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Car Accident Settlement Demand Letter Template
Clearly explain your car accident, document your damages, and demand a fair settlement in one structured letter.
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Car Accident Settlement Demand Letter Template
[Your Full Name]
[Your Mailing Address]
[City, State/Province, ZIP/Postal Code, Country]
Phone: [Your Phone Number]
Email: [Your Email Address]
[Date]
[Insurance Company Name]
Attn: [Claims Adjuster Name or “Claims Department”]
[Insurance Company Address]
[City, State/Province, ZIP/Postal Code, Country]
Subject: Settlement Demand – Car Accident on [Date of Accident] – Claim No. [Claim Number] – Policy No. [Policy Number]
1. Introduction and Claim Information
Dear [Adjuster Name] / [To Whom It May Concern],
I am writing regarding the above-referenced claim arising from the motor vehicle collision that occurred on [Date of Accident] in [City/Location]. This letter sets out the facts of the accident, my injuries and damages, and my demand for a fair settlement of my claim.
Claimant Name: [Your Full Name]
Policyholder / Insured: [Name of Insured]
Policy Number: [Policy Number]
Claim Number: [Claim Number]
2. Description of the Accident and Liability
On [Date] at approximately [Time], I was driving a [Your Vehicle Year, Make, Model] traveling [direction] on [Street/Highway] near [Intersection or Landmark] when the collision occurred.
The other vehicle, a [Other Vehicle Year, Make, Model] driven by [Other Driver’s Name], did the following:
[Short description of what the other driver did, e.g., failed to yield, ran a red light, rear-ended my stopped vehicle, made an unsafe lane change, etc.]
As a result, my vehicle was struck and sustained damage, and I suffered injuries as described below.
Based on the circumstances and any applicable traffic laws, I contend that [Other Driver’s Name] was at fault and that [Insurance Company Name] is responsible for compensating me for my damages under Policy No. [Policy Number].
3. Injuries and Medical Treatment
Immediately after the collision, I experienced the following symptoms and injuries:
[Injury 1, e.g., neck pain / whiplash]
[Injury 2, e.g., back pain / shoulder injury]
[Additional injuries or symptoms]
I sought medical care as follows:
Initial treatment provider: [Name of hospital, urgent care, or doctor], seen on [Date].
Follow-up treatment: [Names of clinics, doctors, physical therapists, chiropractors, or specialists] and dates of treatment.
Diagnostic tests: [X-rays, CT scans, MRIs, or other tests] and dates performed.
My treatment has included:
[Medications prescribed]
[Physical therapy or chiropractic care]
[Injections, procedures, or surgeries, if any]
As of the date of this letter:
My current condition: [Brief summary of ongoing symptoms or status]
Future treatment (if anticipated): [Summary of any recommended future care or follow-up]
4. Economic Damages
My economic losses to date related to this car accident are summarized below. Amounts should be updated based on current records.
a. Medical Expenses (Past and Estimated Future)
Emergency care and initial evaluation: [Currency and Amount]
Follow-up doctor visits and specialist care: [Currency and Amount]
Physical therapy, chiropractic care, or rehabilitation: [Currency and Amount]
Diagnostic tests and imaging: [Currency and Amount]
Medications and medical supplies: [Currency and Amount]
Estimated future medical expenses (if applicable): [Currency and Amount]
Subtotal – Medical Expenses: [Currency and Amount]
b. Lost Income or Earning Capacity
Dates of work missed due to injuries: [Dates or total days]
Employer: [Employer Name]
Gross wages or income lost to date: [Currency and Amount]
Impact on future earning capacity (if applicable): [Brief description and estimated amount, if available]
Subtotal – Lost Income: [Currency and Amount]
c. Property Damage and Other Out-of-Pocket Costs
Vehicle repair or total loss value: [Currency and Amount]
Towing and storage charges: [Currency and Amount]
Rental car or alternative transportation: [Currency and Amount]
Other out-of-pocket expenses related to the accident: [Currency and Amount]
Subtotal – Property and Other Economic Losses: [Currency and Amount]
Total Economic Damages: [Currency and Total Amount]
5. Non-Economic Damages (Pain, Suffering, and Impact)
In addition to the economic losses described above, this accident has caused significant non-economic harm, including:
Physical pain and discomfort associated with my injuries and treatment;
Emotional distress, anxiety, or sleep disruption;
Limitations on daily activities, hobbies, family life, or social interactions;
Temporary or lasting loss of enjoyment of life.
In light of the nature and duration of my injuries, the level of pain, the disruption to my daily life, and the overall impact of this accident, I am claiming:
Total Non-Economic Damages: [Currency and Amount]
6. Total Damages and Settlement Demand
Based on the above, my damages are summarized as follows:
Total Economic Damages: [Currency and Amount]
Total Non-Economic Damages: [Currency and Amount]
Total Damages: [Currency and Total Amount]
To resolve this matter in full and final settlement of all claims arising from the car accident on [Date], I demand:
Settlement Amount Demanded: [Currency and Settlement Amount]
This demand is made in good faith and reflects a reasonable valuation of my claim given the liability facts, documented medical treatment, out-of-pocket losses, and the pain and suffering I have experienced.
7. Supporting Documentation
To assist with your evaluation of this demand, I can provide or have enclosed copies of the following:
Police or accident report;
Policy declarations page (if available);
Medical records and itemized medical bills;
Proof of lost income (pay stubs, employer statement, or similar);
Vehicle repair estimates or total loss documentation;
Receipts for towing, rental car, and other expenses;
Photographs of the accident scene, vehicle damage, and visible injuries;
Prior correspondence regarding this claim.
If you require any additional documentation, please specify your request in writing.
8. Deadline for Response and Notice of Possible Further Action
Please provide a written response to this settlement demand no later than:
Response Deadline: [Date]
Your response should indicate whether you:
Accept this settlement demand;
Make a specific counteroffer; or
Deny the claim in whole or in part, with reasons.
If I do not receive a reasonable settlement offer or explanation by the Response Deadline, I may consider one or more of the following steps:
Continuing any further communication only through a legal representative;
Consulting with or retaining an attorney to pursue my claim;
Filing a lawsuit or taking other lawful action to seek full compensation for my injuries and damages.
9. Reservation of Rights and Closing
Nothing in this letter waives or limits any rights or remedies I may have under applicable law or the insurance policy. All such rights and remedies are expressly reserved, including the right to revise the amounts claimed if new information, bills, or losses arise.
I would prefer to resolve this claim promptly and fairly without formal litigation. Please treat this letter as a formal settlement demand and respond in good faith by the Response Deadline.
Sincerely,
[Your Signature, if printed]
[Your Printed Name]
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Learn more about
Car Accident Settlement Demand Letter Template
Click below for detailed info on the template.
For quick answers, scroll below to see the FAQ.
Click below for detailed info on the template.
For quick answers, scroll below to see the FAQ.
CAR ACCIDENT SETTLEMENT DEMAND LETTER TEMPLATE FAQ
What is a car accident settlement demand letter?
A car accident settlement demand letter is a formal written request sent to an insurance company that explains how the crash happened, describes your injuries and damages, and demands a specific amount of money to settle your claim. It is often used before filing a lawsuit.
When should I send a settlement demand after a car accident?
Many people send a settlement demand after they have finished most of their medical treatment or have a clear picture of their injuries, medical bills, wage loss, and other damages. Sending the letter too early can make it harder to accurately value your claim.
What should a car accident settlement demand letter include?
It should identify the parties and insurance policy, describe the accident and why the other driver is at fault, list your injuries and treatment, summarize your economic losses (bills, lost income, property damage) and non-economic losses (pain and suffering), attach key documents, and state a clear settlement amount and deadline.
Is this letter sent to my own insurer or the other driver’s insurer?
You can adapt this template for either your own carrier (for example, under uninsured/underinsured motorist or MedPay coverage) or the at-fault driver’s liability insurer. You will adjust the wording in the introduction and liability sections depending on who you are addressing.
Does sending a car accident settlement demand letter guarantee payment?
No. The insurer may accept, counter, or deny your demand. The letter is a structured way to present your claim and can help move negotiations forward or support you later if you pursue legal action.
Can AI Lawyer help me customize this car accident settlement demand letter?
Yes. AI Lawyer can help you adapt this Car Accident Settlement Demand Letter template by organizing your accident facts, medical treatment, and damage calculations into clear language. You still provide the real records, bills, and numbers and remain responsible for any decisions about settlement, negotiation, or filing a lawsuit.
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