Car accident not your fault? Some damages but not enough to hire an attorney? Wonder if you can handle the insurance claim yourself? With a little work, yes, you can. Here is how to write a really good first claim letter.
The foundation of any auto insurance claim is the Claim Letter. It is the document where you lay out your case and damages in detail, and demand payment. A well written demand letter serves as a road map for your claim, and can convince the insurance company fighting the claim is a waste of resources. A poorly written Claim Letter can ruin a good claim.
Step 1: Format of the Claim Letter.
The letter should be a clean business letter. It should identify your full name, address, telephone number, and email address. THe person making the claim (you) is normally referred to as the “claimant”.
There should be a “Subject Line” where you list the date of the accident, (called Date of Loss in the insurance world), and the other driver’s name.
The letter should include its mailing date, and the Insurance Company’s Claim Number if one has been assigned.
Then the letter should have 4 main sections: 1) Facts; 2) Liability; 3) Damages; and 4) Demand for Settlement.
Step 2: Fill in the Facts Section with Accident Details.
In the Facts section, the Claimant should describe the basic facts of the accident. Include the type of car you were driving, the date and time, the location of the accident, and the manner in which the accident occurred.
There should also be a statement of what happened to your body or car during the accident to describe the mechanism of the damages.
On June 1, 2044, I was driving southbound on Hwy 405 near the Beach Ave exit in the middle lane at 5:00 pm. Traffic was heavy, and moving slowly. I stopped for stopped traffic in front of me, and you’re insured’s garbage truck collided with the rear of my car. During the impact, the rear of my car was crushed, and my neck and back were violently thrown about the car. The seat belt pinched my neck and chest in an awkward manner. My face hit the steering wheel. Then approx 220 pounds of rotten yogurt poured over my car, entered my windows, fell into my lap and made me physically sick.
Step 3: Fill Out the Liability Section.
The Liability Section is where you lay out the legal foundation for your claim and demand for payment. This section does not need to be very complicated. I always try to keep them short.
The basics are this: The other driver (and/or owner of the vehicle) owes you money. If you need to sue in Civil Court for this accident, you will have to sue the driver and/or owner. But if the driver/owner is insured, the auto insurance company is on the hook to pay any judgment against their insureds you might win. So in this Claim Letter you are going to threaten to sue, and ask the insurance company to pay out of court.
Most auto accident claims are based upon the simple legal theory of negligence. That is the most basic “Cause of Action” for an auto accident claim.
Negligence has 4 main required elements to prove it up in court: 1) defendant had a legal DUTY; 2) defendant BREACHED that duty; 3) the BREACH of duty was the legal CAUSE of; 4) DAMAGES.
To convince the insurance company that they must pay you, you need to show them each of those elements. Using our example above, this can be done in the following manner:
“Your insured had a legal duty to control their vehicle at all times and to take all reasonable steps to prevent injury to others, especially me. Your insured breached that duty by losing control of their vehicle, but following too close, and by colliding with the rear of my car. This breach caused my car to be crushed and yogurted, and caused me to become injured. As a result, I have suffered monetary and personal injury damages that your insureds are legally required to pay.”
Step 4: Fill Out the Damages Section.
In the damages section, there should be 2 sub sections: 1) property damages and 2) personal injury damages.
In the property damage sub section, list the total amount of money you want for damage to your car, and loss of use of the car. In the Personal Injury sub section, list the total of your medical bills (not just your co payments – the total value of the medical services you received regardless of how or if paid) and the amount of money you want for pain, suffering, loss of enjoyment of life and wage loss.
You may want to include a statement of future expected damages if you need more treatment or will feel pain in the future.
How do you calculate the amount to ask for? You make it up.
Step 5: Make a Demand for Settlement.
When you make an insurance claim over a motor vehicle accident, the insurance company wants 1 thing from you. It is called a “Release of All Claims” or “Release”. They want a release signed by you because once they get it – the claim is over forever.
So when you make a demand for a settlement, you are basically saying “I will sign a release if you pay this claim.” Thus, in the demand for settlement section, you want to offer up a release, and make a demand for payment. Yes, you are selling a release.
A settlement demand should also include a deadline for response, and a threat to sue the insured driver and owner in civil court if not paid. By making that threat, you put the insurance company in danger of a “Bad Faith” claim by their insureds if they fail to pay a valid claim cheap and later get sued for more money.
Most Claim Letter demands look something like this:
“This claim has a full value of at least $30,000 if a jury were to hear the evidence. However, I wish to end this claim forever without court litigation early if possible. In exchange for early settlement and payment of this claim in the amount of $8,349, I would be willing to sign and deliver a complete Release of All Claims for you. I request that you respond to this settlement offer within 30 days. If the claim is not settled at that time, I will begin litigation against your insureds for an amount that greatly exceeds this settlement offer with the goal of obtaining a judgment against them.”
Step 6: Follow Up the Claim Letter with Telephone Calls to the Agent, Start Negotiating.
You should follow up your claim letter with phone calls asking for settlement. Dont be surprised if they deny your claim at first. That always happens. They are not just going to pay full value on your claim. You are going to have to fight for it. Do not be afraid to negotiate with the agent over the phone. Offer more documentation, make counter offers, try your best to get the claim settled.
If you fail to settle – you do not have to accept an auto insurance company’s assertions, valuations or liability determinations. The court has the final say on those issues if you have to sue in civil or small claims court.
Questions? Leave a comment.
Copyright 2010-2016 Law Office of Christopher Dort, All rights reserved.