UM/UIM Demand Letter - Louisiana

UM/UIM (UNINSURED/UNDERINSURED MOTORIST) DEMAND LETTER

State of Louisiana

[LAW FIRM LETTERHEAD]

PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION — FOR RESOLUTION PURPOSES ONLY
PROTECTED UNDER LA. CODE OF EVIDENCE ART. 408 AND FED. R. EVID. 408

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA EMAIL TO: [ADJUSTER_EMAIL]

Date: [__/__/____]

[INSURANCE_COMPANY_NAME]
[UM_UIM_CLAIMS_DEPARTMENT_ADDRESS]
[________________________________]

Attention: [ADJUSTER_NAME], [ADJUSTER_TITLE]

Re: UM/UIM POLICY LIMITS DEMAND — LOUISIANA LAW
Insured/Claimant: [INSURED_CLAIMANT_NAME]
Policy Number: [POLICY_NUMBER]
Claim Number: [CLAIM_NUMBER]
Date of Loss: [__/__/____]
Parish of Loss: [PARISH_NAME] Parish, Louisiana
UM/UIM Policy Limits: $[UM_UIM_LIMITS]
Tortfeasor (Delictual Actor): [TORTFEASOR_NAME]
Tortfeasor's Liability Carrier: [TORTFEASOR_CARRIER]
Tortfeasor's Limits: $[TORTFEASOR_LIMITS]
Response Deadline: [__/__/____]

Dear [ADJUSTER_NAME]:

I. INTRODUCTION AND NATURE OF DEMAND

This firm represents [CLIENT_NAME] ("our client"), your own insured, in connection with a claim for uninsured/underinsured motorist ("UM/UIM") benefits under Louisiana law arising from a motor vehicle collision that occurred in [PARISH_NAME] Parish, Louisiana on [__/__/____]. This letter constitutes a formal demand for payment of the full UM/UIM policy limits of $[UM_UIM_LIMITS].

Louisiana is a civil law jurisdiction, and our client's claim sounds in delict under La. C.C. art. 2315 against the tortfeasor and in contract against [CARRIER_SHORT_NAME] under the insuring agreement. Our client's damages far exceed the combined liability and UM/UIM limits available. Under La. R.S. 22:1295, UM/UIM coverage exists precisely for this situation — to protect the insured when the negligent party lacks sufficient coverage to make the victim whole.

II. LOUISIANA UM/UIM LAW

A. The Mandatory Offer Requirement — La. R.S. 22:1295

Louisiana imposes on every automobile liability insurer the affirmative duty to provide UM/UIM coverage equal to bodily injury limits unless the named insured affirmatively rejects, in writing, such coverage or selects lower limits on the form prescribed by the Louisiana Commissioner of Insurance. La. R.S. 22:1295(1)(a)(i)-(ii).

The statutory minimum limits in Louisiana are $15,000 per person / $30,000 per accident (La. R.S. 22:1295(1)(a)(ii), referencing La. R.S. 32:900). Any purported waiver must be executed on the Commissioner's prescribed form and must comply with the six-element test set forth by the Louisiana Supreme Court in Duncan v. USAA Casualty Insurance Co., 950 So. 2d 544 (La. 2006). A defect in the waiver form (e.g., failure to identify the insurer, unsigned form, incorrect form version, missing initials) renders the rejection ineffective and provides UM coverage by operation of law at the policyholder's bodily injury liability limits.

B. Coverage Trigger Under Louisiana Law

Pursuant to La. R.S. 22:1295(2), UM coverage is triggered when the tortfeasor is:

☐ Uninsured (no bodily injury liability policy in force)
☐ Insured by a carrier that has denied coverage or become insolvent
☐ A phantom/hit-and-run driver whose identity cannot be ascertained
☐ Underinsured — meaning the tortfeasor's liability limits are inadequate to fully compensate the claimant (i.e., the "difference" approach under La. R.S. 22:1295(2)(a)(i))

C. Louisiana's Anti-Stacking Rule

Louisiana prohibits intra-policy stacking of UM coverage across multiple vehicles on the same policy. La. R.S. 22:1295(1)(c). However, under Theriot v. Midland Risk Insurance Co., 694 So. 2d 184 (La. 1997), and its progeny, an insured who is injured as a guest passenger in a vehicle not owned by the insured or a resident relative may access both the host vehicle's UM policy AND the insured's own personal UM policy (inter-policy stacking, sometimes termed "two-policy" recovery).

D. Direct Action Statute — La. R.S. 22:1269

Louisiana's Direct Action Statute, as amended by Act 275 of 2024 (effective August 1, 2024), permits direct action against a UM/UIM insurer notwithstanding the general limitations now imposed on third-party direct actions. La. R.S. 22:1269(B)(1)(d) expressly preserves direct action "when the insurer is an uninsured motorist carrier." [CARRIER_SHORT_NAME] remains fully amenable to direct suit in any court of competent jurisdiction in Louisiana.

E. Policy Particulars

III. THE COLLISION AND DELICTUAL LIABILITY

A. Facts of the Collision

On [__/__/____], at approximately [TIME], our client was [DESCRIBE_CLIENT_ACTIVITY] at or near [LOCATION_OF_COLLISION] in [PARISH_NAME] Parish, Louisiana.

[DETAILED_DESCRIPTION_OF_COLLISION: _____________________________________]

B. Delictual Fault of the Tortfeasor Under La. C.C. art. 2315

La. C.C. art. 2315 provides that "[e]very act whatever of man that causes damage to another obliges him by whose fault it happened to repair it." The tortfeasor, [TORTFEASOR_NAME], breached the duties imposed by Louisiana law and the Louisiana Highway Regulatory Act (La. R.S. 32:1 et seq.) in the following particulars:

☐ Failure to maintain proper lookout (La. R.S. 32:81)
☐ Failure to yield right-of-way (La. R.S. 32:121 et seq.)
☐ Following too closely (La. R.S. 32:81(A))
☐ Excessive speed for conditions (La. R.S. 32:64)
☐ Distracted driving / texting while driving (La. R.S. 32:300.5)
☐ Running red light/stop sign (La. R.S. 32:232, 32:123)
☐ Improper lane change (La. R.S. 32:79)
☐ Operating while intoxicated (La. R.S. 14:98)
☐ Other: [________________________________]

C. Evidence of Liability

1. Louisiana Uniform Motor Vehicle Crash Report (DPSMV 1606) — prepared by [INVESTIGATING_AGENCY] (Report No. [REPORT_NUMBER]), which [describes/assigns] fault to [TORTFEASOR_NAME].

2. Independent Witness Statements — [NUMBER] unbiased witnesses observed the collision and corroborate our client's account.

3. Physical Evidence — point of impact, vehicle damage patterns, debris field, and roadway geometry.

4. Expert Reconstruction (if applicable) — [ACCIDENT_RECONSTRUCTIONIST_NAME] has issued a written opinion concluding [SUMMARY_OF_OPINION].

D. Comparative Fault Under La. C.C. art. 2323

Because this cause of action arose [BEFORE/ON OR AFTER] January 1, 2026, Louisiana's pure comparative fault regime under La. C.C. art. 2323 applies in its current form. Our client bears zero percent (0%) comparative fault and is entitled to full recovery. (Note: For causes of action arising on or after January 1, 2026, HB 431 / 2024 imposes a modified 51% bar; counsel should confirm applicability.)

IV. OUR CLIENT'S INJURIES AND TREATMENT

A. Injury Summary

As a direct and proximate result of the delict of [TORTFEASOR_NAME], our client sustained:

☐ [PRIMARY_INJURY_1]
☐ [PRIMARY_INJURY_2]
☐ [PRIMARY_INJURY_3]
☐ [PRIMARY_INJURY_4]

B. Treatment Timeline

C. Current Condition and Prognosis

[DESCRIBE_CURRENT_CONDITION_AND_PROGNOSIS: _______________________________________]

D. Permanent Impairment

E. Collateral Source Rule (Louisiana)

Louisiana applies the collateral source rule to tort recoveries, subject to the Bozeman v. State, 879 So. 2d 692 (La. 2004), and Hoffman v. 21st Century North American Ins. Co., 209 So. 3d 702 (La. 2015), refinements. Medical write-offs procured by attorney-negotiated discounts are generally not recoverable, but health insurance, Medicare/Medicaid contractual adjustments are subject to judicial scrutiny. Our demand computes damages at billed rates consistent with prevailing Louisiana authority.

F. Worker's Compensation Interaction (if applicable)

Should our client's injuries arise out of and in the course of employment, La. R.S. 23:1101-1212 creates a subrogation/reimbursement right in favor of the comp carrier, [WC_CARRIER]. We acknowledge the carrier's intervention right and will coordinate Moody factors/Smith v. Midland Risk reductions as appropriate.

V. DAMAGES (Louisiana "General" and "Special" Damages)

Under Louisiana civil law, damages are categorized as "special damages" (those with a determinable monetary value — medicals, lost wages, property damage) and "general damages" (non-pecuniary — pain and suffering, mental anguish, loss of enjoyment of life, disfigurement, disability). See Wainwright v. Fontenot, 774 So. 2d 70 (La. 2000).

A. Special Damages — Medical Expenses

Past Medical Expenses:

Future Medical Expenses (Present Value per life care plan):

B. Special Damages — Lost Income and Lost Earning Capacity

Past Lost Wages: $[PAST_LOST_INCOME]
Future Lost Earning Capacity (reduced to present value): $[FUTURE_LOST_EARNING_CAPACITY]

C. General Damages

Under Louisiana civil law, general damages are "those which may not be fixed with pecuniary exactitude" (Duncan v. Kansas City S. Ry. Co., 773 So. 2d 670 (La. 2000)). Our client's general damages include:

• Physical pain and suffering (past and future)
• Mental anguish and emotional distress
• Loss of enjoyment of life (McGee v. A C And S, Inc., 933 So. 2d 770 (La. 2006))
• Disfigurement and scarring
• Permanent disability and loss of functional capacity
• Loss of consortium (if derivative claim by spouse/family per La. C.C. art. 2315(B))

[DETAILED_NARRATIVE_OF_GENERAL_DAMAGES: ____________________________________]

D. Damages Summary

VI. SETTLEMENT WITH TORTFEASOR'S LIABILITY CARRIER

A. Current Status

We [HAVE REACHED / ARE PURSUING] a tentative settlement with [TORTFEASOR_CARRIER] for the tortfeasor's liability limits of $[TORTFEASOR_LIMITS]. Under Longo v. Moran, 609 So. 2d 966 (La. App. 1st Cir. 1992), and progeny, the UIM carrier is entitled to advance notice and the opportunity to protect any subrogation interest.

B. Consent-to-Settle / Preservation of Subrogation

Pursuant to the policy's cooperation clause and Niemann v. Travelers Ins. Co., 368 So. 2d 1003 (La. 1979), we hereby request written consent to settle with [TORTFEASOR_CARRIER] within thirty (30) days. If [CARRIER_SHORT_NAME] wishes to preserve any subrogation interest, it must advance the full tortfeasor settlement amount within the time period permitted by Longo and progeny.

Silence or failure to timely respond will be treated as waiver of subrogation.

VII. DEMAND FOR UM/UIM BENEFITS

A. Calculation of UIM Benefits Due

Louisiana follows the "difference approach" to UIM calculation under La. R.S. 22:1295(2)(a)(i). The UIM carrier pays the difference between the tortfeasor's recovered limits and the insured's total damages, up to UIM limits:

B. Policy Limits Demand

We hereby demand tender of the full UM/UIM policy limits of $[UM_UIM_LIMITS].

Our client's damages of $[TOTAL_DAMAGES] vastly exceed the combined liability and UM/UIM coverage available. This is an undeniable policy-limits case under Louisiana law. [CARRIER_SHORT_NAME] faces zero litigation risk exposure beyond the policy limits being demanded here — the only question is whether the Company will voluntarily honor its contractual and statutory obligations.

VIII. BAD FAITH / PENALTY STATUTE WARNING

A. Statutory Duties — La. R.S. 22:1892 (As Amended by Act 3 of 2024)

Important: Effective July 1, 2024, Act 3 of the 2024 Regular Session repealed La. R.S. 22:1973 and consolidated the insurer's statutory duty of good faith into La. R.S. 22:1892, adding La. R.S. 22:1892.2 for catastrophic immovable property claims. For UM/UIM first-party claims, La. R.S. 22:1892 now governs.

La. R.S. 22:1892(A)(1) requires an insurer to "pay the amount of any claim due any insured within thirty days after receipt of satisfactory proofs of loss." La. R.S. 22:1892(A)(4) requires a similar 30-day payment on UM claims after receipt of satisfactory proofs of loss.

La. R.S. 22:1892(B)(1) imposes the penalty for "arbitrary, capricious, or without probable cause" failure to pay: the greater of fifty percent (50%) of the amount due (or $1,000 minimum for property; recent amendments should be consulted for precise current penalty structure) plus reasonable attorney fees and costs.

B. The Reed v. State Farm Standard

The Louisiana Supreme Court in Reed v. State Farm Mut. Auto. Ins. Co., 857 So. 2d 1012 (La. 2003), held that penalties and attorney fees under § 1892 are warranted when the insurer's refusal to pay is "vexatious" — that is, "unjustified, without reasonable or probable cause or excuse." While the bad faith statutes are penal and strictly construed, an insurer cannot hide behind a paper-thin coverage defense when the record demonstrates clear liability and damages exceeding limits.

C. Duty to Tender Undisputed Amounts

Under La. R.S. 22:1892, the Company has an affirmative obligation to tender any undisputed portion of the claim within 30 days of receipt of satisfactory proofs of loss. Failure to do so — even with an ongoing dispute about the full value — triggers penalties. See also La. R.S. 22:1892(B)(1).

This letter, together with the enclosed medical records, bills, police report, and supporting documentation, constitutes satisfactory proof of loss. The 30-day clock under La. R.S. 22:1892 begins to run today.

IX. ARBITRATION / LITIGATION FORUM

A. Policy Arbitration Clause (If Any)

The policy [CONTAINS / DOES NOT CONTAIN] an arbitration clause governing UM/UIM disputes. Louisiana enforces valid UM arbitration clauses subject to La. R.S. 9:4201 et seq. (the Louisiana Binding Arbitration Law) and applicable federal authority.

B. Venue and Choice of Law

Any litigation will be filed in the [PARISH_NAME] Parish [DISTRICT/CITY] Court, where this delict occurred and where our client resides. Louisiana law governs per La. C.C. art. 3515 et seq.

X. PRESCRIPTION / TIME BAR

Louisiana imposes a two-year prescriptive period on delictual actions for causes of action arising on or after July 1, 2024. La. C.C. art. 3493.1 (enacted by Act 423 of 2024). Causes of action arising before July 1, 2024, remain subject to the one-year prescription of former La. C.C. art. 3492.

Our client's claim accrued on [__/__/____]. Prescription runs on [__/__/____] absent interruption. Claims against UM/UIM carriers may be governed by a separate contractual prescription period (typically 10 years under La. C.C. art. 3499 for personal actions, subject to policy-specific provisions).

XI. RESPONSE DEADLINE

This demand expires at 5:00 p.m. Central Time on [__/__/____].

Consequences of Non-Response or Refusal

If [CARRIER_SHORT_NAME] fails to tender the demanded amount by the deadline, we will:

1. File suit in [PARISH_NAME] Parish [DISTRICT] Court (or invoke arbitration if applicable) seeking policy benefits, § 1892 penalties, attorney fees, judicial interest from date of judicial demand under La. C.C. art. 2000, and all costs;
2. Pursue bad faith penalties under La. R.S. 22:1892 as interpreted by Reed v. State Farm and its progeny;
3. File a formal complaint with the Louisiana Department of Insurance, 1702 N. Third Street, P.O. Box 94214, Baton Rouge, LA 70804-9214;
4. Seek all available remedies including, if warranted, discovery of the Company's claims file, adjuster diary, training materials, and reserve information.

XII. DOCUMENT PRESERVATION NOTICE

This letter serves as formal notice to preserve all documents, electronically stored information, audio recordings, text messages, emails, adjuster notes, claim diaries, reserve information, supervisor approvals, reinspection reports, training manuals, and internal communications relating to our client's claim. Spoliation of any such evidence will be the subject of appropriate sanctions under Louisiana law.

XIII. CONCLUSION

This claim presents clear delictual liability, catastrophic injuries, and damages that vastly exceed all available coverage. Louisiana's UM/UIM statute exists precisely to make the insured whole when the tortfeasor lacks means. [CARRIER_SHORT_NAME] has the opportunity — and the contractual duty — to resolve this matter by tendering the policy limits of $[UM_UIM_LIMITS] within 30 days.

Respectfully submitted,

[LAW_FIRM_NAME]

By: _______________________________
[ATTORNEY_NAME]
Louisiana Bar Roll No. [BAR_NUMBER]
[ADDRESS]
[CITY], LA [ZIP]
Phone: [PHONE]
Email: [EMAIL]

Counsel for [CLIENT_NAME]

ENCLOSURES:

• Policy declarations page and UM/UIM coverage provisions
• UM Selection/Rejection form (Commissioner-prescribed form)
• Louisiana Uniform Motor Vehicle Crash Report
• Medical records and itemized bills
• Wage loss documentation
• Photographs of vehicles and scene
• Life care plan and economist report (if applicable)
• Accident reconstruction report (if applicable)

CC:

• [CLIENT_NAME]
• [TORTFEASOR_CARRIER] (re: consent to settle under Longo v. Moran)

LOUISIANA UM/UIM QUICK REFERENCE

SOURCES AND REFERENCES

• La. R.S. 22:1295 — Uninsured Motorist Coverage; mandatory offer: https://legis.la.gov/Legis/Law.aspx?d=509044
• La. R.S. 22:1892 — Prompt payment of claims; penalties: https://legis.la.gov/Legis/Law.aspx?d=509041
• La. R.S. 22:1269 — Direct Action Statute: https://legis.la.gov/legis/Law.aspx?d=508142
• La. C.C. art. 2315 — General delictual responsibility
• La. C.C. art. 2323 — Comparative fault
• La. C.C. art. 3493.1 — Two-year prescription for delictual actions (Act 423, HB 315 of 2024)
• Louisiana Act 3 of 2024 — Bad Faith Statute Overhaul: https://legis.la.gov/legis/ViewDocument.aspx?d=1372369
• Reed v. State Farm Mut. Auto. Ins. Co., 857 So. 2d 1012 (La. 2003)
• Theriot v. Midland Risk Ins. Co., 694 So. 2d 184 (La. 1997)
• Duncan v. USAA Cas. Ins. Co., 950 So. 2d 544 (La. 2006)
• Longo v. Moran, 609 So. 2d 966 (La. App. 1st Cir. 1992)
• Niemann v. Travelers Ins. Co., 368 So. 2d 1003 (La. 1979)
• Louisiana Department of Insurance: https://www.ldi.la.gov/