Personal Injury Demand Letter Template (Car Accident) – Free Word & PDF
Use this free personal injury demand letter (United States): fill it in online, download it as Word or PDF, and follow our step-by-step guide – where to send it, whether it needs notarizing, what to attach and mistakes to avoid.
| Country | 🇺🇸 United States |
|---|---|
| Document type | Complaints & legal |
| Format | Word, PDF & fill in online |
| Cost | Free |
| Time to complete | about 5 minutes |
| Notarization | Not required |
| Sent to | At-fault driver’s insurer |
| Key deadline | State statute of limitations |
What is this letter for?
A demand letter starts settlement negotiations with the at-fault driver’s insurance company after a car accident. It summarizes how the accident happened, your injuries and treatment, your financial losses (medical bills, lost wages, property damage) and the amount you are asking for. Insurers usually respond with a counteroffer. Every state has a statute of limitations for injury claims, so do not let negotiations run past that deadline.
Where do you send it?
Send it to the at-fault driver’s insurance adjuster by certified mail or the insurer’s claims email, quoting the claim number.
Does it need to be notarized?
Not required. No notarization is needed. Sign the letter and attach copies of records (keep the originals).
Step-by-step process
- Report the accident and open a claim with the insurer.
- Complete medical treatment and collect records and bills.
- Calculate economic losses and choose a demand amount.
- Send the demand letter with documents.
- Negotiate the counteroffer; consider a lawyer if talks stall.
What you need before you start
- Claim number and adjuster’s name
- Medical records and itemized bills
- Proof of lost wages and repair estimates
How to use this template
- Click each yellow field inside the letter and type your details directly (Enter jumps to the next field).
- Read the text through; the “Edit” button lets you change any sentence.
- Click “Word”, “PDF” or “Copy”, then sign and send.
Free template : personal injury demand letter
Your full name
Street address
City, State ZIP
Phone | Email
Today’s date
Adjuster name
Insurance company
Insurer address
Re: Demand for settlement – Claim Claim number, insured At-fault driver, date of loss Accident date
Dear Recipient name,
I am writing to present my claim for injuries and losses from the accident on Accident date at Location, caused by your insured, At-fault driver, who ran a red light / rear-ended my vehicle.
As a result, I suffered injuries and received treatment from providers between Treatment dates. My doctor has current prognosis.
My damages are: medical expenses $Medical total; lost wages $Lost wages; property damage $Property damage; and pain and suffering. Copies of records and bills are enclosed.
I demand $Settlement amount to settle this claim. Please respond in writing by Response deadline.
Sincerely,
Your full name
Letter variations
Property damage only
My vehicle was damaged in the accident. The repair estimate from [[Body shop]] is $[[Amount]], and I also incurred $[[Amount]] for a rental car.
Response to a low offer
I have reviewed your offer of $[[Amount]], which does not reflect my medical expenses of $[[Amount]] and lost wages. I am prepared to settle for $[[Amount]].
Checklist before you send
- ☑️ Claim number
- ☑️ Accident facts
- ☑️ Injuries and treatment
- ☑️ Itemized damages
- ☑️ Demand amount and deadline
- ☑️ Copies of documents
⚠️ Disclaimer: this template is for general guidance only and is not legal advice. Always check the requirements of the organization you are writing to before sending it.
🏛️ Official sources
Always check the latest rules on the official website before sending.
Common mistakes to avoid
- ❌ Sending it before treatment ends.
- ❌ Admitting fault or minimizing injuries.
- ❌ Missing the statute of limitations.
Tips before you send it
- Wait until you finish treatment (or reach maximum medical improvement) before sending.
- Never accept the first offer without reviewing it.
- Talk to a personal injury lawyer for serious injuries.
Frequently asked questions
When should I send a demand letter?
Usually after you finish medical treatment, so you know the full cost of your injuries.
How much should I ask for?
Total your economic losses and add a reasonable amount for pain and suffering; expect negotiation.
How long does the insurer have to respond?
It varies by state; many insurers reply within 30 days.
Is there a deadline to settle?
Yes, each state has a statute of limitations for filing a lawsuit; keep it in mind.
Where do I send this letter (personal injury demand letter)?
Send it to the at-fault driver’s insurance adjuster by certified mail or the insurer’s claims email, quoting the claim number.
Does this letter (personal injury demand letter) need to be notarized?
Not required – No notarization is needed. Sign the letter and attach copies of records (keep the originals).