Car Accident Demand Letter: What Goes In It and When

Until the demand is sent, the insurer has a claim file with a police report, some bills and the adjuster's notes. The demand is the injured person's statement of the claim: what happened, what it did, what it cost and what it is worth. The adjuster enters the demand's contents into the valuation system, and the range that comes out is the range within which the adjuster negotiates. A thorough demand produces a higher range than a thin one, because the system reads what it is given.

The demand also fixes the claim's shape for everything that follows. If the claim settles, it settles within the frame the demand set. If it goes to a lawsuit, the demand is the first statement of the case the defense attorney reads, and the attorney who wrote it is held to it. It is written with both possibilities in mind.

The timing follows from the purpose. A demand sent before treatment ends values an injury whose extent is unknown; a demand sent after treatment, with the final diagnosis, the discharge note and any opinion on permanence, values the actual injury. Insurers make early offers precisely because they are low; the demand is the answer to them, sent when the claim can be valued.

Liability first: a factual account of the crash, the other driver's fault with reference to the police report, any citation, witness statements and photographs, and a response to any fault argument the insurer has raised. Then the injuries: each diagnosis, in the doctors' words, with the records that establish it, and the mechanism relating it to the crash. Then the treatment: the emergency room, the physicians, the imaging, the specialists, the therapy and any surgery, in sequence, with the duration and the discharge status.

Then the economic losses: the medical bills itemized by provider with the amounts billed and, where the state requires, paid; the lost income with the employer's documentation; and any other expense, mileage to treatment, medication, equipment, household help. Then the non-economic losses: the pain, the limitation, the effect on work, family and activities, in specific terms rather than generalities, and any lasting effect with the doctor's opinion on permanence. Then future costs, where a doctor has projected further treatment.

Then the figure: a specific demand, usually set above the realistic range to leave room, supported by the preceding sections, with a deadline for response. The package attaches everything: the police report, the records, the bills, the wage letter, the photographs, and any opinion letters. The letter is organized so that an adjuster can find each element and enter it, because that is what the adjuster will do.

Suppose you were rear-ended at a light, had a neck injury with a disc bulge on MRI, treated for five months with therapy and an injection, and were discharged with residual stiffness the physiatrist described as likely to persist. Medical bills were $18,500, and you missed two weeks of work, $2,400. The insurer had accepted fault and offered $5,000 in week three.

The demand, sent in month six, set out the rear-end crash and the accepted fault; the diagnosis of cervical strain and disc bulge with the MRI report; the treatment sequence with every record; the bills by provider; the wage letter; the effect on your work at a desk, your sleep and your running; the physiatrist's opinion on persistence; and a demand of $65,000. The package ran to several dozen pages of attachments.

The insurer responded in four weeks at $19,000. Three rounds over two months brought it to $34,000, and the claim settled there. Had the demand omitted the physiatrist's opinion on persistence, the range would have been set lower, and had it been sent in month two without the MRI and the injection, the figure would have been a fraction. All figures are hypothetical; the pattern of a first offer near the bills and movement on documented permanence is typical.

The demand is assembled during treatment and sent when treatment ends; the work is in the gathering.

• Request complete records and itemized bills from every provider as treatment proceeds, not at the end; records departments take weeks.
• Get a written work restriction from each doctor and a wage letter from the employer stating position, pay, dates missed and lost overtime.
• Ask the treating doctor, at discharge, for a written opinion on prognosis, permanence and future treatment; it is the single most valuable attachment.
• Keep a log of the injury's effect on daily life from the start; specific entries are more persuasive than a summary written later.
• Collect the police report, photographs, witness statements and any camera footage, and address any fault argument the insurer has raised.
• Set the figure with the realistic range in mind, above it to leave room, and within what the evidence supports; an inflated figure costs credibility.
• Send the demand once, complete, by a method that documents delivery, with a response deadline, and do not send pieces.

The demand's contents are shaped by the state's rules. Where medical expenses are valued at the amount paid rather than billed, as in California and Texas among others, the demand presents the paid amounts; where billed amounts are recoverable, it presents those. The state's comparative negligence rule determines how much attention the liability section gives to the insurer's fault arguments, and in the contributory negligence states the liability section must be airtight. Damage caps shape the non-economic figure.

In no-fault states, the demand to the at-fault driver's insurer must establish that the injury meets the threshold, with the doctors' opinions on permanence or seriousness as the central attachment, and it accounts for what PIP has paid. Several states have statutes requiring insurers to respond to claims within set periods and to pay or deny within set periods after receiving proof of loss, which a demand with a deadline invokes; a few states, including Florida and Georgia, have specific statutory demand procedures that, if followed precisely, expose the insurer to liability above the policy limits if it fails to settle.

The deadline to file a lawsuit runs regardless of the demand: one year in Tennessee and Kentucky, two in Texas, California, Florida and Georgia, three in New York and North Carolina. A demand sent too close to the deadline leaves no room to negotiate, and a claim that has not settled must be filed before the deadline whatever the state of negotiations.

The insurer acknowledges the demand, often requests additional records, and responds with an offer in two to six weeks, usually well below the demand and often near the medical bills. The response may also restate fault arguments or dispute the relationship of some treatment to the crash. Each point is answered in writing, with evidence rather than argument, and a counter-demand follows. Two to four rounds over one to three months is the usual course.

A settlement is confirmed in writing, a release is sent and signed, and payment follows in three to six weeks, with liens resolved from the proceeds. An insurer that does not respond, or whose final offer is unreasonable, is answered with a lawsuit, filed before the deadline, which moves the claim to the court's timeline and to discovery, where the insurer's own evaluation of the claim is tested.

The demand is often sent by an attorney, and insurers respond differently to a represented claimant, because the alternative to settlement is a lawsuit the attorney will file. An unrepresented claimant can send a demand, and the elements are the same; the difference is in the credibility of the threat behind it.

A demand letter is the document the insurer values the claim from, sent once and complete after treatment, with every record attached and a figure the evidence supports, and its quality determines the range the negotiation happens in. The questions to answer early are whether treatment has ended, whether the records and the doctor's opinion on permanence are in hand, and what the realistic range is. Most personal injury attorneys work on contingency and prepare demands as the core of what they do.

Ask Legal Matters is a free claim-review request service, not a law firm. Requests may be shared with independent attorneys and legal services partners who handle inquiries in your state, and an attorney must evaluate the facts before anyone can say what the claim is worth. If you are at the stage of valuing your claim, you can request a free claim review.

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