____] | [____] | [____] |
| Proof of loss or requested proof | [____] | [____] | [____] | [____] | [____] |
| Tortfeasor settlement notice | [____] | [____] | [____] | [____] | [____] |
| Consent or waiver request | [____] | [____] | [____] | [____] | [____] |
| Subrogation-protection step | [____] | [____] | [____] | [____] | [____] |
| Arbitration demand | [____] | [____] | [____] | [____] | [____] |
| Lawsuit or other proceeding | [____] | [____] | [____] | [____] | [____] |
| Other | [____] | [____] | [____] | [____] | [____] |
Independent deadline review by / date: [________________________________]
A proposed negotiation date does not extend or replace a legal, policy,
contractual, administrative, arbitration, appeal, or filing deadline.
5. Liability and accident record
| Topic | Claimant position | Other position | Evidence | Unresolved issue |
|---|---|---|---|---|
| Drivers and vehicles | [____] | [____] | [____] | [____] |
| Road, weather, traffic, and visibility | [____] | [____] | [____] | [____] |
| Collision sequence | [____] | [____] | [____] | [____] |
| Duties and claimed breach | [____] | [____] | [____] | [____] |
| Causation | [____] | [____] | [____] | [____] |
| Fault allocation | [____] | [____] | [____] | [____] |
| Defenses or immunities | [____] | [____] | [____] | [____] |
Police, crash, incident, body-camera, dispatch, citation, and agency records: [________________________________]
Photographs, video, vehicle data, telematics, phone, roadway, and physical evidence: [________________________________]
Witnesses and experts: [________________________________]
6. Tortfeasor and other-coverage record
| Source | Carrier / responsible party | Limit or asset | Claim status | Offer / payment | Release or consent issue |
|---|---|---|---|---|---|
| Tortfeasor liability | [____] | $[____] | [____] | $[____] | [____] |
| Employer / owner / household | [____] | $[____] | [____] | $[____] | [____] |
| Additional or umbrella coverage | [____] | $[____] | [____] | $[____] | [____] |
| Workers' compensation / benefits | [____] | $[____] | [____] | $[____] | [____] |
| Other | [____] | $[____] | [____] | $[____] | [____] |
Coverage-search steps and evidence: [________________________________]
Proposed tortfeasor release terms: [________________________________]
Do not sign a release, covenant, dismissal, trust instruction, indemnity, or
settlement document until UM/UIM counsel approves its effect on coverage,
subrogation, liens, and remaining claims.
7. Injury, treatment, and causation record
| Condition or injury | Onset / diagnosis | Provider | Treatment | Causation support | Status / prognosis |
|---|---|---|---|---|---|
| [____] | [____] | [____] | [____] | [____] | [____] |
| [____] | [____] | [____] | [____] | [____] | [____] |
Prior or subsequent conditions and events: [________________________________]
Gaps, referrals, recommendations, restrictions, and future care: [________________________________]
Medical-record, billing, authorization, privacy, and expert plan: [________________________________]
8. Damages and payment ledger
Record claimed amounts without assuming legal recoverability.
| Category | Gross amount | Paid / adjusted | Claimed balance | Evidence | Authority / policy treatment |
|---|---|---|---|---|---|
| Medical and care expense | $[____] | $[____] | $[____] | [____] | [____] |
| Income or earning loss | $[____] | $[____] | $[____] | [____] | [____] |
| Property and out-of-pocket loss | $[____] | $[____] | $[____] | [____] | [____] |
| Future expense or loss | $[____] | $[____] | $[____] | [____] | [____] |
| Non-economic harm | $[____] | $[____] | $[____] | [____] | [____] |
| Other | $[____] | $[____] | $[____] | [____] | [____] |
Credits, offsets, collateral sources, deductibles, advances, and prior payments: [________________________________]
Valuation range and methodology: [________________________________]
9. Lien, reimbursement, benefit, and approval register
| Potential interest or approval | Holder / decision maker | Notice and records | Amount / status | Resolution route | Completion evidence |
|---|---|---|---|---|---|
| [____] | [____] | [____] | $[____] | [____] | [____] |
| [____] | [____] | [____] | $[____] | [____] | [____] |
Minor, protected person, estate, bankruptcy, benefits, government, health
plan, insurer, court, agency, or fiduciary issue: [________________________________]
10. Insurer-request and claim-file log
| Date | Sender | Request / communication | Response / production | Reservation or issue | Proof |
|---|---|---|---|---|---|
| [____] | [____] | [____] | [____] | [____] | [____] |
Examination, medical examination, recorded statement, authorization, or
independent-evaluation issue: [________________________________]
Privilege, work product, confidentiality, medical privacy, and protected-data review: [________________________________]
11. Demand design
| Component | Approved content |
|---|---|
| Sender and recipient | [________________________________] |
| Communication type and purpose | [________________________________] |
| Coverage position | [________________________________] |
| Liability position | [________________________________] |
| Injury and damages summary | [________________________________] |
| Enclosures and evidence | [________________________________] |
| Amount or relief requested | [________________________________] |
| Proposed response date | [________________________________] |
| Consent, waiver, or other separate request | [________________________________] |
| Reservation of rights and deadlines | [________________________________] |
| Follow-up route | [________________________________] |
The final communication must distinguish a settlement proposal from any policy
notice, consent request, proof, demand required to trigger a procedure, or
formal arbitration or court filing.
12. Drafting workspace
Matter and policy
[Identify the claimant, accident, insurer, complete policy, endorsements, and
claim number.]
Coverage position
[State only coverage conclusions supported by the completed policy and
authority register.]
Accident, liability, and causation
[State record-supported facts and acknowledge material disputes.]
Injury and damages
[Summarize verified records and calculations without overstating prognosis,
causation, balance, or legal recoverability.]
Request and response
[State the approved amount or action, a negotiation date, delivery method, and
any separate consent or waiver request. Do not imply silence has an effect
unless current authority and policy language establish it.]
Rights and deadlines
[Preserve independently verified routes and deadlines without threatening
unsupported penalties, arbitration, suit, fees, or bad faith.]
13. Final review
☐ Complete policies, endorsements, applications, renewals, and claim file reviewed
☐ Coverage, limit, priority, stacking, offset, exhaustion, consent, and subrogation resolved
☐ Every policy, notice, limitations, arbitration, and filing deadline calendared
☐ Tortfeasor coverage, offer, release, and other sources verified
☐ Liability, causation, injury, treatment, damages, and evidence reconciled
☐ Liens, reimbursement, benefits, approvals, taxes, and protected persons addressed
☐ Final communication type and required contents identified
☐ Proposed response date is not described as a legal deadline
☐ No consent-by-silence, automatic penalty, fee, interest, arbitration, or bad-faith claim remains
Preparing counsel: [________________________________]
Coverage reviewer: [________________________________]
Damages reviewer: [________________________________]
Final review date: [__/__/____]
About This Template
A demand letter is a formal written request to fix a problem or pay what is owed, sent before anyone files a lawsuit. It gives the other side a real chance to settle, creates a record of your attempt to resolve things, and in many cases (unpaid debts, insurance claims, broken contracts) starts a legally required response window. A well-written demand letter lays out what happened, what you want, and a deadline to act, which is often enough to get results without ever going to court.
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 2026-08-23.
Last updated: 2026-08-23
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