Demand Letter Template


Demand Letter
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.
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