ACKNOWLEDGEMENT OF A SETTLEMENT LETTER
After an oral settlement has been reached between the insurance adjuster and accident victim, it
is important to memorialize what has been orally agreed upon so the accident victim is protected
until the release and settlement paperwork arrives. This letter is important because it serves as a
record of the offer and acceptance made between the victim and insurance adjuster. This letter
lays out all terms that were agreed upon between the victim and adjuster. Please see below for an
example/template of an acknowledgement of a settlement letter.
Date of Letter
Adjuster’s Name
Insurance Company’s Name
Insurance Company’s Address
Re:
Your Name
Insured’s Name
Claim Number
Date of Accident
Dear Mr./Ms. [ADJUSTER’S NAME]:
I am writing pursuant to our telephone conversation in which we spoke and agreed to resolve my
personal injury claim in the lump sum amount of [INSERT AMOUNT]. I’m writing to
acknowledge the settlement and memorialize the terms and conditions of the agreed upon
settlement and release. When we spoke on [INSERT DATE], we agreed to the lump sum amount
of [INSERT AMOUNT] for my [INSERT CLAIM TYPE].
I look forward to receiving the settlement and release at the following address:
Your Street Address
Your City, State, Zip
If you have any further questions regarding this letter or our settlement, please feel free to
contact me directly at [INSERT YOUR PHONE NUMBER HERE].
Thank you,
[YOUR SIGNATURE]
[TYPE YOUR NAME]