Pursuant to the telephone conversation we had on (date), please allow this letter to confirm we have agreed to settle my claim that is referenced above. Fill in your contact details, account number and any extra information you want to include in the grey shaded areas.Today's date will be added automatically. In this guide you will learn: What is an insurance demand letter, How to write a demand letter, How much to ask for in a settlement demand letter. Can City personnel fill out the form for me? Complete and Submit an Online Claim Form. This letter is in reference to the account number identified above and its outstanding debt.