When you spend as much time preparing for a claim as you have, it’s natural to start to wonder when your efforts will finally pay off. Despite the pain of your injuries and the stress you’re dealing with, you’ve worked hard to determine liability and collect proof of the at-fault party’s negligence. You’ve made it through your treatment phase, keeping all of your doctor appointments even when it wasn’t convenient, and made sure that your doctor has documented every medical complaint you had. You’ve been building your claim, carefully creating a winning hand for yourself. Now it’s time to show the insurance adjuster your cards.
What Is a Demand Letter?
While your evidence is important, it doesn’t speak for itself. It can’t tell the full story of what happened and how your injuries have impacted your life. Evidence alone doesn’t effectively communicate the value of your claim, which is why you have to craft a demand letter. The demand letter is a written narrative that ties together all of the evidence you have collected relating to the other party’s liability and your damages. It is the centerpiece of the demand package, in which you submit all of your evidence to the insurance company for consideration. In your demand, you explain why you deserve compensation and back up every claim with evidence. You request compensation, directly or indirectly.
Your demand letter opens up your claim for negotiation and sets the tone for how your negotiations will go. A strong demand letter will help you maximize your settlement, while a weak one can jeopardize your chances of recovering anywhere near the amount of money you deserve.
Make Your Demand a Reason for Settling Out-of-Court
While your demand letter should tell the story of what happened in the case of your accident – both the causes and the effects – it should also provide the insurance adjuster with a snapshot of what to expect in a trial, should the company fail to settle the claim with you out-of-court. Your letter must be as compelling as possible.
Litigation is always a gamble for insurance companies. In a settlement, the amount of money you receive is limited to the amount of coverage the policy provides. In the case of a jury verdict, the sky is the limit. Jurors can award claimants as much as they want to, which means the insurance company can’t protect a policyholder from losing personal assets if the award is higher than the policy coverage limits. Your demand package should paint a full picture of your life after the accident so that the insurance company sees you as a threat if the claim were to go to trial.
Getting Started: Gathering Your Evidence
Before you start writing, bring together all of your evidence. Make sure you have:
- All evidence of liability, including:
- any police report or incident report
- copies of laws, rules, or construction codes that illustrate negligence on the part of the other party in terms of operating a vehicle, maintaining a property, or building a structure
- All evidence of economic damages, including:
- complete medical bills
- work records or employer statement indicating the amount of time you missed work and the amount of income you lost as a result, accompanied by a doctor’s note detailing why your injuries prevented you from working during that time
- documentation of injury-related expenses, such as hospital parking receipts
- documentation of any related property damage (not including a car damaged in a motor vehicle accident)
- All evidence of non-economic damages, including:
- complete medical records to illustrate your ongoing complaints
- photographs of any damage to your car, even though you are treating this property damage as a separate claim, to illustrate the severity of the accident (if applicable)
- your journal or other personal documentation of how the accident has impacted your life and made it difficult to perform certain necessary or enjoyable actions
In civil claims, we call this collection a “preponderance of evidence.” These documents will make up the evidence portion of your demand package, in which you will refer to them as “exhibits” organized by letter or number.
How Long Should Your Demand Letter Be?
There are few absolute requirements for a demand letter, beyond the attachment of your preponderance of evidence. Writing a demand letter is an art, and different people do it in different ways. Some attorneys will simply draft a letter demanding that the insurance adjuster to call them to discuss compensation and enclose the letter with the client’s medical bills. Others go into slightly more detail, providing a summary of what happened and demanding a specific amount of money.
At our office, we find the most success with detailed demand letters that thoroughly explain the liability of the policyholder and the consequences of the accident. Below, we’ll walk you through the step-by-step process of writing a demand letter in this style, and even provide you with a sample outline you can use for writing your own demand. Preparing a demand letter as thoroughly as possible illustrates to the insurance adjuster that you are ready to take the case to litigation if necessary to get the settlement you deserve. Also, since the demand package is the focal point of negotiations, you can’t simply add items that you forgot later on. Even if the insurance adjuster receives your documents, after-the-fact additions to a demand letter rarely receive enough consideration to change a settlement substantially.
Sending an addendum after-the-fact won’t have as much impact as including all of your information in your original demand letter – and it may not have enough influence to make any difference at all. Photo Credit: Flickr (Creative Commons license).
So, how long should your demand letter be? We recommend making it as long as it possibly can be without containing fluff. You don’t have to restate information in its entirety if you are already including the evidence in exhibits, but don’t leave anything out, either. Generally speaking, your letter will be at least a few typed pages long, not including the exhibits you attach. Demand letters as long as 10 or more pages aren’t uncommon for cases in which the victim had to undergo numerous medical treatments.
Tips for Writing a Successful Demand Letter
Read on to learn best practices for writing the many sections of a demand letter. You can also download our sample outline and use it to write your own demand letter. [gview file=”//www.myinjuryattorney.com/law-blog/wp-content/uploads/2013/12/Sample-Demand-Letter-Outline.pdf”]
Knowing how to start your demand letter can be tricky. On the first page, you always want to include the date you wrote (or finished) the letter, your own information and claim number under a “Claimant Information” section, and the basic facts of when and where the accident occurred under an “Incident Description/Liability” section. This allows the insurance adjuster to quickly recognize which case the demand is in reference to without having to dig through the document.
One question that can stump you when you set out to write a demand letter is whether to use first person (“I”) or third person (he/she). While attorneys refer to clients in third person in demand letters, it’s fine for you to use “I” when handling a claim yourself. Photo Credit: Flickr (Creative Commons license).
At our office, we always begin our demand letters with liability. We explain what happened, usually under a section titled “Description of Accident” or something similar. A good staring place for this section is “on the above-named date…” Be specific regarding what happened.
If your injury involved an automobile accident, you might state first that you owned and/or operated the vehicle, then explain what the vehicle was doing at the time of the accident. If you were traveling, in which direction were you going? Did you have the right-of-way, and if so, why? If you were stopped, note the reason, whether it’s traffic, a stop sign, or a red traffic light. Name the person who hit you, where your vehicle sustained the impact, and any movement that resulted. For example, you might say something like, “I was stopped at a red light at the intersection of Second Street and Main Street when I was rear-ended by a vehicle owned and operated by Mr. Joe Smith. The impact of the collision pushed my car into the vehicle in front of me.”
Similarly, if your accident involved a hazardous premises, explain what you were doing and where. For example, if you suffered a slip-and-fall in a store or restaurant, don’t just say that you were on the property. Indicate what you were doing (shopping, walking to the restroom, etc.) and in what part of the premises (the produce aisle, for example).
You do not need to get into the details of your injuries yet. Instead, present what we call a “theory of negligence.” You should explain what specifically makes the other party – the insurance company’s policyholder – at fault. This is where you include evidence of liability, such as police reports, laws that the at-fault party has violated, and witness accounts that support your claim. In the case of the car accident discussed above, you can explain that the insurance company’s policyholder failed to maintain a safe following distance, as required by law, and is therefore clearly negligent. You would cite the exhibits that illustrate your point.
The next step is a section we refer to as “Medical Treatment and Damages” in the demand letter. For ourselves, we simply call it the “narrative,” because we use this portion of the demand letter to tell the story of what the accident victim has gone through and felt. This section will include the results of every medical appointment, an inventory of every successful and unsuccessful medical treatment, and the effects of the accident on your life. Be especially clear about the permanence of injuries and effects that continue to impact your life.
To start, you will go through every individual medical appointment, beginning with the first intervention after the accident occurred, even if you went directly to the emergency room. For each entry, include the date, the name of the doctor who treated you, the facility where you received treatment, and the complaints that led you to seek medical care. Then explain what happened, including any diagnosis the doctor made, any tests or procedures performed, any medication or other course of treatment prescribed, and any recommendations or referrals to other medical care providers. If the doctor discussed your prognosis, mention the possibility of any long-term effects your doctor voiced to you in your demand.
Treat each appointment as a separate paragraph for clarity’s sake. Don’t worry if this portion of your demand letter seems repetitive. You likely will be saying some of the same things over and over again, including the doctors you saw, the pain you experienced, and any treatments you employed for a long span of time. You won’t remember the details of every appointment offhand, so consult your medical records as you write your demand letter to ensure that your statements are accurate and that you’re not forgetting anything important. This section alone could take up several pages of your demand letter, but that’s okay. At the end of this section, you should include bulleted lists that summarize your injuries, diagnostic tests, and procedures. Though not required, photographs of your injury can help prove your point, especially if the wound has a dramatic visual appearance or if a person viewing the photograph can see how clearly the injury is affecting your life.
You should also include a brief section about your prior medical conditions. Although it’s unfortunately common for insurance adjusters to try to blame accident-related injuries on prior conditions, being upfront about your relevant medical history is important. If you have no relevant prior conditions, you can simply enclose a medical chart that predates the accident, and let the insurance adjuster know that such a document is enclosed. If you do have prior medical conditions that are relevant to your accident-related injuries, mention the specific injuries that are not part of your prior medical history, or note that a medical professional found that the accident has aggravated your existing medical condition.
Next is where the “damages” part of the “Medical Treatment and Damages” subheading comes in. Start with your medical bills. Include the treating entity (doctor, hospital, or facility), the dates of treatment, and the amount of the bills. Even if you have seen the same doctor on multiple occasions, you can include the total amount of medical bills charged by that doctor as a single value. If you do this, make sure the date range reflects the full length of time you have been treating with the doctor, rather than simply the date of a single appointment.
In the event that your health insurance paid some or all of your medical bills and is asserting a lien on any settlement you receive, include that information in your demand letter, as well.
You will also have to include the economic damages from wage loss. Create this as its own separate section. Include your job title and employer, your salary broken down by day, and the dates that you missed work on the orders of your medical professional. If you took sick, vacation, or personal days, or other types of paid time off, for the purposes of getting paid while unable to work, you can still recover compensation. Those days were yours to use for something other than coping with injuries from an accident. To avoid any confusion, break down how many of each type of days you took (including any unpaid time off) and the salary you missed each day. Be sure to subtract any income continuation benefits that you may be receiving from your own insurance company. Compile the total amount of uncompensated wage loss you suffered as a result of the accident.
If you had any additional economic damages, include a section with those costs, as well. Remember, you must have documentation for all damages you are claiming if you want the insurance adjuster to take your claim seriously. Finally, add a section summarizing all of your economic damages.
If applicable, our attorneys will usually include a separate section conveying any necessary information regarding serious injury threshold limitations. Typically, this only applies to motor vehicle accidents in cases where you selected verbal threshold rather than no threshold (in New Jersey) or limited tort rather than full tort (in Pennsylvania) coverage option. Often, threshold requirements boil down to permanent effects. Think hard about any permanent effects that you could face as a result of the accident. If injuries have left you with a limited range of motion – even slightly limited – it can factor into your claim. Lingering aches and pains, vision problems, and even scarring could fall under the category of permanent injuries.
Next, you’ll want to include an inventory of all exhibits. Itemize them by letters in a way that makes sense based on how you structured your demand letter. We typically itemize most exhibits alphabetically (A, B, C), but for medical bills and records, we assign numbers rather than letters so that insurance adjusters can distinguish medical documents from other piece of evidence.
Conclusion and Demand
In your conclusion, you will summarize that you have suffered considerable or significant damages as a result of this accident caused by the insurance carrier’s policyholder. If your injuries are permanent in some way, say so here. Elaborate on the possibility of ongoing effects on your health and of any future problems you may experience. If there’s a chance that you could need future care, say so. Reiterate that your economic losses are also considerable.
As a result, make your demands. Which demands to make will depend on your claim, but keep in mind that your demand is the starting point of your negotiations. You certainly won’t get more money than you request in your demand, which is why our office does not typically include a dollar amount in a demand letter. Remember, calculating the value of your claim is an art, not a science. It doesn’t happen often, but it is possible that the insurance adjuster could evaluate your claim at a higher value than you are. Rather than locking yourself into a lower settlement, we recommend making one of the following demands, instead:
- I hereby make a demand for compensation in the amount of the entire policy limit.
- I hereby demand that you disclose your policyholder’s policy limits for the purpose of negotiating a settlement.
The Value of Showmanship
From the moment you begin crafting your letter to the moment you mail off your demand package, keep in mind the value of showmanship. A demand letter is occasion to be a hero. Don’t minimize your complaints, because doing so could minimize your settlement. Use vivid language and specific descriptions when possible. Remember, though, that while you want to make your demand as compelling as possible, you can’t embellish it with details that are misleading or untrue. Doing so is insurance fraud, which is both unethical and illegal.
When your demand letter is complete, you may wonder how to best prepare your demand package for delivery. If all of your exhibits fit in a large envelope, that’s fine. Some people prefer to get more attention for their demand packages. You may want to send a demand package via FedEx or another service rather than standard postal mail, simply because it will get more attention. If you have too many exhibits to fit into an envelope, consider mailing your demand package as a box. Such a delivery certainly makes a statement, and it can prevent your demand from getting lost in the clutter of an insurance adjuster’s desk.
Check back soon for the next installment of How to Handle Your Own Personal Injury Claim, where we’ll reveal negotiation secrets!