Personal Injury Demand Letters: How to Write a Strong Demand

Begin with the routing information the adjuster needs before reading a word of argument: your client, the insured, the date of loss, the claim and policy numbers and, in a limits case, the bodily-injury limit. Beneath it, a caption that names the letter’s legal function (a settlement demand, or a time-limited policy-limits demand) and a settlement-purposes legend.

Then make the ask in the first paragraph. Who you represent, what happened in one clause, the figure demanded, and the two or three reasons it is justified: liability is clear, the damages are documented, and the value of the claim supports the number. Adjusters read hundreds of demands; a demand that first appears on page nine is a demand that gets skimmed. Close the introduction with a one-paragraph reservation of privilege so the enclosed records cannot later be treated as a blanket authorization.

Describe what happened the way an investigator would: date, time, location, direction of travel, signal phase or hazard, point of impact, and what happened to the vehicles or the claimant afterward. Each fact should trace to something in the exhibits (the report, a photograph, a statement), so the narrative reads as a summary of the record rather than as advocacy.

Aggravating facts belong here too, stated once and with numbers: a measured alcohol concentration, a citation, an admission, a prior complaint about the same hazard. Stated plainly in the facts section, they support the liability and damages arguments later without being repeated, and they are the raw material for the exemplary-damages analysis in the next step, so record them precisely: the concentration, the speed, the phone records, the prior complaints, the arrest. Put the vehicle or scene photographs in the body of the letter, not only in the exhibits; a photograph answers the low-impact argument before the adjuster makes it.

Keep the adjectives out. “Violent” is acceptable if the photographs show it; “horrific” is not evidence of anything. The persuasive version of a facts section is the one the defense cannot dispute.

Argue liability from the specific duty the defendant owed and breached: the transportation code section on signals or following distance, the premises owner’s duty to inspect and warn, the statute that imposes strict liability for a dog bite. Cite it, then apply it to the facts already established. A letter built on the statute signals that the petition is half drafted.

Causation is argued twice: general causation here (the breach caused the collision) and medical causation in the injuries section (the collision caused these diagnoses). Keep them separate so each is complete.

Then take the defense away. Every adjuster is required to consider comparative fault, and every file has a candidate: speed, distraction, a late entry, an open-and-obvious hazard, provocation. Name the anticipated defense and foreclose it with the evidence: the signal sequence, the witness, the point of impact, the absence of any citation to your client. A comparative-fault argument left unanswered becomes a percentage taken off the offer.

Start with the baseline: age, work, activity and the absence of active treatment before the incident, in two or three sentences. Everything that follows is measured against it, and it is what makes the loss legible to someone who has never met your client.

Then move through treatment in date order, provider by provider. Each entry should carry the subjective complaint, the objective finding, the diagnosis, the provider’s causation or aggravation language where the record contains it, and the plan. Write from the records. Do not skip treatment gaps or degenerative findings, and leave unrelated dates of service out of the chronology and the specials. End at discharge or MMI, with remaining symptoms and recommended future care.

Read the medical chronology guide for what is a medical chronology, which fields to include, and how to prepare one an adjuster can verify.

Present medical expenses by provider, and within each provider list every individual charge line exactly as it appears on the provider’s itemized statement, in the same order: CPT code, description, date of service and billed amount, with a subtotal per provider and a total at the end. Do not summarize by visit or by category. Carriers run the CPT codes through their own evaluation software to price the claim, so a table that already contains every code, in order, is one the adjuster can enter quickly and completely. That means a faster evaluation and a faster offer, and no treatment left out of the calculation.

Only charges the reviewer has tied to the incident belong in the table, for two reasons, one cumulative and one immediate. Carriers keep data on the firms that send them demands, and a firm that regularly includes unrelated treatment is priced as one whose totals need discounting, on this file and on the next one. And on the file in front of them, a single unrelated charge lets the adjuster assume that some percentage of all the treatment is unrelated, and the percentage they assume is usually higher than the truth. Leave the routine physical and the unrelated prescription out of the letter and document them as excluded in the summary spreadsheet, so the total is defensible and the omission is transparent rather than hidden.

Itemize future medical expense from the treatment plan in the records: the confirmatory injection, the ablation if it succeeds, the maintenance therapy, the follow-up evaluation, each with a cost. A percentage uplift or a round number invites the adjuster to price future care at zero; an itemized plan traced to a provider’s recommendation survives scrutiny.

Wage loss is arithmetic: rate, hours, weeks, the phases of missed and restricted work, one total, and the supporting exhibit named in the paragraph. Add property damage only if it has not been resolved separately, and lost earning capacity only with a vocational or medical opinion behind it. Where the analysis in Step 3 supports exemplary damages, plead them in this section under the governing statute, less as a number than as the insured’s uninsurable exposure.

General damages are where demands most often drift into adjectives, and where adjusters most readily discount. The answer is to argue them in categories, each anchored to facts already established in the chronology: the pain scores and invasive procedures for physical suffering; the standardized instrument scores, formal diagnosis and treatment course for psychological harm; the specific tasks the client can no longer do the way she did them for loss of function and daily life.

Give each category its own number and one or two sentences of justification. The working rule is to start each of the three categories at roughly one times the related medical specials, so that three categories at baseline produce general damages of about three times the specials, arrived at transparently rather than as a lump sum. Move a category above baseline, up to about two times the specials, only where the record shows unusual severity (a traumatic brain injury, a surgical repair, permanent impairment or disfigurement), and hold the others at baseline. It is a case-by-case judgment, and the justifying sentence should say what in the record earns the higher figure. Where carriers evaluate with software, coded diagnoses, objective findings, treatment duration and documented daily-life impact are the inputs that move the output; a single lump-sum multiplier with nothing behind it is not.

Before the demand itself, a damages summary: economic subtotal, non-economic subtotal, total. Then the sentence the letter exists for, stating what the arithmetic means: that the value of the claim exceeds the available limit, or supports the figure demanded. After ten pages of evidence the conclusion should be one line.

The demand paragraph does four things. It states the number (or the policy limits) without hedging; conditional language gives the carrier room to argue it never received a real offer. It states what is offered in return, typically a release of the insured. It addresses liens, usually by agreeing to satisfy valid liens from the proceeds. And it sets a deadline: a date, a time and a time zone, with the consequence stated. Thirty days is the conventional response window for an ordinary demand; time-limited policy-limits demands use shorter windows, and several states now prescribe minimum periods and required contents by statute. Confirm the rule in your jurisdiction before choosing a window.

Close with the signature block and the enclosure list. Then stop. A demand that keeps arguing after the ask has been made reads as uncertain.

The exhibits are the package, and their order is what makes them usable. Separate every medical document into two groups before anything else: bills only, then records only. Within each group, one exhibit per provider, with the providers in the same order in both groups, so that the adjuster who has just read a provider’s bills at Exhibit A3 knows that provider’s records are at Exhibit B3. Then the crash or incident report and investigation materials, the photographs, and the wage documentation, in the order the letter cites them. Letter each group, number each provider within it, and cite the exhibit in the letter wherever a fact depends on it. In a well-assembled package each exhibit is a bookmarked section of one PDF, so the adjuster can go from a citation to its source in one click.

Two checks before it goes out. Every provider in the bills appears in the records and in the chronology, and vice versa; a bill without a record, or a record without a bill, is a question the adjuster will ask. And the exhibit index in the letter matches the bookmarks in the PDF, group for group and provider for provider.

Finish with a summary of every charge and diagnosis, coded and categorized by relation to the incident. It is what lets the adjuster reconcile the letter against the bills in minutes instead of disputing the total. Redaction is the final pass over the assembled exhibits, and it has its own step.

Redaction is the last pass over the package, done on the exhibit copies after they are assembled and before they are bookmarked. It protects the client, and it keeps the adjuster’s evaluation on the injuries and the billed charges rather than on collateral facts. Five categories cover nearly everything that should come out.