Sample Car Accident Demand Letter to an Auto Insurance Company

You write a demand letter once you’ve completed your medical treatment, or are very close to doing so. By this time, you should have copies of the following documentation:

  • Medical, chiropractic, or dental records and bills
  • Receipts for other expenses (e.g. medications, crutches, cervical collars, etc.)
  • A letter from your employer confirming your lost wages
  • The police report and witness statements, if applicable

Most claims adjusters are working on over a hundred claims at any one time, so you want your demand letter to stand out. While you won’t be using an attorney’s letterhead, there’s no reason you can’t craft your letter just as professionally as an attorney.

Type your letter on clean white bond paper, free of grammar and spelling errors. It should have a beginning and an end, with a discussion of the elements vital to your demand in between. Be sure to send the letter through Certified Mail (Return Receipt Requested) to confirm the date the insurance company receives the letter.

Below is a sample demand letter you can use as a guide when writing your own letter. Notice we’ve substituted the word “collision” for the word “accident.” Accident can imply your injuries weren’t anyone’s fault, or if fault existed, it was minimal.

While no one would suggest the driver who caused your injuries did so intentionally, referring to the event as a “collision” eliminates the notion it was a chance occurrence.

Throughout the letter you will notice buttons. Click these hints for the reasoning behind that section’s wording and format.

Car Collision Demand Letter Example

January 14, 2014

Ms. Louise Jones
Claims Adjuster
ABC Insurance Company
Anytown, NY 11007


Claim Number:


Your Insured:

Alex Smith


Ima Viktum

Claimant DOB:


Date of Loss:


“Date of Loss” refers to the date you were injured. When discussing the day of the injury, avoid using phrases like “…the day it happened,” or “…it happened on Monday.”


Judges want people to settle their disputes, as it lightens their load. Thus, many judges give settlement negotiations a form of qualified confidentiality. This means that what you discuss with the adjuster during settlement negotiations can’t later be used against you if the claim ends up in trial.

This can be important when discussing issues like contributory or comparative negligence, preexisting injuries, prior claims, and more. Titling your demand letter with the words “For Settlement Purposes Only” confirms you have a reasonable expectation that what you discuss in this letter can’t later be used against you if trial becomes necessary.

Dear Ms. Jones:

As you know, on December 15th, 2013, I was seriously injured in an automobile collision caused by your insured, Alex Smith. The evidence clearly shows your insured’s negligence was the direct and proximate cause of my injuries and resultant damages. Those damages include medical and chiropractic bills, out-of-pocket expenses, lost wages, and pain and suffering.

“Direct and proximate” cause is a legal phrase connecting the at-fault driver’s negligence to your damages, to the exclusion of any other intervening factors. In most cases, “pain and suffering” is a phrase that includes emotional distress and mental anguish.


On December 15th, 2014, at approximately 6:30 pm, I was driving home after completing my shift at the CDP Company. As you know from our previous discussions, I have been employed since 2008 as a sheet fitter with the CDP Company at 1256 Main Street, Phoenix, Arizona 85014.

I was driving my 2010 Honda Accord north in the far right lane of the Maricopa Expressway. At all times, I was observing the posted speed limit of 65 miles per hour, wearing my seat belt, and fully cognizant of surrounding traffic.

This statement deters any claims of contributory or comparative negligence.

As I was preparing to enter the exit ramp for Thunderbird Road, suddenly, and without notice, your insured moved from the center lane directly in front of my car. As he did, the right rear quarter panel of his 2012 Chevy Cruze slammed into the left front quarter panel of my Honda. The brutal force of impact propelled my Honda into the exit ramp’s concrete retaining wall. My head and neck violently jolted back and forth, and side to side.

Using adjectives like “brutal,” and adverbs like “violently,” reminds the adjuster how serious the collision was.

After careening off the cement wall, my Honda finally came to an abrupt stop. I felt a searing and acute pain in my head, neck, and shoulder areas. Your insured pulled over in front of me. We both exited our cars and began to speak. When I asked your insured why he cut in front of me, he said he was distracted. He explained that when he realized he was about to miss the Thunderbird Road exit, he quickly changed lanes to exit.

Be sure to include incriminating statements of the at-fault driver. Admissions of distraction, sleepiness, texting, etc. are considered “admissions against (the insured’s) interest.” Such admissions can be quite powerful if used in court, and claims adjusters know it.

I called 911 and reported the collision. The Phoenix Police and Fire and Rescue arrived within several minutes. Your insured stated he was not injured; but I was in excruciating pain. After evaluating me at the scene, Fire and Rescue transferred me to the Phoenix General Hospital’s Emergency Room.

If you weren’t transferred to an emergency room, use the following: “At the time of the collision, I didn’t believe I required emergency room treatment. After the police completed their on-site investigation, I drove home.” Or, if your car was heavily damaged, you can say, “A friend, John Doe, drove me home.” Then state that when you began to feel pain, you immediately sought medical treatment.

As you know, Sam Shapley witnessed the collision. Mr. Shapley was traveling directly behind me in his car. He pulled over immediately after the collision. Mr. Shapely told the responding police officer, John Jacobs, that he clearly saw your insured cut in front of me without signaling and collided into the front of my Honda.

Officer Jacobs issued two (2) traffic citations to your insured for “Failing to Signal” and “Illegal Lane Change.” Officer Jacob’s diagram on the back of the police report unequivocally shows your insured was at fault. And witness Sam Shapley’s statement makes clear your insured caused the collision to the exclusion of any other factors.


Doris Waters M.D. at Phoenix General Hospital’s Emergency Room examined me the day of the collision. After ruling out any fractures, Dr. Waters ordered an MRI exam, which showed that I sustained a Grade 3 tear to the crucial ligament in my right shoulder and a Grade 2 sprain to the crucial ligament in my left shoulder.

Wherever possible, use accurate medical terminology to describe your injuries.

For the pain, Dr. Waters prescribed Vicodin 5mg #30 and Flexeril 10mg #30, and ordered six (6) weeks of therapy. I was told by Dr. Waters not to return to my job as a sheet fitter during that time, as doing so would likely exacerbate my injuries and prolong my recovery.

This makes clear to the adjuster you aren’t a malingerer. Rather, by following the doctor’s orders, you will heal faster and be able to return to work sooner.

Following her orders, I sought treatment at the We-Care Chiropractic Clinic located at 1145 Bell Avenue, Phoenix, Arizona, 85667. There I underwent a prolonged and painful recovery.


Driving distance to and from treatment at the We-Care Chiropractic Clinic totaled 200 miles, at 55 cents per mile, equals $110.00. Medications totaled $200.00. The cervical collar was $75.00. My total out-of-pocket expenses are $385.00.


I have worked as a sheet fitter for the CDP Company since 2008. At the time of the collision, I made $18.00 an hour. I did not receive any income during my convalescence since my injury was not related to my job. As a result, I lost $4,320.00 in wages.


This entire event has been devastating. I never asked for any of this. Before your insured crashed into me, I led a full life, free of pain and discomfort. But ever since the collision, I have suffered from extreme pain and discomfort, anxiety, guilt, and depression – all directly attributable to your insured’s negligence.

The loss of income placed a terrible financial burden upon my family. Without an income, I was forced to borrow money from family members and friends. This was embarrassing and strained my marriage. Moreover, because of the pain and suffering I’ve endured, I have also been unable to enjoy the intimacy I previously shared with my wife.

Loss of intimacy with a spouse is called “Loss of Consortium.” Courts have recognized loss of consortium as a valid and compensable form of damages.

There is no way your company can fully compensate me for all I have suffered. At a minimum, I expect you as their representative to try to compensate me for my injuries and damages.


  • City of Phoenix Police Report
  • City of Phoenix Fire and Rescue Report
  • Witness Statement of Mr. Sam Shapely
  • Lost Wage Verification from CDP Company
  • Phoenix General Hospital Medical Bills
  • We-Care Chiropractic Clinic Narrative
  • Medical Narrative of Dr. Doris Waters
  • Receipts for Miscellaneous Expenses


Phoenix General Hospital


We-Care Chiropractic Clinic


Out-of-Pocket Expenses


Lost Wages CDP Company



After careful consideration of the issues involved in this claim, and a review of jury verdicts and insurance company settlements with similar fact patterns, I believe the amount of $24,705.00 represents a fair and equitable settlement amount.

In “soft tissue” injury claims such as the one depicted in this letter, it’s acceptable to use a multiple of anywhere from 3 to 5 times the medical bills. Out-of-pocket expenses and lost wages would then be added on top of that number. You can also research jury awards for similar cases in your area at websites like

The medical bills in this claim totaled $5,000.00. While demanding 4 times medical bills, plus expenses and lost wages ($24,705.00) may be a little high, such a demand leaves room to negotiate.

Yours truly,

Ima Viktum
1456 Mill Ave
Phoenix, AZ 85014

Home telephone: 555-678-6666
Cell number: 555-587-6698
Email address:

While you don’t need to list all of your contact information, offering as much as possible means you likely won’t miss a call, email, or letter from the claims adjuster.

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