Settlement Demand Letter Generator

Draft a strong legal demand to the insurance company outlining your injuries and damages

A comprehensive settlement demand is the key to negotiating a fair payout. Use this tool to detail your medical expenses, lost wages, and pain and suffering, and present a formal financial demand to the adjuster.

Document Details

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Victim / Plaintiff Info

Full Name

Mailing Address

City

State

ZIP Code

Insurance & Defendant Info

Insurance Company Name

Adjuster Name

Claim Number

Insurance Address

City

State

ZIP Code

Defendant (At-Fault Driver/Company)

Accident Details

Date of Accident

Location (Intersection/Highway)

Description of Accident & Liability

Injuries & Damages

Description of Injuries & Treatment

Past Medical Expenses ($)

Future Medical Expenses ($)

Lost Wages ($)

Property Damage ($)

Pain and Suffering ($)

Demand & Deadline

Total Settlement Demand ($)

Response Deadline (Days)

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[Your Name]

[Your Address]

[City], [State] [Zip]

October 9, 2026

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED

[Insurance Company Name]

Attn: Claims Department

[Insurance Address]

[City], [State] [ZIP]

CLAIMANT:	[Your Name]
INSURED (AT-FAULT):	[At-Fault Party]
CLAIM NUMBER:	[Claim Number]
DATE OF LOSS:	[Date of Accident]

SETTLEMENT DEMAND FOR PURPOSES OF SETTLEMENT ONLY

Dear Claims Adjuster:

As you are aware, I was severely injured on [Date]when your insured, [Defendant], negligently operated their commercial vehicle, causing a collision at [Location].

Liability

[Detailed description of how the accident occurred and why the insured is 100% at fault.]

Based on the facts, the police report, and applicable traffic laws, liability is clear. Your insured breached their duty of care, directly causing the collision and my subsequent injuries.

Injuries and Medical Treatment

[Detailed description of injuries, emergency room visits, surgeries, physical therapy, and ongoing pain.]

I have suffered significant physical pain, emotional distress, and loss of enjoyment of life as a direct result of this collision.

Special Damages

To date, I have incurred the following special damages. Attached to this demand are the corresponding medical records and itemized bills.

Past Medical Expenses:	$0.00
Estimated Future Medical Costs:	$0.00
Lost Wages / Loss of Earning Capacity:	$0.00
Property Damage / Out of Pocket:	$0.00
General Damages (Pain & Suffering):	$0.00
TOTAL DEMAND:	$0.00

Settlement Demand

In an effort to avoid the time, expense, and uncertainty of litigation, I am willing to fully and finally settle this claim against your insured for the sum of $0.00.

This offer will remain open for 30 days from the date of this letter. If I do not receive a favorable response by that time, this offer will be withdrawn, and I will be forced to pursue formal legal action against your insured, which may result in a verdict exceeding policy limits.

I look forward to hearing from you promptly.

Sincerely,

[Your Name]

Enclosures: Medical Records, Itemized Bills, Police Report