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Sample Personal Injury Demand Letter




Demand Letter Template



Demand Letter for Personal Injury


Sean Williams
1234 Main Street
Arlington, TX 76010
July 16, 2011



Mr. John Carter
Claims Adjuster
ACME Insurance
25 South Street
Fort Worth, TX 76052


Re: Your Insured, Kevin Nettles
Claimant: John Knox
Claim No.: 123-4567
Date of Loss: June 10, 2011

Dear Mr. Carter,

With regard to our previous conversation on June 20, 2011 I was injured during a bike accident with Kevin Nettles, your insured. I was riding south along side Grogan's Mill Road and your insured was heading north. While going around a bend on the bike path your insured failed to stay in his lane and ran into me with his bike.

The impact threw me off my bike and into a tree. Hitting the tree while traveling at a high rate of speed knocked me unconscious and badly bruised. Paramedics arrived and took me to the MD Anderson Emergency Room where they discovered I had extensive bruising both internally and externally, and x-rays revealed two broken ribs and a broken left leg and arm.

I was left in casts and ordered to a week of bed rest. Pain medication was also prescribed for all the pain that I was in.

Sleeping was very difficult while I was bed ridden because the pain kept waking me up at night. After returning home I still needed to go back to the doctor's office for multiple follow ups to closely monitor my injuries from the bike accident.

During my painful recovery time I missed three weeks of work due to being unable to move myself freely about. When I did get back to work my days were unproductive because of the casts I had to wear and still being in some pain.

I am still suffering from pain episodes a couple of times a day. My doctor is telling me that the occasional pain will continue for the next several months. My medical expenses were as follows:

Ambulance fee: $3,000
MD Anderson Emergency Room: $15,000
MD Anderson X-Rays: $5,000
Leg and Arm Cast: $3,000
Prescription Medications: $750

Total: $26,750

Enclosed there is a letter from my place of employment confirming the days of work that I missed. The letter also documents that I lost $12,000 in wages.

Due to the fact that there was complete negligence on the part of your insured client I experienced a great deal of pain and suffering. In fact a lot of suffering is still taking place along with disrupting my life. Due to these circumstances I demand compensation for my injuries and general damages in the amount of $45,000.

I look forward to hearing from you as soon as possible regarding this matter, no more than fourteen days from the date of this letter.

Best Regards,


Sean Williams





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