WRONGFUL DEATH DEMAND LETTER

Demand on Behalf of Statutory Beneficiaries and Estate

[LAW FIRM LETTERHEAD]

DATE: [________________________________]

VIA: Certified Mail, Return Receipt Requested
AND: Email to [________________________________]

TO:

[ADJUSTER NAME]
[INSURANCE COMPANY]
[ADDRESS]
[CITY, STATE ZIP]

Claim Number: [________________________________]
Insured: [________________________________]
Date of Loss: [________________________________]

RE: WRONGFUL DEATH CLAIM

Dear [ADJUSTER NAME]:

This firm represents [PERSONAL REPRESENTATIVE NAME], as Personal Representative of the Estate of [DECEDENT NAME], deceased, and the statutory wrongful death beneficiaries, in connection with claims arising from the death of [DECEDENT NAME] on [DATE OF DEATH], caused by the negligence of your insured.

I. INTRODUCTION

This demand presents claims under both:

☐ Wrongful Death Statute - [STATE STATUTE CITATION] - claims by statutory beneficiaries for their own damages
☐ Survival Statute - [STATE STATUTE CITATION] - claims by the estate for decedent's damages prior to death

II. THE DECEDENT

A. Personal Information

Full Legal Name: [________________________________]
Date of Birth: [________________________________]
Date of Death: [________________________________]
Age at Death: [________________________________]
Place of Death: [________________________________]
Cause of Death: [________________________________]
Marital Status: [________________________________]
Occupation: [________________________________]
Employer: [________________________________]
Annual Income: $[________________________________]

B. Life Expectancy

Based on actuarial tables, [DECEDENT] had a remaining life expectancy of approximately [____] years at the time of death.

C. Health Prior to Incident

[DECEDENT] was in [excellent/good/fair] health prior to the incident, with the following relevant medical history:
[________________________________]
[________________________________]

III. STATUTORY BENEFICIARIES

The following individuals are entitled to recover under [STATE]'s wrongful death statute:

A. Spouse

Name: [________________________________]
Date of Birth: [________________________________]
Date of Marriage: [________________________________]
Length of Marriage: [________________________________]

B. Children

C. Parents (if applicable)

D. Other Statutory Beneficiaries (if applicable)

[List any other beneficiaries recognized under applicable statute]
[________________________________]

IV. ESTATE ADMINISTRATION

Estate Case Number: [________________________________]
Court: [________________________________]
Personal Representative: [________________________________]
Letters Testamentary/Administration Issued: [________________________________]
Estate Attorney (if different): [________________________________]

V. LIABILITY

A. Facts of the Incident

[Provide detailed narrative of how the incident occurred and caused decedent's death:]

On [DATE], at approximately [TIME], [DECEDENT] was [description of what decedent was doing]. At that time, your insured, [INSURED NAME], [description of negligent act or omission].

As a direct and proximate result of [INSURED]'s negligence, [DECEDENT] sustained fatal injuries and died on [DATE - same day or after interval of survival].

[________________________________]
[________________________________]
[________________________________]

B. Evidence of Liability

Police/Investigation Report:
[Summarize findings]

Witness Statements:
[Summarize witness accounts]

Physical Evidence:
[Describe evidence]

Expert Analysis:
[Summarize expert opinions]

C. Legal Analysis

Your insured's negligence caused [DECEDENT]'s death through:

☐ [Describe specific negligent acts]
☐ [Describe breach of duty]
☐ [Describe causation]

Applicable Statutes Violated:
[________________________________]

D. Conclusion on Liability

Liability is clear. Your insured is fully responsible for [DECEDENT]'s wrongful death.

VI. SURVIVAL ACTION DAMAGES

[// GUIDANCE: These are decedent's own damages from time of injury to death]

A. Medical Expenses

[DECEDENT] incurred the following medical expenses from the time of injury until death:

B. Pain and Suffering (Decedent's)

[DECEDENT] survived for [TIME PERIOD] after the incident and experienced [describe pain and suffering]:

[________________________________]
[________________________________]

Survival Period Pain and Suffering: $[________________________________]

C. Other Survival Damages

D. Total Survival Action Damages

VII. WRONGFUL DEATH DAMAGES

[// GUIDANCE: These are beneficiaries' own damages for loss of decedent]

A. Funeral and Burial Expenses

B. Loss of Financial Support

Decedent's Earnings:
- Annual Gross Income: $[________________________________]
- Annual Net Income (available for family): $[________________________________]
- Expected Retirement Age: [________________________________]
- Years of Expected Future Earnings: [________________________________]

Economic Loss Calculation:

[// GUIDANCE: Attach economist report if available]

C. Loss of Benefits

D. Loss of Services

[DECEDENT] provided the following household services:

Present Value of Lost Services: $[________________________________]

E. Loss of Parental Guidance and Training (Minor Children)

[Describe loss to minor children:]

[DECEDENT] was actively involved in [his/her] children's lives:
- [Description of parenting activities]
- [Description of guidance provided]
- [Description of future involvement that will be missed]

Claimed for each minor child:
| Child | Damages |
|-------|---------|
| [________] | $[________] |
| [________] | $[________] |
| TOTAL PARENTAL GUIDANCE | $[________] |

F. Loss of Companionship, Society, and Comfort

Surviving Spouse:

[Describe the marital relationship and loss:]

[________________________________]
[________________________________]

Spouse's Loss of Consortium: $[________________________________]

Children:

[Describe each child's relationship with decedent and loss:]

Parents (if applicable):

[________________________________]

G. Mental Anguish of Beneficiaries

[Describe the emotional impact on each beneficiary:]

Spouse:
[________________________________]

Children:
[________________________________]

Parents:
[________________________________]

VIII. TOTAL DAMAGES SUMMARY

A. Survival Action (Estate)

B. Wrongful Death (Beneficiaries)

C. Combined Total

IX. SETTLEMENT DEMAND

Based upon the clear liability, the devastating loss to [DECEDENT]'s family, and the substantial damages incurred, we demand the sum of:

$[________________________________]

to fully and finally resolve all claims arising from this wrongful death, including both the survival action and wrongful death claims.

X. ALLOCATION OF SETTLEMENT

[// GUIDANCE: May be required by court, affects lien resolution]

Upon settlement, the proceeds will be allocated as follows, subject to court approval if required:

XI. LIENS AND SUBROGATION

A. Medicare/Medicaid

[// GUIDANCE: Medicare conditional payments may apply to survival action medical expenses]

☐ Decedent was a Medicare beneficiary
☐ Medicare conditional payments: $[________]
☐ Medicaid lien: $[________]

B. Other Liens

XII. RESPONSE DEADLINE

Please respond to this demand within thirty (30) days. Given the clear liability and substantial damages, we expect a prompt and fair offer.

If we do not receive a reasonable response, we will proceed with filing a wrongful death lawsuit without further notice.

XIII. ENCLOSURES

☐ Death Certificate
☐ Autopsy Report (if applicable)
☐ Medical Records and Bills
☐ Police/Investigation Reports
☐ Witness Statements
☐ Letters Testamentary/Administration
☐ Marriage Certificate
☐ Birth Certificates of Children
☐ Employment Records / Tax Returns
☐ Economic Expert Report
☐ Funeral and Burial Receipts
☐ Photographs of Decedent with Family
☐ Declarations from Beneficiaries
☐ Other: [________________________________]

XIV. RESERVATION OF RIGHTS

This demand is not an exhaustive statement of all damages. All rights and claims are expressly reserved, including punitive damages where applicable.

Please direct all communications to:

[ATTORNEY NAME]
[LAW FIRM NAME]
[ADDRESS]
Phone: [________________________________]
Email: [________________________________]

Very truly yours,

[SIGNATURE]

[ATTORNEY NAME]
Attorney for the Estate of [DECEDENT] and Statutory Beneficiaries
[STATE BAR NUMBER]

cc:
☐ [PERSONAL REPRESENTATIVE]
☐ [BENEFICIARIES]
☐ File