Sample Settlement Demand Letter
[Date]
VIA OVERNIGHT MAIL
Mr. John Goodhands
Claims Adjuster
Onyourside Insurance Company
101 Somewhere Road
Rome, Georgia 30324
Re: Onyourside Insurance Company Insured: John P. Negligently
Claimant: Mike Hurtsobad
Claim No.: *******
Date of Incident: **************
Dear Mr. Goodhands:
Please take notice that on July 7, 200_ I suffered extensive injuries as a direct result of an incident involving a vehicle driven by your insured Mr. John P. Negligently. The following is a brief summary of the incident: Mr. Negligently was driving his 2008 Honda Accord in a southbound direction on Peachtree Road. Mr. Negligently failed to adhere to the stop sign at the intersection of Peachtree Road and Klondike Road. Additionally, Mr. Negligently was exceeding the posted speed limit when his vehicle entered the intersection in question. Mr. Negligently then impacted the front passenger side of my vehicle causing substantial damage to the vehicle and injury to me. For your convenience I have attached a copy of the accident report.
The massive impact threw my vehicle several yards and caused ___________damage to the ___________ of my vehicle. As a result of the impact my head/body/knee was smashed against the interior of the vehicle causing my serious bodily injury.
The following is a list of medical treatment I have been forced to incur as a direct and proximate result of the negligent behavior of your insured, Mr. Negligently:
Paramedic Treatment
I was treated at the scene by paramedics, who performed an evaluation of my injuries and provide general care for my injuries.
Happy Day Hospital
After the wreck, I was treated by the staff at Happy Day Hospital on July _______, who placed my arm in a splint (list all treatments). At the recommendation of the staff I underwent an (MRI or whatever evaluations – as applicable)
Physical Therapy Science
At the recommendation of the physicians at Happy Day Hospital I received physical therapy from Physical Therapy Science on the following dates:________________________ in order to alleviate the pain I was suffering from the wreck.
As a result of the wreck I have incurred a great deal of pain and suffering and have had difficulty sleeping due to the pain. I am forced to take ________ medications in order to cope with my injuries. It has been a long painful process recovering from these injuries.
Even now I suffer recurring pains and have difficulty getting around. My care providers have advised me that the pains will continue for many more months or even years.
As specified in the enclosed records, my medical expenses were as follows:
Paramedic/Ambulance fee $________
Happy Day Hospital (emergency room) $________
Happy Day Hospital (x-rays, MRI, etc) $________
Physical Therapy Science $________
Other (be sure to specify all) $________
Prescribed medication costs $________
Total Medical Expenses: $_______
Additionally, I was forced to miss __ days of work as a result of the wreck. Enclosed is a letter from my place of employment confirms the days of work I had to miss. The letter also indicates the wages I lost in that time $______ (4 weeks at $____ per week).
As a result of our insured negligence I was forced to endure a great deal of pain, suffering and disruption to my life. Much of the suffering is still going on. Due to this I demand compensation for my injuries and general damages in the amount of $_______________.
I look forward to hearing from you soon on this matter, no more than 30 days from the date of this letter. My hope is to resolve this matter amicably without the need of retaining trial counsel to protect my interests.
Yours truly,
Mike Hurtsobad
Enclosures:
Exhibit A – Accident Report
Exhibit B – Paramedics medical/incident records
Exhibit C – Happy Day Hospital medical records
Exhibit D – Physical Therapy Science
Exhibit E – Medication receipts
Exhibit F – Lost wages support documents
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