7 tips for writing a payment demand letter to an insurance company
In the aftermath of an auto accident, it can be daunting to begin the process of settlement on your own. It may have taken you weeks or even months to fully heal from your injuries, if that’s even possible. Now, you are back to school or work, and it’s finally time to get reimbursed for your pain and suffering, medical expenses and property damage so that you can settle your case once and for all and move forward from the trauma of being involved in a collision that wasn’t your fault.
In order to make sure that you receive the full and fair settlement that you deserve, it’s important to know what insurance adjusters look at in each injury claim that helps them to determine the monetary value of that case. It’s also worth understanding how to present the facts of your case to the insurance adjuster as effectively as possible.
Here at Scholle Law, our Atlanta accident attorneys have successfully resolved hundreds of cases and have over 20 years of experience dealing with insurance companies and adjusters. In that time, we’ve picked up a few “best practices” when it comes to writing demand letters to insurers. In this article, we’ll summarize these tips.
Tip #1: Organize your expenses
Before you start putting pen to paper, the first step is to gather all of your receipts and out-of-pocket expenses related to the accident. Insurance adjusters will typically base their settlement offers on expenses that have been incurred as a result of the wreck, such as medical bills acquired from treatment, prescriptions purchased for sustained injuries, loss of earnings from inability to work, repair bills to any property damage sustained (such as your vehicle), loss of irreplaceable items, and so on. These are known as “special damages.”
Every personal injury case will look a little different depending on the specific types of special damages incurred in that individual case, but they are generally out-of-pocket expenses that can be determined by adding together all of the losses incurred from the accident.
Once you have gathered all of your medical records, lost wages, and bills and receipts that you will turn into the insurance adjuster, it’s time to start writing!
Tip #2: Establish the facts
Think of your demand letter as a full and complete explanation of your experience in the auto accident. Often, it’s better to write under the assumption that the reader doesn’t know anything about what happened in the accident or with your medical treatment that followed.
Begin with the accident itself. Explain where you were at the time of the collision, including the street names. Let the adjuster know what you were doing. Were you at a complete stop waiting on traffic or a red light and were suddenly rear-ended? Or perhaps you were driving along in your lane of travel when someone pulled out in front of you.
No matter the circumstances surrounding the point of impact, try to explain it to the best of your ability as clearly as possible. If you have a copy of the motor vehicle accident report, use it to list the exact date, time and street names. It may also have information about the at-fault driver and if any citations were given by the reporting officer on the scene. It may also contain witness statements.
All of these elements are important because you want to explain why their insured is responsible for the accident.
Tip #3: Share your perspective
After the facts about how and when the motor vehicle accident occurred have been established, it’s time to describe what happened to you following the collision. For some, this begins immediately following the impact.
Let the adjuster know what you remember and how the pain began. For example, if you remember hitting your head against the window or your knee pushing into the dashboard, put that in the demand. While your medical records will show the adjuster what your treatments were following the collision, only you know what happened in the vehicle at the time of the impact.
Further, only you know the amount of pain you were in, so clearly spell out to the insurance adjuster exactly when you first started experiencing pain and in what areas of the body. For some, that may be immediate. For others, the pain may not register until the hours or days following the accident once the adrenaline has died down and the muscle aches and pain begins to set in.
Tip #4: Detail your road to recovery
Once you have explained to the adjuster how the accident happened and when your symptoms began, it’s time to detail your medical treatment. This may have begun at the scene of the accident if you were treated by paramedics or transported to the emergency room via ambulance. Your medical care could have also begun in the days or weeks following the motor vehicle collision if you weren’t able to present to a doctor’s office until then.
Either way, you want to explain when and where you were seen by a doctor, as well as the reason why you had to go to the doctor (such as what symptoms you were experiencing) and what the treatment provided. In fact, you want to do this for your entire course and scope of treatment.
This could include treatment from a primary care doctor who prescribed some pain medication or anti-inflammatories and then referred you to a physical therapist. It could be an emergency room visit that resulted in a physical exam and some X-rays, CT or MRI imaging. Or, it could also be a chiropractic visit where you received some spinal manipulation.
For some people, a few visits and some medication may have been all that it took for their injuries to subside. But for others, it may take weeks or even months of physical therapy, injections or, even worse, surgery. Since no 2 individuals heal at precisely the same, it’s imperative that you make sure that the insurance adjuster understands exactly what your road to recovery looked like.
Tip #5: Acknowledge and emphasize your pain and suffering
No matter what the course and scope of treatment, it’s important to remember to emphasize your pain and suffering. While your medical records will clearly explain what the doctor did, it’s up to you to make sure the adjuster understands how you felt and the way the injuries you were experiencing affected your day-to-day activities.
For instance, if you were unable to go to the gym because your back was in too much pain or you couldn’t carry groceries into the house because the weight was too much for your shoulders, put that in your demand letter. Clarifying the pain and suffering you experience can help increase the settlement offer presented by the insurance company because these are examples of “general damages.”
General damages represent the types of losses that can’t be as easily assigned a monetary value. Examples of general damages include:
- Pain and suffering — the pain and emotional distress endured as a result of the accident
- Emotional trauma — can include depression, anxiety, insomnia and more
- Loss of consortium — the loss of the companionship or benefits of married life, such as the ability to show affection
- Future medical care — ongoing medical treatments or surgery that has been recommended
- Overall lowered quality of life — can occur if an accident has left you with any type of permanent disability, scar or disfigurement)
Tip #6: Request a reasonable settlement amount
Once you have explained to the adjuster what happened in the accident, the injuries you sustained and the course of treatment you underwent to recover, it’s time to ask for a settlement amount. This is a specific dollar amount that will compensate you for all of your financial losses, including your medical bills, out-of-pocket expenses, lost wages and non-economic damages such as your pain and suffering.
It’s important to note that this number should be higher than what you may think your claim is actually worth so that you are able to negotiate with the insurance adjuster if they come back with a settlement offer that is lower than desired. However, you should also be realistic in your settlement figure.
Ultimately, you want the insurance adjuster to work with you on an acceptable settlement amount that you can both agree on. Asking for an unreasonably high sum right off the bat can cause the adjuster to not take your demand seriously.
A general rule of thumb is to demand double or even triple the amount of your total special damages.
Tip #7: Review your letter and send!
When you’ve fully written your demand letter, look over it one last time before sending it over to the at-fault driver’s insurance company. Make sure that it has a full and complete description of how the collision occurred, an overview of the injuries you sustained and the medical treatment you received, as well as the pain and suffering you experienced and how that affected your daily life.
Finally, make sure that the letter clearly states the settlement number you are demanding. And don’t forget to attach all of the supporting documents that you collected to the demand letter. This should include any medical records, bills, out-of-pocket expenses, lost wages and evidence from the accident that proves liability, such as the motor vehicle accident report and photographs of the scene, property damage or injuries.
Now that you have a general idea of how insurance companies value claims, you will be better equipped to settle your personal injury claim. It’s important to remember that insurance companies are businesses first and foremost. It’s the adjuster’s job to get you to settle your case for as little as possible, or to find a way to deny your claim for personal injury altogether.
Often, you will be offered a lower amount than you believe you should be owed, but understand that this is a normal part of the process and shouldn’t be taken personally. While it can be a frustrating process, it’s important to make sure that you are getting the full value of what your claim is worth.
Thankfully, you don’t have to settle your case on your own. If you find that an insurance company is trying to shortchange your personal injury settlement, you can always contact a skilled personal injury lawyer for advice. At Scholle Law, we’ve written thousands of demand letters and can assist you in preparing the perfect one that will ensure you receive the maximum settlement that you deserve.