This form is a sample letter in Word format covering the subject matter of the title of the form.
[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Insurance Company Name] [Attn: Claims Department] [Address] [City, State, ZIP Code] Subject: Refusal to Pay Requested Damages — Traffic Accident [Case Number] Dear Sir/Madam, I am writing to formally request that you reconsider your decision to refuse payment for damages resulting from a traffic accident that occurred on [Date] at [Location]. As a resident of South Dakota, I have reached out to you as the insurance provider in my case, expecting a fair evaluation and settlement for my damages. Let me provide you with a comprehensive account of the accident. On the aforementioned date, I was driving my vehicle, a [Make, Model, Year], on [Road Name/Highway] in South Dakota. At around [Time], the defendant, [Other Driver's Name], suddenly veered into my lane without any indication or warning. Despite my immediate attempt to avoid a collision by applying the brakes and maneuvering out of the way, our vehicles collided. Following the accident, I promptly contacted law enforcement and documented the incident with the police report, which I have attached to this letter for your reference. The official report clearly establishes the negligence of the defendant and supports my claim for damages inflicted upon my vehicle. Additionally, I sought immediate medical attention due to the impact of the collision, which left me with injuries requiring medical treatment. A comprehensive evaluation by my physician documented the injuries sustained as a direct result of the accident. These documented medical records are also enclosed for your review. Considering the facts presented, it is evident that the accident was solely caused by the negligence of the defendant. Despite this, I was shocked and disappointed to receive your recent letter, rejecting my claim for damages. Your refusal to pay for the repairs for my vehicle and the medical expenses has placed an undue burden on me, and I find it necessary to address this matter formally. Under South Dakota law, it is the responsibility of the at-fault driver's insurance company to compensate the injured party for their losses in a timely manner. As I have met all the necessary requirements to establish my claim, including providing documentation of damages, medical records, and the police report, it is imperative that you overturn your decision to deny my claim. I kindly request that you review the enclosed evidence once again and reconsider your position. The damages suffered as a result of this accident, both in terms of property damage and personal injury, are significant and require your prompt attention. If I do not receive a satisfactory response within 10 business days from the receipt of this letter, I will have no alternative but to exercise my rights under South Dakota law to pursue legal action to recover the full amount owed, as well as any additional expenses incurred as a result of your refusal to fulfill your obligations. I hope that we can resolve this matter amicably and avoid any further escalation. Your prompt attention to this inquiry is greatly appreciated. If you need any further information or require supporting documentation, please do not hesitate to contact me. Thank you for your immediate attention to this matter. Sincerely, [Your Name] Enclosures: — Copy of PolicReportor— - Medical records and bills — Any other relevant supporting documents
[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Insurance Company Name] [Attn: Claims Department] [Address] [City, State, ZIP Code] Subject: Refusal to Pay Requested Damages — Traffic Accident [Case Number] Dear Sir/Madam, I am writing to formally request that you reconsider your decision to refuse payment for damages resulting from a traffic accident that occurred on [Date] at [Location]. As a resident of South Dakota, I have reached out to you as the insurance provider in my case, expecting a fair evaluation and settlement for my damages. Let me provide you with a comprehensive account of the accident. On the aforementioned date, I was driving my vehicle, a [Make, Model, Year], on [Road Name/Highway] in South Dakota. At around [Time], the defendant, [Other Driver's Name], suddenly veered into my lane without any indication or warning. Despite my immediate attempt to avoid a collision by applying the brakes and maneuvering out of the way, our vehicles collided. Following the accident, I promptly contacted law enforcement and documented the incident with the police report, which I have attached to this letter for your reference. The official report clearly establishes the negligence of the defendant and supports my claim for damages inflicted upon my vehicle. Additionally, I sought immediate medical attention due to the impact of the collision, which left me with injuries requiring medical treatment. A comprehensive evaluation by my physician documented the injuries sustained as a direct result of the accident. These documented medical records are also enclosed for your review. Considering the facts presented, it is evident that the accident was solely caused by the negligence of the defendant. Despite this, I was shocked and disappointed to receive your recent letter, rejecting my claim for damages. Your refusal to pay for the repairs for my vehicle and the medical expenses has placed an undue burden on me, and I find it necessary to address this matter formally. Under South Dakota law, it is the responsibility of the at-fault driver's insurance company to compensate the injured party for their losses in a timely manner. As I have met all the necessary requirements to establish my claim, including providing documentation of damages, medical records, and the police report, it is imperative that you overturn your decision to deny my claim. I kindly request that you review the enclosed evidence once again and reconsider your position. The damages suffered as a result of this accident, both in terms of property damage and personal injury, are significant and require your prompt attention. If I do not receive a satisfactory response within 10 business days from the receipt of this letter, I will have no alternative but to exercise my rights under South Dakota law to pursue legal action to recover the full amount owed, as well as any additional expenses incurred as a result of your refusal to fulfill your obligations. I hope that we can resolve this matter amicably and avoid any further escalation. Your prompt attention to this inquiry is greatly appreciated. If you need any further information or require supporting documentation, please do not hesitate to contact me. Thank you for your immediate attention to this matter. Sincerely, [Your Name] Enclosures: — Copy of PolicReportor— - Medical records and bills — Any other relevant supporting documents