Truck Accident Demand Letter Template
Date: [Date]
Sent Via: ☐ Email ☐ Certified Mail ☐ Online Portal ☐ Other: [Method]
Claim Number: [Claim # (if known)]
To (Insurance Company / Claims Adjuster):
[Insurance Company Name]
Attn: [Adjuster Name / Claims Department]
[Address]
[Email/Phone]
cc (Optional): [Trucking Company Name] — Attn: [Safety/Claims Contact] — [Email/Phone]
From: [Your Full Name] — [Phone] — [Email]
Mailing Address: [Your Address]
Re: Settlement Demand — Truck Accident on [Accident Date] at [Location]
Dear [Adjuster Name or “Claims Department”],
1. Accident Summary (5W1H)
1.1 Who: [Truck Driver Name] and [Trucking Company Name] and [Other].
1.2 What: [Collision type] involving my vehicle and a commercial truck.
1.3 Where: [Street/City/State] at/near [Intersection/Landmark].
1.4 When: [Accident Date/Time].
1.5 Why: [Unsafe maneuver/Failure to yield/Other].
1.6 How: [Short sequence of events in 1–3 sentences].
1.7 Vehicles: My vehicle: [Year/Make/Model]; Commercial vehicle: [Year/Make/Model] unit/plate: [__].
2. Injuries and Treatment
2.1 Injuries Reported: [List injuries in plain language].
2.2 Initial Care: [ER/Urgent care] — [Date(s)].
2.3 Follow-Up Care: [PT/Chiropractic/Primary care/Specialist] — [Date range].
2.4 Current Status: ☐ Fully recovered ☐ Improving ☐ Ongoing symptoms: [__].
2.5 Future Care (if known): [Follow-ups/therapy/imaging/referrals].
3. Losses and Supporting Totals
3.1 Medical Expenses: $[Amount] (to date).
3.2 Wage Loss / Time Off Work: $[Amount] (dates missed: [__]).
3.3 Property Damage: $[Amount] (estimate/invoice reference: [__]).
3.4 Out-of-Pocket Costs: $[Amount] (receipt reference: [__]).
3.5 Total Documented Economic Losses (Estimate): $[Total].
4. Liability Position
4.1 Liability Summary: [Why the truck driver and/or trucking company is responsible].
4.2 Evidence Referenced: [Police report ID] and [Photos/Video IDs] and [Witness information] and [Other].
5. Settlement Demand
5.1 Demand Amount: $[Demand Amount] to resolve this claim.
5.2 Demand Includes: [Economic losses] and [pain/disruption/recovery impact].
5.3 Settlement Scope: [Bodily injury and property damage] and [other].
6. Response Instructions and Enclosures
6.1 Written Response Deadline: [Deadline Date (allow 10–20 business days)].
6.2 If Additional Information Is Needed: [Identify specific items requested in writing before the deadline].
6.3 Payment Instructions: Payable to [Name(s)] and mailed to [Address] or other instructions: [__].
6.4 Release for Review: [Release language requested before payment].
6.5 Attachments: ☐ Police report ☐ Photos/videos ☐ Witness statements/contact list ☐ Medical bills/records summary ☐ Wage verification ☐ Repair estimate/invoice ☐ Receipts ☐ Other: [List].
Witness Name | Role | Phone/Email | What the Witness Observed | Photo/Video Available |
[Name] | [Bystander/Passenger/Other] | [Contact] | [Observation] | [Yes/No/Unknown] |
[Name] | [Bystander/Passenger/Other] | [Contact] | [Observation] | [Yes/No/Unknown] |
Witness Name | Role | Phone/Email | What the Witness Observed | Photo/Video Available |
[Name] | [Bystander/Passenger/Other] | [Contact] | [Observation] | [Yes/No/Unknown] |
[Name] | [Bystander/Passenger/Other] | [Contact] | [Observation] | [Yes/No/Unknown] |
Witness Name
Role
Phone/Email
What the Witness Observed
Photo/Video Available
[Name]
[Bystander/Passenger/Other]
[Contact]
[Observation]
[Yes/No/Unknown]
8. Vehicle/Traffic Addendum
8.1 Commercial Vehicle Identifiers: [Tractor-trailer/Box truck/Other] and [Unit #] and [Plate] and [Company markings].
8.2 Police/Incident Identifier: [Agency] and [Report #].
8.3 Collision Diagram Reference: [Attachment ID/Sketch description].
9. Environment and Conditions
9.1 Roadway and Visibility: [Lighting] and [lane markings] and [construction/obstructions].
9.2 Weather and Surface: [Weather] and [surface condition].
9.3 Traffic Conditions: [Light/Moderate/Heavy] and [stopped/flowing].
Sincerely,
[Your Full Name]
Signature: ___________________________
Printed Name: [Your Full Name]
Point of Contact for Responses: [Name/Email/Phone]
Witness Name | Role | Phone/Email | What the Witness Observed | Photo/Video Available |
[Name] | [Bystander/Passenger/Other] | [Contact] | [Observation] | [Yes/No/Unknown] |
[Name] | [Bystander/Passenger/Other] | [Contact] | [Observation] | [Yes/No/Unknown] |
