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Demand Letter to Insurance Company (Claim / Settlement) Template
Clearly present your claim and demand a fair settlement from the insurance company in a structured, professional letter.
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Demand Letter to Insurance Company (Claim / Settlement) 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 – 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 under Policy No. [Policy Number] issued by [Insurance Company Name]. This letter sets out a summary of the incident, my damages, and my demand for a fair settlement of this claim.
Insured / Claimant Name: [Insured or Claimant Full Name]
Policyholder (if different): [Policyholder Name]
Claim Number: [Claim Number]
Date of Loss / Incident: [Date]
Type of Claim: [Auto / Property / Liability / Other]
2. Policy and Coverage
The claim arises under the coverage provided by the above policy, which includes:
Type of coverage: [Liability / Collision / Comprehensive / Property / Medical / Other]
Relevant coverage limits: [Limit Amounts]
Based on the circumstances of this claim, it is my position that coverage applies and that [Insurance Company Name] is responsible for paying my documented losses up to the applicable limits.
3. Facts of the Incident
The essential facts of the incident are as follows:
Date and time: [Date and Time]
Location: [Location]
Parties involved: [Names of drivers, property owners, or other parties]
Description of what occurred: [Incident Description]
Any police report, incident report, or similar documentation has been filed with: [Agency or Authority Name], Report No. [Report Number] (if applicable).
4. Liability and Responsibility
Based on the facts and available evidence, I believe liability rests with:
Responsible party: [Name or “your insured”]
Basis for liability: [Brief explanation, such as “failure to yield,” “rear-end collision,” “negligent maintenance,” “unsafe condition,” etc.]
I am not aware of any valid defense that would relieve [Insurance Company Name] or its insured of responsibility for the losses described below.
5. Injuries and/or Property Damage
Depending on the type of claim, describe the harm suffered. Adjust or remove sections that do not apply.
Personal Injuries (if applicable)
Nature of injuries: [Short description]
Initial treatment date and provider: [Provider Name and Date]
Ongoing treatment: [Therapist/Doctor/Clinic Name and frequency]
Property Damage (if applicable)
Property damaged: [Vehicle / Building / Contents / Other]
Description of damage: [Short description]
Repair status: [Repaired / Not yet repaired / Total loss]
6. Damages and Losses
My current damages related to this claim are summarized below. Amounts should be updated as needed.
Economic Damages
Medical expenses (past): [Amount and Currency]
Estimated future medical expenses (if any): [Amount and Currency]
Property repair or replacement costs: [Amount and Currency]
Loss of use (rental, alternative arrangements): [Amount and Currency]
Lost income or earnings: [Amount and Currency]
Other out-of-pocket expenses: [Amount and Currency]
Subtotal – Economic Damages: [Amount and Currency]
Non-Economic Damages (if applicable)
Pain and suffering, inconvenience, and impact on daily life: [Amount and Currency]
Total Non-Economic Damages Claimed: [Amount and Currency]
Total Damages Claimed
Total Amount of Damages: [Amount and Currency]
7. Settlement Demand
In order to resolve this claim in full, I am prepared to accept the following settlement:
Settlement amount demanded: [Amount and Currency]
This amount is based on the damages described above and reflects a fair resolution in light of the facts, coverage, and impact of this incident.
Upon payment of the agreed settlement and execution of appropriate release documents, I will consider all claims arising from this incident against [Insurance Company Name] and its insured resolved, subject to the final written settlement agreement.
8. Supporting Documentation
To assist your evaluation of this demand, I can provide or have enclosed copies of the following documents:
Policy and declarations page;
Police or incident report;
Medical records and bills;
Repair estimates and invoices;
Photographs of injuries, damage, or scene;
Proof of lost income (pay stubs, employer letter, or similar);
Any prior correspondence regarding this claim.
If additional information is required, please let me know in writing as soon as possible.
9. Deadline for Response
Please provide a written response to this settlement demand no later than:
Response Deadline: [Date]
Your response should state whether you:
Accept the demand as stated;
Make a counteroffer, with explanation; or
Deny the claim and the reasons for denial.
10. Notice of Possible Further Action
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 to negotiate only through written communications or representatives;
Consulting with or retaining legal counsel to pursue the claim;
Filing a lawsuit or taking other action allowed by law to seek full compensation for my losses.
I would prefer to resolve this matter directly with [Insurance Company Name] without the need for further escalation.
11. Reservation of Rights
Nothing in this letter waives or limits any rights or claims I may have under the insurance policy or applicable law. All rights and remedies are expressly reserved, including the right to revise the amounts claimed if new information or expenses arise.
12. Closing
Please treat this letter as a formal settlement demand. I look forward to your timely and good-faith response.
Sincerely,
[Your Signature, if printed]
[Your Printed Name]
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Learn more about
Demand Letter to Insurance Company (Claim / Settlement) 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.
DEMAND LETTER TO INSURANCE COMPANY (CLAIM / SETTLEMENT) TEMPLATE FAQ
What is a demand letter to an insurance company?
A demand letter to an insurance company is a formal written request asking the insurer to pay a settlement amount on a claim. It summarizes the incident, explains why the insured or claimant is entitled to coverage, lists damages or losses, and states the total amount requested.
When should I use this insurance demand letter?
Use this letter after you have opened a claim, gathered key documents (such as medical records, repair estimates, or proof of loss), and are ready to request a specific settlement amount. It is commonly used in auto accidents, property damage claims, and personal injury claims before litigation.
What should a demand letter to an insurance company include?
It should identify the parties and policy, state the claim number, briefly describe the incident and liability, outline injuries or damage, list economic and non-economic losses (where applicable), attach supporting documents, and demand a specific settlement amount by a clear deadline.
Can I use this template for auto, property, or injury claims?
Yes. You can adapt this template for vehicle accidents, homeowners or renters insurance claims, business property claims, or personal injury claims (such as slip-and-fall or liability incidents). You simply adjust the description of the incident and the types of damages listed.
Does sending this demand letter guarantee the insurance company will pay?
No. The letter presents your position and requested settlement, but the insurer may accept, negotiate, or deny the claim. However, a well-organized demand letter can help move negotiations forward and create a clear record of what you requested and why.
Can AI Lawyer help me customize this insurance claim demand letter?
Yes. AI Lawyer can help you tailor this Demand Letter to Insurance Company (Claim / Settlement) template by organizing the facts, damages, and settlement amount in clear language. You still provide the real documents and numbers and remain responsible for any decisions about settlement, negotiation, or legal action.
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