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Personal Injury Demand Letter – Sample

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Personal Injury Demand Letter – Sample

Updated August 24, 2023

A personal injury demand letter is a document that requests a settlement for injuries incurred during an accident.  The individual is seeking payment for personal injury only.

Table of Contents

What to Include?

  • Details of the facts surrounding the accident
  • Advisement of why the other party should be held responsible
  • Information regarding injuries
  • Settlement Amount being requested (Inclusive of medical expenses, lost wages, pain and suffering, etc.)
  • Supporting documentation for the claim (policy records, medical information regarding injuries, hospital invoices, witness reports, out-of-pocket expenses, etc.)
  • A statement advising the letter is for settlement purposes

How to Make a Personal Injury Claim (3 steps)

  1. Give Details About the Injury
  2. Negotiate a Settlement
  3. Further Action

1. Give Details About the Injury

All details surrounding the injury(s) in question should be provided. If treatment was received for the injuries the treatments and any future treatments that may be needed for each injury.

2. Negotiate a Settlement

Advise that there is an opportunity for the individual or legally responsible insurance agency to settle for a set monetary amount. Ensure the amount listed is itemized with all expenses incurred and any future financial needs.

3. Further Action

The Personal Injury Demand Letter should be sent via certified mail or in a form that will provide evidence it has been received.


Sample Demand Letter

Anchor General Insurance
John Jones – Senior Claims Adjuster
1915 Central Park Avenue
Scottsdale, AZ 85253April 1, 2018


Re: Claim Number QA-789654C

Insured: Corin Matthews
Claimant: Timothy Sutton
Date of Birth: 05/19/1957
Date of Accident: 4/14/2017

Dear Mr. Jones,

On April 14th, 2017 I suffered severe and critical injuries, when the actions of your insured, Corin Matthews, caused a most horrific car accident. Your insured failed to stop at a red traffic signal and violently crashed into my vehicle.

While I have been advised by several medical experts and doctors that my condition is now more stable, I have suffered significant pain and suffering and will continue to do so for many years to come. I would like for you to review the information I have provided below, and documents attached, to help facilitate and expedite my settlement claim.

On the morning of April 14th, 2017 I was approaching the intersection as the light was green and clearly in my favor. While I was at the intersection of Scottsdale Road and Shea Boulevard with the intention of heading north toward Cafe Monarch; your insured, Corin Matthews, struck my vehicle so forcefully and without warning that my car was forced into a median at which point both the median and the electrical post fell and hit my car. This severe accident was due to the fact that your insured was going too fast to stop in a timely and safe manner. Had the insured appropriately headed the red traffic light, this accident could have been avoided.

You will see in the pictures attached the severe damage to my vehicle and myself. I was rushed to the Emergency Room at which point I needed emergency surgery to amputate my foot. The crash, caused my right leg to be ripped in shreds and was crushed beyond repair. Imagine my surprise and emotional distress when I woke up to the horrific scene of no longer having one of my legs. From that moment, I have undergone physical and mental therapy. I have had to tend to other wounds incurred on my head, arms, and back (please see attached pictures). I have yet to return to work and will not be able to continue my job until I am no longer taking the pain medication and needless physical therapy (currently I am still undergoing 3 hours of rehabilitation each day and 1 hour of mental therapy).  Below you will find a summary of the damages to date:

Ambulance Transfer – $1,500.35
Leg Amputation – $53,052.50
Follow Up Care (3-year minimum) – $48,550.00
X-Rays – $3,700.00
Pain Prescriptions – $850.75
Crutches – $75.00
Leg Prosthetic – $5,000.00
Emergency Room Cost – $6,675.00
Lost Wages – $52,005.80
Mental Therapy – $8,850.20
Future Mental Therapy – $35,500.00
Emotional Distress – $50,000.00
Pain and Suffering – $300,000.00                             

Total Damages – $565,759.60

Your insured was rightfully cited by the authorities and is clearly liable for my losses and injuries. Your insured’s negligence has forever changed my life and they are a direct cause of my injuries, pain and suffering. I hereby make demand of $565,759.60 for my injuries, loss, pain and suffering which were in direct correlation with the accident your insured has caused.  Please respond back to this demand letter no later than 30 days from the postmarked date.

Thank you in advance for your time and consideration of the above claim. Should there be any questions additional details needed, please do not hesitate in contacting me.


Timothy Sutton