Sample Demand Letter for Settlement in a Parking Lot Injury Claim

Just as injuries are unique to every victim, so are the facts of each personal injury claim. The following demand letter example deals with a parking lot injury after a visitor falls in a pothole. This letter should only be used as a guide. Don’t copy it word for word. Rather, substitute your specific case information where appropriate.

Click on the buttons to better understand the language used and for more insight into each section.

Learn more about parking lot injury claims here.

Parking Lot Injury Demand Letter Example

June 10, 2015


Goaway Insurance Company
Ms. Wonna Pae
Claims Adjuster
125 Main Street, Suite A
Phoenix, AZ 85006


Claim Number:


Your Insured:

Neglajunt Food Emporium


Vicc Timm

Claimant DOB:


Date of Injury:



A demand letter is considered part of pre-trial settlement negotiations. Judges typically disallow the content of these negotiations to be used in court. While titling your demand letter with the words FOR SETTLEMENT PURPOSES ONLY is not legally required, doing so conveys your expectation of confidentiality.

Dear Ms. Pae:

Please let this letter serve as my formal demand for compensation in the above-referenced claim. As you are aware, I am currently not represented by an attorney. My continuing hope is to avoid litigation by bringing this matter to a prompt and amicable resolution.

This sets the stage for the rest of the letter. It makes clear you’re acting in good faith and prefer to settle your claim, but you won’t hesitate to file a lawsuit or hire an attorney if necessary.

As you are aware, I was injured on May 28, 2015, while walking in your insured’s parking lot. Because of poor lighting, I was unable to see a large pothole. I fell into it, sustaining serious injuries. As a direct and proximate result of your insured’s negligence, I incurred substantial medical and chiropractic bills, out-of-pocket expenses, lost wages, and prolonged pain and suffering.

Using the key words “direct and proximate” shows the adjuster you understand one of the crucial elements of negligence.


The factual summary is a review of the events leading to the injury and its aftermath. Don’t editorialize. Language that might be characterized by the adjuster as “whining” or “complaining” should be kept out of the factual summary (and all other parts of the letter).

On May 28, 2015, at approximately 8:30 p.m., I drove into your insured’s parking lot located at 365 Andover Street, Phoenix, AZ. I was there to purchase groceries. As I pulled into the parking lot, I noticed several overhead lights were out. For this reason, I parked as close as possible to a lighted area in the parking lot.

I made my way to the front door of the store, watching where I was stepping. As I neared the front of the store, I suddenly found myself flung to the ground and realized I had stepped into a large pothole. I immediately felt a searing pain in my right leg.

Fortunately, another person saw me as I lay on the ground in pain. I later learned the witness’s name is Ms. Barbara Wyatt of 56 Mott Street, Phoenix, AZ. I asked Ms. Wyatt to go into your insured’s store and ask for help.

Do your best to find a witness to the incident. An impartial witness statement will substantiate your version of events.

Several minutes later, Ms. Wyatt returned along with the store’s manager. The manager, Don Handy, asked if I needed an ambulance. I told him while my leg was injured, I was able to walk and didn’t require an ambulance. I asked Mr. Handy to create an incident report, noting I fell and was injured. He agreed, and I hobbled back into the store. Mr. Handy told me someone from the store’s corporate office would get in touch with me.

Adjusters heavily rely on incident reports made by their insured. It’s important to tell the adjuster you know the incident report exists, even if you won’t be able to get the report without filing a lawsuit.


The morning after my injury, I awoke in terrible pain and discomfort. I could barely bend my leg to get out of bed. My wife drove me to the Skylane Hospital Emergency Room. There I saw Dr. Avery Smith. Dr. Smith ordered an MRI exam, which showed sprains to my semi-membranosus and semitendinous muscles, commonly known as hamstring muscles.

Dr. Smith prescribed Flexeril and Vicodin for my pain. He told me I should keep off my leg for the next 21 days to afford my muscles time to heal. He also ordered me to seek physical therapy. The hospital provided crutches and I was discharged.

This language lends credibility to your injuries and required treatment, and avoids any claim by the adjuster you may be malingering.

The next day my wife drove me to the Interhaven Chiropractic Center. After being examined by Dr. Reno, she told me I would need therapy, including leg massage, electrical stimulation, and weight training. I followed Dr. Reno’s orders and submitted to therapy. It was long and painful. During my treatment I was unable to enjoy the same sense of closeness and intimacy I normally shared with my wife.

Loss of intimacy resulting from an injury is referred to as “loss of consortium.” In many cases, a victim can claim loss of consortium as a part of damages.


I am a 33-year-old male with an unremarkable medical history. In 2010 I visited the Skylane Emergency Room to treat a case of food poisoning. Prior to that, in 2007 I was treated for a broken arm. At the time I fell in your insured’s parking lot I was in excellent health.

Hopefully your medical history shows that you have no related injuries, and that any prior injuries were fully healed at the time of the present injury. If you do have a pre-existing injury, the adjuster may claim your current injury is not new, but merely an exacerbation of your pre-existing condition.


I have been employed since February 8, 2010 with the UBS Delivery Company. In the past 5 years, I have only missed 7 days of work due to injury or illness. My job duties include driving a delivery truck and delivering packages. During my treatment and recovery, my supervisor assigned my route to another driver.

Since my return to work I’ve been relegated to customer service duties. I’m not sure when I will be able to return to my delivery route. Because my injuries did not occur at work, I was unable to receive workers’ compensation benefits.

Let the adjuster know you’re gainfully employed, and it’s unusual for you to miss work for injury or illness. Describe how the injury has affected not only your wages, but your employment status as well.


The following list includes my medical costs and other expenses related to my injury. I have attached copies of representative bills and receipts, along with a letter from my employer confirming my lost wages.

In this section you’ll list your medical bills, lost wages, and collateral expenses such as the cost of medicines, bandages, crutches, hospital parking lot fees, etc. Don’t include pain and suffering here. As you’ll see below, compensation for pain and suffering is determined as a multiple of your medical bills, and will be included in your total settlement demand.

Skylane Hospital ER


Interhaven Chiropractic Center


Medications, crutches


Transportation, parking fees


Lost Wages


After careful consideration of liability and damages, and an in-depth review of standard settlements for injury cases with similar fact patterns, I am convinced a fair and reasonable settlement including pain and suffering is $19,224.00.

For soft-tissue injuries like muscle and ligament sprains, you can use a multiple of 3 or 4 times the victim’s medical bills to come up with a total settlement demand. That amount takes into account all documented expenses, and includes compensation for pain and suffering. The adjuster probably won’t accept your first demand, it’s more of a starting point for negotiations.

I look forward to hearing from you.


Vicc Timm
36 James Way
Phoenix, AZ 86704

Only list an address and phone number where you’re comfortable receiving correspondence from the insurance company.

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