UM/UIM Demand Letter - Massachusetts

UM/UIM (UNINSURED/UNDERINSURED MOTORIST) DEMAND LETTER

Commonwealth of Massachusetts

[LAW FIRM LETTERHEAD]

SETTLEMENT COMMUNICATION - FOR COMPROMISE PURPOSES ONLY
MASS. GUIDE TO EVID. § 408 / FED. R. EVID. 408 MAY LIMIT SPECIFIED USES OF DISPUTED-CLAIM NEGOTIATIONS; THEY DO NOT CREATE A GENERAL PRIVILEGE

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

Date: [__/__/____]

[INSURANCE_COMPANY_NAME]
[UM_UIM_CLAIMS_DEPARTMENT_ADDRESS]
[CITY], [STATE] [ZIP]

Attention: [________________________________], [ADJUSTER_TITLE]

Re: UM/UIM POLICY LIMITS DEMAND — MASSACHUSETTS LAW
Insured/Claimant: [________________________________]
Policy Number: [________________________________]
Claim Number: [________________________________]
Date of Loss: [__/__/____]
UM Limits (per M.G.L. c. 175, § 113L): [________________________________]
UIM Limits (per M.G.L. c. 175, § 113L): [________________________________]
Tortfeasor: [________________________________]
Tortfeasor's Carrier: [________________________________]
Tortfeasor's Limits: [________________________________]
Response Deadline: [__/__/____]

Dear [ADJUSTER_NAME]:

I. INTRODUCTION AND NATURE OF DEMAND

This firm represents [________________________________] ("our client") in connection with a claim for ☐ Uninsured Motorist ☐ Underinsured Motorist benefits under Part 3 (Bodily Injury Caused by an Uninsured Auto) and/or Part 12 (Bodily Injury Caused by an Underinsured Auto) of the Massachusetts Standard Automobile Policy, pursuant to M.G.L. c. 175, § 113L, arising from a motor vehicle collision that occurred on [__/__/____] in the Commonwealth of Massachusetts. This letter constitutes a formal demand for payment of the full UM/UIM policy limits of $[UM_UIM_LIMITS].

Our client's damages far exceed the available coverage. Massachusetts requires uninsured motorist coverage under M.G.L. c. 175, § 113L(1); underinsured motorist protection under § 113L(2) applies when the policyholder elected that additional coverage. We seek benefits under the coverage shown in this policy.

If the carrier has already engaged in an unfair claim settlement practice, the optional M.G.L. c. 93A, § 9(3) demand in Section IX must identify that conduct and the injury it caused. M.G.L. c. 176D, § 3(9) defines prohibited practices; it does not create a separate notice procedure.

II. MASSACHUSETTS UM/UIM LAW FRAMEWORK

A. Statutory Basis — M.G.L. c. 175, § 113L

Massachusetts is a compulsory insurance state. Under M.G.L. c. 175, § 113L(1), every Massachusetts motor vehicle liability policy must provide uninsured motorist coverage in amounts equal to those prescribed for bodily injury liability — the minimum compulsory limits being $25,000 per person / $50,000 per accident for policies written or renewed on or after July 1, 2025 (increased from $20,000/$40,000 by Ch. 275 of the Acts of 2024; older policies may still carry the prior $20,000/$40,000 limits). Higher limits may be purchased, and most policies include underinsured motorist coverage at the insured's elected limits under Part 12 of the Massachusetts Standard Auto Policy.

B. No-Stacking Rule

Important note regarding stacking: Under M.G.L. c. 175, § 113L(5), UM/UIM limits from multiple vehicles or policies may not be stacked to determine the limits of insurance available. However, an insured who is not a named insured on any policy providing UM coverage may recover from the policy of a resident relative providing the highest limits of such coverage, whether or not that vehicle was involved in the accident. M.G.L. c. 175, § 113L(5).

C. Trigger for Underinsured Motorist Benefits

Under M.G.L. c. 175, § 113L(2), elected underinsured motorist coverage applies when the tortfeasor's bodily-injury liability limits are less than the insured's UIM limits and insufficient to compensate the insured. The statute makes coverage available only to the extent the UIM limits exceed those bodily-injury liability limits, subject to the policy terms. State both limits and all payments in the calculation below.

D. Coverage Analysis

E. Coverage Trigger

☐ Uninsured Motorist (Part 3) — Triggered Because:

• ☐ The tortfeasor had no Massachusetts compulsory insurance at the time of the collision
• ☐ The tortfeasor's insurer has denied coverage or is insolvent (triggering Massachusetts Insurers Insolvency Fund rights under M.G.L. c. 175D)
• ☐ The tortfeasor was an unidentified hit-and-run driver (M.G.L. c. 175, § 113L(1) includes hit-and-run vehicles; document the event and check the applicable policy’s notice and proof terms without assuming physical contact is required)
• ☐ The out-of-state vehicle carried no insurance

☐ Underinsured Motorist (Part 12) — Triggered Because:

• ☐ The tortfeasor's liability limits of $[TORTFEASOR_LIMITS] are less than our client's UIM limits of $[UIM_LIMITS]
• ☐ Our client's damages exceed the tortfeasor's available coverage
• ☐ The liability carrier has tendered (or offered to tender) its policy limits

III. THE COLLISION AND LIABILITY

A. Facts of the Collision

On [__/__/____] at approximately [____] [AM/PM], our client was [________________________________] at or near [________________________________] in [CITY/TOWN], Massachusetts.

[DETAILED_DESCRIPTION_OF_COLLISION]

B. Tortfeasor's Negligence

The tortfeasor, [________________________________], was negligent as a matter of Massachusetts common law and statute:

• ☐ Failure to maintain proper lookout
• ☐ Violation of M.G.L. c. 89, § 8 (failure to yield right-of-way at intersection under the applicable rule)
• ☐ Violation of M.G.L. c. 89, § 4B (failure to yield when entering highway)
• ☐ Failure to keep right when meeting an oncoming vehicle — M.G.L. c. 89, § 1
• ☐ Unsafe passing of a vehicle traveling in the same direction — M.G.L. c. 89, § 2
• ☐ Unsafe lane change — M.G.L. c. 89, § 4A
• ☐ Violation of M.G.L. c. 90, § 17 (speeding / operating at unreasonable speed)
• ☐ Violation of M.G.L. c. 90, § 24 (operating under the influence — OUI)
• ☐ Following too closely or maintaining an unsafe distance (describe the facts and identify the applicable traffic rule): [________________________________]
• ☐ Violation of M.G.L. c. 90, § 13B (use of mobile device — distracted driving)
• ☐ Other: [________________________________]

A proved violation of an applicable safety rule may be evidence of negligence when the rule was designed to prevent the incident; the violation alone does not establish negligence. Massachusetts Superior Court Model Civil Jury Instructions, Negligence on Premises (2021).

C. Evidence of Liability

1. Police Crash Report
[________________________________] Police Department / Massachusetts State Police Crash Report (Motor Vehicle Crash Police Report — MVCPR No. [REPORT_NUMBER]), if prepared; obtain the report and confirm its facts.

2. Registry of Motor Vehicles Records
Operator history obtained from the Massachusetts Registry of Motor Vehicles pursuant to M.G.L. c. 90, § 30.

3. Witness Statements
[NUMBER] independent witnesses observed the collision.

4. Physical Evidence
Point of impact, vehicle damage patterns, crush analysis, and skid marks.

5. Expert Analysis (if applicable)
[ACCIDENT_RECONSTRUCTIONIST_NAME] has concluded: [SUMMARY_OF_OPINION]

D. Our Client's Freedom from Comparative Negligence

Under M.G.L. c. 231, § 85 (Modified Comparative Negligence — 51% bar), our client's recovery is reduced only by the percentage of fault attributed to our client, and is barred only if our client's negligence exceeds that of the tortfeasor. Here, our client bears zero comparative fault.

IV. TORT THRESHOLD AND PIP COORDINATION

A. Massachusetts Tort Threshold — M.G.L. c. 231, § 6D

Our client has satisfied the Massachusetts tort threshold under M.G.L. c. 231, § 6D, which permits recovery for pain and suffering where:

• ☐ Reasonable and necessary medical expenses exceed $2,000; OR
• ☐ Injury consists in whole or in part of death; OR
• ☐ Loss of a body member; OR
• ☐ Permanent and serious disfigurement; OR
• ☐ A fractured bone; OR
• ☐ Substantial loss of sight or hearing

Our client's medical expenses of $[____] exceed $2,000, AND our client sustained [________________________________], independently satisfying the threshold.

B. PIP Benefits — M.G.L. c. 90, § 34M

Our client has received/is receiving Personal Injury Protection benefits from [PIP_CARRIER] in the amount of $[____]. M.G.L. c. 90, § 34A defines PIP with a limit of at least $8,000 per person; § 34M governs payment and permitted deductible adjustments. Confirm the actual policy limit and coordination. For the M.G.L. c. 231, § 6D threshold, count reasonable and necessary treatment expenses incurred even if PIP paid them; identify PIP payments separately when calculating the amount demanded to avoid duplicate recovery. We confirm that PIP benefits have been properly coordinated and that any PIP lien rights are acknowledged.

C. Tort Exemption Does Not Bar UM/UIM Recovery

Calculate UM/UIM damages from what the insured is legally entitled to recover from the tortfeasor under M.G.L. c. 175, § 113L. Exclude amounts covered by the PIP tort exemption in M.G.L. c. 90, § 34M, and claim pain and suffering only when the M.G.L. c. 231, § 6D threshold or an exception applies.

V. OUR CLIENT'S INJURIES AND TREATMENT

A. Injury Summary

As a direct and proximate result of this collision, our client sustained:

Primary Injuries:

• [PRIMARY_INJURY_1]
• [PRIMARY_INJURY_2]
• [PRIMARY_INJURY_3]

B. Treatment Timeline

C. Current Condition and Prognosis

[DESCRIBE_CURRENT_CONDITION_AND_PROGNOSIS]

D. Permanent Impairment

Per the AMA Guides to the Evaluation of Permanent Impairment (6th Ed.):

VI. DAMAGES

A. Medical Expenses (Post-PIP)

Past Medical Expenses:

Collateral source review: M.G.L. c. 231, § 60G addresses certain claims against health care providers; it does not govern this motor-vehicle demand. Document billed charges, reasonable treatment expenses, payments, liens, and amounts still owed separately before calculating recoverable medical damages.

Future Medical Expenses (Present Value):

B. Lost Wages

Past Lost Wages (Post-PIP):

PIP covered 75% of lost wages up to the $8,000 combined cap. Remaining lost wages: $[TOTAL_PAST_LOST_WAGES]

Future Lost Earning Capacity:

$[FUTURE_LOST_EARNING_CAPACITY] (Present Value)

C. Pain and Suffering / Non-Economic Damages

Massachusetts permits recovery for physical pain, mental suffering, loss of enjoyment of life, scarring/disfigurement, and loss of bodily function. See Mass. Superior Court Civil Jury Instructions, Model Jury Instruction 3.03.

[DESCRIBE_PAIN_AND_SUFFERING]

D. Loss of Consortium (if applicable)

Identify the person asserting any derivative consortium claim and the legal basis for that person's claim: [________________________________]. M.G.L. c. 231, § 85X specifically provides a claim to the parents of a seriously injured minor child or dependent adult child. Value, if applicable: $[____]

E. Damages Summary

VII. SETTLEMENT WITH TORTFEASOR'S INSURER AND CONSENT TO SETTLE

A. Settlement Status

We ☐ have reached ☐ are pursuing a settlement with [TORTFEASOR_CARRIER] for the tortfeasor's policy limits of $[TORTFEASOR_LIMITS].

B. Consent to Settle / Preservation of Subrogation Rights

Pursuant to Part 12 of the Massachusetts Standard Automobile Policy and Liberty Mut. Ins. Co. v. Tabor, 407 Mass. 354 (1990), we hereby request written consent to settle with the tortfeasor's carrier. The Massachusetts Standard Policy requires the UIM carrier's consent before the insured releases the tortfeasor in order to preserve the UIM carrier's subrogation rights.

Please provide a written response about consent within [____] days. Before releasing the tortfeasor, counsel will review the policy's consent and subrogation provisions and any response from [CARRIER_SHORT_NAME].

VIII. DEMAND FOR UM/UIM BENEFITS

A. Calculation of UIM Benefits Due

B. Policy Limits Demand

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

Our client’s documented damages of $[TOTAL_DAMAGES] exceed the coverage identified above, and our client demands the available policy limits. M.G.L. c. 176D, § 3(9)(f) requires prompt, fair and equitable settlement of claims in which liability has become reasonably clear. The Carrier should evaluate the liability, damages, and available coverage and make a supported settlement offer; an offer below policy limits is not automatically a violation.

IX. CLAIM HANDLING AND OPTIONAL M.G.L. c. 93A DEMAND

A. Statutory Duty

[CARRIER_SHORT_NAME] owes our client, its own insured, statutory duties under M.G.L. c. 176D, § 3(9), including the duty to:

• Effectuate prompt, fair and equitable settlement of claims in which liability has become reasonably clear (§ 3(9)(f))
• Acknowledge and act reasonably promptly upon communications (§ 3(9)(b))
• Adopt and implement reasonable standards for prompt investigation (§ 3(9)(c))
• Not refuse payment without conducting a reasonable investigation (§ 3(9)(d))
• Not compel insureds to institute litigation by offering substantially less than amounts ultimately recovered (§ 3(9)(g))
• Promptly provide a reasonable explanation of the basis for denial (§ 3(9)(n))

B. Private Right of Action Under c. 93A, § 9

An insurer's violation of M.G.L. c. 176D, § 3(9) constitutes, per se, an unfair or deceptive act under M.G.L. c. 93A, § 2. Hopkins v. Liberty Mut. Ins. Co., 434 Mass. 556 (2001); Van Dyke v. St. Paul Fire & Marine Ins. Co., 388 Mass. 671 (1983). A claimant has a private right of action under M.G.L. c. 93A, § 9.

C. Optional Demand for an Existing Unfair Practice

☐ M.G.L. c. 93A, § 9(3) demand: On [DATE], [CARRIER_SHORT_NAME] [DESCRIBE THE SPECIFIC UNFAIR CLAIM PRACTICE THAT ALREADY OCCURRED, WITH FACTS]. This caused our client [DESCRIBE THE INJURY SUFFERED]. On our client's behalf, we demand [SPECIFIC RELIEF] for that practice. This paragraph is a written demand for relief under § 9(3); the carrier has thirty days after its mailing or delivery to make a written settlement tender.

☐ Policy benefits demand only: No completed § 9(3) demand is included in this letter. Any later consumer protection demand must identify an unfair practice that occurred and the resulting injury.

D. Available Remedies

Under M.G.L. c. 93A, § 9(3):

1. Actual damages (or $25 minimum)
2. Double to treble damages for knowing or willful violations
3. Reasonable attorneys' fees and costs, subject to § 9(4)'s limit after rejection of a timely reasonable offer

Interest on a judgment for pecuniary damages on the contractual UM/UIM claim is governed by M.G.L. c. 231, § 6C: the established contract rate, or otherwise twelve percent annually from breach or demand (from filing if neither date is established). It is separate from the § 9 remedies listed above.

Under Rhodes v. AIG Domestic Claims, Inc., 461 Mass. 486 (2012), multiple damages are calculated based on the underlying judgment (not merely loss-of-use damages). AIG's $22+ million exposure in Rhodes should serve as a cautionary example.

E. 30-Day Written-Tender Window

If the § 9(3) paragraph above is completed, [CARRIER_SHORT_NAME] may tender a written offer of settlement within thirty days after mailing or delivery of this demand. A reasonable rejected tender may limit recovery. Multiple damages require the court's separate finding of a willful or knowing violation or a bad-faith refusal to grant relief with the knowledge specified in § 9(3); nonresponse alone does not establish that finding.

If an unfair practice occurs and remains unresolved after any required § 9(3) demand period, our client may pursue available relief under c. 93A for conduct described in c. 176D, § 3(9).

X. ARBITRATION UNDER THE MASSACHUSETTS STANDARD POLICY

A. Arbitration Clause

Part 12 of the Massachusetts Standard Automobile Policy provides for binding arbitration of UM/UIM disputes where the parties cannot agree on (1) whether the insured is legally entitled to recover, or (2) the amount of damages. See Liberty Mut. Ins. Co. v. Tabor, 407 Mass. 354 (1990).

B. Arbitration Demand (If Applicable)

If [CARRIER_SHORT_NAME] fails to accept this demand within the deadline below, consider this letter formal notice of demand for arbitration under Part 12 of the Massachusetts Standard Auto Policy. We will select [________________________________] as our client's arbitrator pursuant to the policy provisions. Please identify [CARRIER_SHORT_NAME]'s arbitrator within [____] days.

Before arbitration or suit, counsel should determine the applicable limitation period and accrual date for this policy claim under M.G.L. c. 260, §§ 2 and 2A and current controlling decisions. Do not assume the tortfeasor's deadline controls the claim against the carrier.

XI. RESPONSE DEADLINE

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

Note: This deadline is separate from § 9(3)'s 30-day written-tender window; the statute does not compel a response.

Consequences of Non-Response

If [CARRIER_SHORT_NAME] fails to accept this demand:

1. We will invoke binding arbitration under Part 12 of the Massachusetts Standard Auto Policy
2. We will file suit in Massachusetts Superior Court (M.G.L. c. 212, § 4) or appropriate District Court
3. If supported by an existing unfair practice and a proper presuit demand, we may pursue c. 93A relief based on c. 176D, § 3(9); interest on a contractual damages judgment is governed separately by M.G.L. c. 231, § 6C
4. We will file a formal complaint with the Massachusetts Division of Insurance, Consumer Services Unit, 1 Federal Street, Suite 700, Boston, MA 02110
5. We will notify the Attorney General's Insurance and Financial Services Division

XII. CONCLUSION

This claim presents clear liability, serious injuries satisfying the M.G.L. c. 231, § 6D threshold, and damages far exceeding the available coverage. [CARRIER_SHORT_NAME] has an opportunity to resolve this matter fairly by paying the policy limits to its own insured under Massachusetts law. We request a written tender or response within § 9's 30-day window if that consumer provision applies.

Respectfully submitted,

[LAW_FIRM_NAME]

By: _______________________________
[ATTORNEY_NAME]
BBO# [________________________________]
[ADDRESS]
[CITY], MA [ZIP]
[PHONE]
[EMAIL]

Counsel for [CLIENT_NAME]

ENCLOSURES:

• ☐ Policy declarations page and Massachusetts Standard Auto Policy
• ☐ M.V.C.P.R. (Police Crash Report)
• ☐ Medical records and itemized bills
• ☐ PIP payment ledger
• ☐ Wage loss documentation (W-2s, paystubs, employer letter)
• ☐ Photographs of vehicle damage and injuries
• ☐ Expert reports
• ☐ Tortfeasor carrier correspondence

CC:

• [CLIENT_NAME]
• [TORTFEASOR_CARRIER] (re: consent to settle)

MASSACHUSETTS UM/UIM LAW QUICK REFERENCE

Sources and References

• M.G.L. c. 175, § 113L — Uninsured Motorists; Insufficient Liability Limits
• M.G.L. c. 90, § 34A — PIP definition and minimum limit
• M.G.L. c. 90, § 34M — Personal Injury Protection
• M.G.L. c. 89, § 8 — Intersection right of way
• M.G.L. c. 260, §§ 2, 2A — Limitation categories
• M.G.L. c. 93A, § 9 — Consumer Protection, Private Remedies
• M.G.L. c. 176D, § 3 — Unfair Claim Settlement Practices
• M.G.L. c. 231, § 6D — Tort Threshold
• M.G.L. c. 231, § 6C — Interest on Contractual Damages
• Hopkins v. Liberty Mutual Insurance Co., 434 Mass. 556 (2001)
• Bobick v. United States Fidelity & Guaranty Co., 439 Mass. 652 (2003)
• Rhodes v. AIG Domestic Claims, Inc., 461 Mass. 486 (2012)
• Massachusetts Division of Insurance
• DOI insurance complaint filing and mailing address