Personal Injury Demand Letter Example for Slip and Fall on a Wet Floor

There will come a time in your personal injury claim when you’ve fully recovered from your injuries. At this point, you will make a written demand upon the insurance company for the amount of compensation you believe is fair based on the facts and law relevant to your claim.

Your demand letter is the point in your claim where settlement negotiations begin in earnest. Based on the information in your letter, the insurance adjuster will either accept your demand and pay the amount you request, or more likely, make a counter-offer.

The sample demand letter below can serve as a guide when writing your own demand letter. We deal with a slip and fall injury due to a wet floor, but the format will work with almost any type of premises liability claim.

Along the way we’ve added sections to help you better understand important language and ideas.

Learn more about wet floor injury claims here.

Sample Demand Letter for a Slip and Fall Injury

November 12, 2014

Getsude Insurance Company
Ms. Wona Seddle
Claims Adjuster
125 Clay Street, Suite A
Newark, NJ 07110


Claim Number:


Your Insured:

Fast Stop Convenience Store


Joe Moen

Claimant DOB:


Date of Injury:



Judges typically disallow the content of pre-trial settlement negotiations to be used in court. Because a demand letter is considered part of negotiations, the contents of these letters can’t be used against you if your claim goes to trial. While titling your demand letter with the words FOR SETTLEMENT PURPOSES ONLY isn’t a legal requirement, doing so clearly conveys your expectation of confidentiality.

Dear Ms. Seddle:

Here you’ll briefly recount the events leading to your injury, its aftermath, and the damages you sustained. Damages can include your medical and chiropractic bills, out-of-pocket expenses (for items such as medications, bandages, crutches, etc.), lost wages, and your pain and suffering.

Your insured is the corporate owner of the Fast Stop Convenience Store located at 1356 Haley Drive, Trenton, NJ. On October 13, 2014, I was seriously injured when I slipped and fell on soda that had accumulated on the floor of your insured’s store. My injuries included a severely sprained plantaris tendon in my left leg and abrasions to both hands.

Your insured had a legal duty to make the premises safe for its customers. It wholly failed in that duty. Your insured’s failure to cordon off the slippery area or place a sign indicating the floor was wet constitutes negligence. That negligence was the direct and proximate cause of my injuries and resulting damages.

The phrase “direct and proximate cause” is a legal phrase used primarily in personal injury claims. It makes the required legal connection between the insured’s negligence and your injuries.

Your insured contends I contributed to my injuries by ignoring the spilled soda and walking through it. That is wholly untrue. I did not see the spilled soda and certainly did not walk through it intentionally. I behaved as any other customer would have in the same circumstances.

Use this language if the adjuster alleges you contributed to your own injuries, or there is any evidence of comparative negligence. If you did engage in behavior which might be considered reckless, and the adjuster doesn’t know about it or hasn’t brought it up, then you’re not required to bring it up either.

I was treated for my injuries at the Walker Hospital Emergency Room located at 456 Main Street, Trenton, NJ, and subsequently at the Haven Chiropractic Clinic located at 713 Main Street in Trenton. In addition to the costs of treatment, I sustained out-of-pocket expenses and lost wages.

I want to make clear that I never asked for any of this to happen. Before October 13, 2014, I enjoyed a full life, free of pain and discomfort. On October 13th, however, all that changed. Because of your insured’s negligence, I unnecessarily endured substantial monetary losses and great pain and discomfort.

As you are aware, I am currently not represented by an attorney. I am writing this demand letter in good faith, in hope of settling my claim amicably and without the need for litigation.

This makes clear you are acting in good faith and prefer to settle your claim, but you won’t hesitate to file a lawsuit or retain an attorney if necessary.


The factual summary is a more detailed review of the relevant details of your injury and resulting damages. While you may find some of the language in the demand letter repetitive, the repetition helps avoid confusion while adding greater impact.

On October 13, 2014, at approximately 3:00 p.m., I entered the Fast Stop Convenience Store to purchase a bottle of water. I proceeded down the aisle toward the cooler until I suddenly felt my legs go out from under me. As I fell, both my hands raked across the shelving and my left leg twisted unnaturally beneath me.

As I slowly stood up, I realized I had slipped and fell on a wet substance I later identified as soda. As a result of the fall, my hands were bloodied and my left leg was in great pain.

I made my way to the cashier who identified herself as Ariyana Ali. I told Ms. Ali I fell on spilled soda in the aisle in front of the cooler and was injured. I asked Ms. Ali to complete an incident report confirming my fall. I also asked her for the name and contact information of the owner.

Ms. Ali told me I shouldn’t have been running down the aisle, and that if I had been walking, I would have seen the spilled soda and avoided it. Her allegations were entirely false. I was not running, but walking carefully. While I haven’t had access to the store’s surveillance video, I am aware you have reviewed it and it confirms:

  1. There was soda on the floor
  2. There was no “Caution” or “Wet Floor” sign
  3. I fell onto the hard floor after slipping on the soda
  4. I was walking, not running at the time

The next morning, October 14th, I awoke in substantial pain. I could barely stand on my left leg. I noticed the upper part of my left leg was swollen and bruised. My sister Avery drove me to the Walker Hospital Emergency Room located at 456 Main Street, Trenton, NJ. There I was treated by Dr. Ellsworth Smith.

After a physical examination, Dr. Smith diagnosed my injury as a severely sprained plantaris tendon in my left leg, and abrasions and bruising to both hands. Dr. Smith indicated my plantaris tendon would take between four and six weeks to heal. She said for the first two weeks I would have to keep my left leg immobilized as much as possible, using crutches and resting my leg whenever possible.

Dr. Smith indicated that therapy would help with the healing process and expedite my returning to full use of my left leg. Dr. Smith indicated I should not return to my work duties as a landscaper for a minimum of three weeks.

Following Dr. Smith’s orders, I kept pressure off my left leg for the first two weeks. On October 27, I sought therapy at the Haven Chiropractic Clinic located at 713 Main Street in Trenton, NJ. There I received electrical stimulation, massage, and exercise.

Following your doctor’s orders precisely shows the adjuster you didn’t unnecessarily prolong your treatment to “milk” the case.

During the entire course of recovery and treatment, I endured great pain and discomfort. Performing customary and necessary functions such as bathing, dressing, cleaning, and other personal activities was cumbersome. Additionally, because I was unable to work during the first three weeks, I lost substantial and necessary income. I had to borrow money from my parents just to pay my bills.

It’s important to let the adjuster know your injuries amounted to much more than the substantial pain and discomfort you endured. Describe how her insured’s negligence negatively impacted even the most basic of your daily activities, including not being able to pay your bills.


I was initially treated at the Walker Hospital Emergency Room located at 456 Main Street, Trenton, NJ. There I was treated by Ellsworth Smith, M.D. who ordered x-rays. After a physical examination, Dr. Smith diagnosed my injuries as a severely sprained plantaris tendon in my left leg and abrasions and bruising to both hands.

My hands were treated with a topical antibacterial ointment and bandaged. I was also provided with crutches. Dr. Smith prescribed Vicodin 10mg #30 prn, and Flexeril 10mg #30, twice daily for my leg injury, and Neosporin to avoid infection to my hands.

On October 27, 2014, following Dr. Smith’s orders I sought therapy at the Haven Chiropractic Clinic located at 713 Main Street in Trenton, NJ. There I received electrical stimulation, massage therapy, and whirlpool immersion for the following 2 weeks.


I am a 30-year-old male with an unremarkable medical history. My medical treatment includes hospitalization in June 2010 at the Walker Hospital for a fractured left clavicle. At the time of the injury made the basis of this claim, I was fully recovered from the fracture to my left clavicle and in excellent health.

It’s important to let the adjuster know any prior injuries or illnesses were fully treated and your recovery was complete. This way the adjuster can’t say your current injury is just an exacerbation of a previous injury.


I have been employed full-time for the last two years as a crew leader with the Evergreen Landscape Company located at 1477 Mill Street, Trenton, NJ. Prior to that, I was employed for six years as a landscaper with the Acorn Landscaping Company of 7271 Beckley Street, Rutledge, NJ. During the last eight years, I have missed a total of eleven days of work due to injury or illness.

If you can, try to establish a strong work history. This tells the adjuster you are a serious worker and that missing work for illness or injury is something you don’t do unless absolutely necessary.


The following is a list of my medical bills and out-of-pocket expenses related to this claim. I have sent you copies of my medical records and bills, along with copies of receipts for medications, the crutches, and transportation costs. You also have a letter from my employer confirming my lost wages.

Do not include pain and suffering here. Pain and suffering compensation is determined as a multiple of your medical costs, and will be included in your final settlement demand below this list.

Walker Hospital


Haven Chiropractic Clinic


Medications, bandages, crutches


Transportation, parking fees


Lost Wages


After careful consideration of liability and damages, and a review of standard settlements for leg and hand injury cases with similar fact patterns, I am convinced a fair and reasonable settlement inclusive of my pain and suffering is $17,509.00.

For soft-tissue injuries like muscle and ligament sprains, you can use a multiple of 2 to 4 times the victim’s medical bills, plus expenses and lost wages, to come up with a total settlement demand. That amount will include all medical costs and other financial losses, and compensation for pain and suffering.

In the above example, the victim’s medical and chiropractic bills amount to $3,720.00. By settling for four times medicals ($14,880.00), plus expenses and lost wages ($2,629.00), the total settlement demand is $17,509.00. This covers all the victim’s documented expenses, and leaves $11,160.00 for pain and suffering.

The adjuster probably won’t accept this initial demand for settlement. It’s more of a starting point for negotiations.

I look forward to hearing from you.


Joe Moen
3252 E. Elm St.
Sunny, AZ 32502

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

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