Car Accident Demand Letter Template – Sample

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Updated April 07, 2022

A car accident demand letter is written to request payment in relation to a personal injury that occurred during a car accident. In most cases, this involves the driver or passenger, not at fault, that was injured in the accident. The letter commonly acts as an instrument to forward any medical bills to the other driver or their insurance company. Depending on the severity of the claims, if the amount is not paid or there is no response legal action may follow.

Table of Contents

What to Include?

For a Car Accident Demand Letter to be most effective, it should be comprised of the following:

  • A detailed account of the facts surrounding the accident should be documented. The account should be poised and not emotional.
  • The letter should include an explanation of why the individual feels that the party in question should be held liable for all medical costs or injury treatment and property damage.
  • A detailed itemized list of all fees incurred due to treatments, medications, copays, surgeries, property damage, and any other additional costs that may have been incurred such as lawyers, caregivers, etc.
  • An account of all time taken off work and lost wages from the time off.
  • A medical statement documented by the treating physician(s).
  • Supporting documentation from any law enforcement reports, witness statements or employer statements.

The final amount the individual is requesting to be paid out. The lost wages and all costs incurred should be combined.

How to Get Paid (after a car accident)

Step 1 – Enter the Accident Details

The detailed account of the accident should include all aspects. Some preceding information may be necessary (“I was heading to pick up my son, when…”) as this would be appropriate in providing a full depiction of everything that occurred, in order for the insurance company to make a final determination. The individual will want to provide the direction of travel, speed, intersection or freeway information and who they believe caused the accident versus the person that should not be held liable. Supporting statements should be made with evidence, such as the police report, should be provided.

Step 2 – Write the Injuries and Medical Treatment Sustained

A full list of injuries and all receipts from medical bills should be included. Providing pictures may help depict how long an individual incurred the injuries for and a list of all medical treatments received due to the direct result of the accident should also be attached.

Step 3 – Calculate the Total Demand ($)

The total demand should be mainly from:

  • Vehicle Damage
  • Medical Costs
  • Work Absence

Perhaps the biggest financial affect anyone involved in a vehicle accident is earnings and wages lost. It’s important to note that time off work for doctor’s appointments or therapy, regardless of the length of time, should be documented. Paystubs showing a lack of wages or employer statements are helpful in providing evidence. Any lost property due to the accident should be accounted for in terms of damages, which may include the vehicle itself and any items that were damaged

Step 4 – Send Report to Insurance Company or the Driver

Once the letter is ready it should be sent to the appropriate insurance company or the driver of the vehicle. Legal counsel should be consulted to ensure the letter provides all necessary details and evidence. The Car Accident Demand letter should be sent via certified mail confirm it made it to the correct destination and it has been received.

After the demand has been paid the parties should enter into a Car Accident Release of Liability.

(Video) Car Accident Demand Letter – EXPLAINED

How to Write (Fill-in)

Download: Adobe PDF, Microsoft Word (.docx), Open Document Text (.odt)

Step 1 – Save The Car Accident Demand Letter

The demand letter used to inform a Driver that he or she is delinquent regarding his or her responsibilities to an Accident Victim is a downloadable item. Three buttons beneath the preview and three text links above these instructions grant access to a “PDF or “Adobe PDF” file, “Word” or a “Microsoft Word (.docx)” file, and an “ODT” or “Open Document Text (.ODT)” version of this document.


Step 2 – Identify The Car Accident Victim’s Return Address

This letter may be sent by the Car Accident Victim or by his or her Representative, Agent, Attorney-in-Fact, or Attorney. For our goals, we shall assume this is a direct correspondence from the Car Accident Victim to the Delinquent Driver. Thus, locate the word “From” then report the full name and return mailing address for this letter. This will be the entity and address the Recipient will be obligated to direct his or her response to whether it is positive or negative.


Step 3 – Declare The Formal Date Of The Demand Letter

It is imperative to the function of all letters demanding compliance that a specific calendar “Date” is attached to the letter. The “Date” label will need this calendar month and day on the first line that follows and the appropriate year on the second line.


Step 4 – Directly Address The Offending Vehicle Owner

The next task set by this letter will be a clear identification of the Delinquent Driver as the intended Recipient. This is the entity who is financially responsible for the damages caused by the automobile accident.  


Step 5 – Document The Accident Date

This demand will begin with a basic declaration statement succinctly summarizing the reason this letter is being sent. The opening statement however is not complete and will need your participation for its presentation. Look through your records, then report the exact calendar date of the accident by typing in the month and day (calendar day) on the first blank space after the wording “…Car Accident That Occurred On” then complete this date with the two-digit year on the space that follows.   


Step 6 – Present The Demand Amount

The blank line after the dollar sign in the first paragraph will conclude the declaration statement beginning this letter. This line is reserved strictly for the full amount of money the Delinquent Driver must pay or arrange to be paid to the Accident Victim. 


Step 7 – Itemize All Dollar Amounts Contributing To The Total Demand

The next portion of this letter will also necessitate some information from your current records to be reported accurately. Several lines formatted to accept dollar value entries are presented as the second paragraph of this demand. Notice that each one’s label will directly refer to an amount of money lost by the Accident Victim or owed by the Accident Victim as a result of the Driver’s actions. Begin satisfying these requests for information with a total required for all the “Injuries/Treatment” the Victim received. These can be summed up by looking through the medical, therapy, and pharmaceutical bills generated for the services and the products the Victim paid for or owes. Make sure this is an accurate sum then, input it directly after the “Injuries/Treatment” label.  “Out Of Pocket Expenses” refers to money the Victim paid in miscellaneous expenses. For instance, did the Victim need to pay for a tow truck at the time of the accident? Did he or she need to rent a car or pay for public transportation? Perhaps he or she needed to pay for extra time in child-care due to a longer commute without a vehicle? These are all legitimate expenses that may have been accrued by the Victim as a result of the accident. They should be considered, summed up, then listed on the second blank line if the Accident Victim intends to recoup the monies spent on these “Out Of Pocket Expenses.” If there is any question as to what can legitimately fall under this category, then many would consider it wise to consult with a professional or an attorney with knowledge of the current driving laws in the state where the accident occurred.Unfortunately, many car accidents will cause the Victim to suffer “Lost Wages/Earnings” due to lost time, long-lasting injuries, or mental/emotional trauma. Regardless of the exact reason if such loss of money is a consequence of the accident, then make sure a full account of this loss is entered as a dollar value after the label “Lost Wages/Earnings”Finally, all “Pain And Suffering” the Accident Victim endured and currently endured may also be summed up for a dollar value. Before reporting this, it is strongly suggested that you consult with your insurance company or an attorney to obtain or verify the dollar amount that should be listed here. Once this figure has been calculated, enter it on the “Pain And Suffering” line. Many insurance companies will set this amount to be between three and nine times the amount in medical bills that resulted from the accident while others will use a different formula. Therefore, many would consider it wise to consult your insurance company’s paperwork or that of the Delinquent Driver’s when assessing this sum.


Step 8 – Report The Details Of The Car Accident

The third part of this demand bears the title “Statement Of Facts: Car Accident.” Here we will perform two tasks. First, we will further define the accident itself, then we will expand on how the accident impacted the Victim’s finances. Begin by recording the exact date and time of the accident using the blank lines before and after the term “…At Approximately…” to do so. Remember to indicate whether the accident occurred in the “A.M.” (12:00 a.m. to 11:59 a.m.) or “P.M.” (12:00 p.m. to 11:59 p.m.)” by marking the appropriately labeled checkbox.Several blank lines are on display beneath accident’s reported date and time. Use these to describe how the accident occurred or the series of events before and during the accident. Be as specific as possible. If any reliable witness accounts are on record, you may want to consult them after you have filled in this area for accuracy.


Step 9 – Produce A Report For Each Accident Expense

Several more headings will make up this section. Notice that each one will correspond to the summary expenses you supplied above. Here, you will give specific reasons for the numbers you entered. The “Injuries And Treatment” statement will need a listing of the physical damage to the Accident Victim’s body along with the treatment or therapy that was required. This information can be gathered by looking through your medical records and bills to all documents referring to the accident as a cause to the physical damage or ailment the Victim had to pay for treating then listing all such pains, damage, and ailments on such documents.The “Out-Of-Pocket Expenses,” like the previous two sections, must serve to reinforce the amount you listed above. Use this section to explain how the accident has caused the Victim to pay for items or services he or she would not normally need. A good example are Parents whose car was destroyed and must now pay a private company to bus his, her, or their children to school and back or to daycare. If at all possible, be prepared with proofs in the form of receipts for these items or at least the name of the entity that was patronized. This is strongly recommended since these losses can be notoriously difficult to regain without proof.
The “Lost Wages/Earning” will aim to support the dollar amount you entered earlier. Look through your records (limit your search to dates after the accident!) for any losses in earnings caused by the Victim being in the concerned accident. For instance, if a Contractor’s leg is broken and he or she can no longer work while it heals, this can cause a considerable loss. The Contractor in this case can be expected to produce some work records to indicate this. Employees for businesses or other entities will be able to simply list the number of absent days from work that the Victim missed. See the example below for such a case.
The “Pain And Suffering” section here will largely depend upon what the local and state laws will allow to be deemed as such. For instance, the Victim may now need physical therapy, or the Victim may have relapsed to a drug and alcohol problem due to suffering PTSD. There are quite a few scenarios that can define the short and long-term suffering the Victim of an accident may need to deal and pay for. Additionally, some states, unlike the one in our example, will limit how much can be recouped for “Pain And Suffering.” It will be left up to your Representatives and yourself to be abreast of the law. To be as safe as possible, you will need to refer to your records (i.e. courts, insurance companies, attorneys) to see what was deemed to be the Delinquent Driver’s responsibility.   


Step 10 – Close This Letter With Your Signature

A letter demanding that action be taken, or consequences be faced will not be taken seriously in nearly all cases unless it is signed by the Sender or the Accident Victim. For this effect, locate the blank line labeled “Sincerely,” then make sure one of these parties sign this line. Keep in mind, if this is not the Car Accident Victim then it must be someone who is authorized to represent the Car Accident Victim (i.e. an Attorney-in-Fact acting on behalf of an incapacitated Principal through a medical power of attorney). 


Related Forms

Car Accident Settlement Agreement – If the driver at fault and the victim agree to a settlement amount, an official release should be given to the driver once the funds have been paid.




Insurance Company Demand Letter – Use if the individual that was injured is demanding money from an insurance company.