This form is a sample letter in Word format covering the subject matter of the title of the form.
Subject: Request for Compensation for Automobile Accident — Demand for Damages to Party Opposite [Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Party Opposite's Name] [Party Opposite's Address] [City, State, ZIP Code] [Insurance Company Name] [Attn: Claims Department] [Address] [City, State, ZIP Code] Re: Automobile Accident Demand for Damages to Party Opposite Dear [Party Opposite's Name], I hope this letter finds you well. I am writing to formally demand compensation for damages and personal injuries sustained as a result of the automobile accident that occurred in Phoenix, Arizona, on [Accident Date] involving our vehicles. I kindly request that you forward this letter to your insurance company to initiate the claims process. The detailed account of the accident is as follows: On [Accident Date], at approximately [Accident Time], I was driving my [Make and Model of Vehicle] eastbound on [Street Name]. As I approached the intersection of [Intersection Name], your vehicle, a [Make and Model of Opposite Party's Vehicle], negligently failed to stop at the red light and crashed into my vehicle with significant impact. As a direct result of the accident, I suffered the following injuries and damages: 1. Physical Injuries — I sustained severe trauma to my head, neck, and back, resulting in debilitating pain and restricted mobility. These injuries require ongoing medical treatment, physical therapy, and potential long-term care. I have attached medical records from [Doctor/Hospital Name] supporting these injuries as evidence. 2. Property Damage — The collision caused extensive damage to my vehicle, including significant repairs needed for the front bumper, engine, and various other mechanical components. Enclosed, please find the repair estimate provided by [Auto Repair Shop] with an itemized breakdown of repair costs. 3. Emotional Distress — The traumatic nature of the accident has caused me emotional distress, anxiety, sleep disturbances, and a diminished quality of life. This mental anguish has also resulted in the need for psychological counseling to address the psychological trauma associated with the accident. Based on the liability established in the police report [Attach Accident Report Number and Copy], it is evident that your negligence and failure to adhere to traffic laws were the primary causes of this accident. As a responsible driver, I was obeying all traffic rules and regulations, hence should not bear any responsibility for the incident. Therefore, I am demanding compensation in the amount of $[Requested Compensation] to cover all medical expenses, lost wages due to time off work, vehicle repairs, rental car expenses, and pain and suffering endured as a result of this unfortunate event. Please note that this is a formal demand, and I expect you to respond within [Number of Days — recommended 30 days] of receiving this letter. Failure to do so or an inadequate response will leave me no choice but to pursue legal action, including filing a personal injury lawsuit to secure my rightful compensation. I request that you provide your insurance information promptly to my attorney, [Attorney's Name], at [Attorney's Address]. Kindly direct all communication regarding this matter to my attorney to ensure an efficient and legally compliant resolution. Thank you for your immediate attention to this matter. I hope we can reach a fair and amicable resolution without the need for litigation. I eagerly await your prompt response. Sincerely, [Your Name]
Subject: Request for Compensation for Automobile Accident — Demand for Damages to Party Opposite [Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Party Opposite's Name] [Party Opposite's Address] [City, State, ZIP Code] [Insurance Company Name] [Attn: Claims Department] [Address] [City, State, ZIP Code] Re: Automobile Accident Demand for Damages to Party Opposite Dear [Party Opposite's Name], I hope this letter finds you well. I am writing to formally demand compensation for damages and personal injuries sustained as a result of the automobile accident that occurred in Phoenix, Arizona, on [Accident Date] involving our vehicles. I kindly request that you forward this letter to your insurance company to initiate the claims process. The detailed account of the accident is as follows: On [Accident Date], at approximately [Accident Time], I was driving my [Make and Model of Vehicle] eastbound on [Street Name]. As I approached the intersection of [Intersection Name], your vehicle, a [Make and Model of Opposite Party's Vehicle], negligently failed to stop at the red light and crashed into my vehicle with significant impact. As a direct result of the accident, I suffered the following injuries and damages: 1. Physical Injuries — I sustained severe trauma to my head, neck, and back, resulting in debilitating pain and restricted mobility. These injuries require ongoing medical treatment, physical therapy, and potential long-term care. I have attached medical records from [Doctor/Hospital Name] supporting these injuries as evidence. 2. Property Damage — The collision caused extensive damage to my vehicle, including significant repairs needed for the front bumper, engine, and various other mechanical components. Enclosed, please find the repair estimate provided by [Auto Repair Shop] with an itemized breakdown of repair costs. 3. Emotional Distress — The traumatic nature of the accident has caused me emotional distress, anxiety, sleep disturbances, and a diminished quality of life. This mental anguish has also resulted in the need for psychological counseling to address the psychological trauma associated with the accident. Based on the liability established in the police report [Attach Accident Report Number and Copy], it is evident that your negligence and failure to adhere to traffic laws were the primary causes of this accident. As a responsible driver, I was obeying all traffic rules and regulations, hence should not bear any responsibility for the incident. Therefore, I am demanding compensation in the amount of $[Requested Compensation] to cover all medical expenses, lost wages due to time off work, vehicle repairs, rental car expenses, and pain and suffering endured as a result of this unfortunate event. Please note that this is a formal demand, and I expect you to respond within [Number of Days — recommended 30 days] of receiving this letter. Failure to do so or an inadequate response will leave me no choice but to pursue legal action, including filing a personal injury lawsuit to secure my rightful compensation. I request that you provide your insurance information promptly to my attorney, [Attorney's Name], at [Attorney's Address]. Kindly direct all communication regarding this matter to my attorney to ensure an efficient and legally compliant resolution. Thank you for your immediate attention to this matter. I hope we can reach a fair and amicable resolution without the need for litigation. I eagerly await your prompt response. Sincerely, [Your Name]