Sample Demand Letter — Head-On Collision

Were you recently injured in a head-on car collision? Are you interested in receiving compensation for your medical bills, lost wages, and suffering? Filing a personal injury claim can do just that.

The first step in any personal injury claim is writing a demand letter to the other driver’s insurance company. These letters should be very thorough, from the details of the accident to the list of injuries and treatments you need compensation for.

They should also be presented with:

  • copies of medical records
  • witness statements
  • expense receipts
  • a letter from your employer regarding your lost wages
  • any other documents supporting your case

A well-written demand letter can make all the difference when beginning a claim, so it is essential that they are formatted and presented correctly. The best way to insure this is by working directly with a personal injury attorney. However, you can get started on your own by following the formatted sample letter below.

Sample Demand Letter for a Head-On Collision

The following demand letter should be heavily referenced when writing your own to insure that the correct information is included.


[Your Name]

[Your Address]

[Your City, State, and Zip Code]

[The Date]

[Name of the Claims Adjuster]

[His or Her Job Title]

[Address of the Insurance Company]

[City, State, and Zip Code of the Insurance Company]

Re: Your Insured, [Name of the Defendant]

Claimant: [Your Full Legal Name]

Claim Number: (only include this if a claim number has already been assigned and you have received correspondence on the matter)

Date of Loss: [Date of the Accident or Incident that Caused Your Injuries]

Dear Mr./Ms. [Name of Claims Adjuster]

After our previous discussion on February 13, 2015, I am writing to present you with my formal demand for compensation regarding the collision involving your insured, Ms. Marissa Farrell.

I only recently finished receiving treatment for the injuries I suffered due to Ms. Farrell. As you know, Ms. Farrell was driving on the street opposite of me at [insert location] when she veered onto my side of the road, causing a head-on collision. After the accident, Ms. Farrell failed to pass a breathalyzer test and was found to be driving under the influence. Ms. Farrell’s ignorance of [insert state]’s traffic and DUI laws makes her negligent and responsible for the injuries, loss of wages, and suffering I sustained from the incident.

On the night of January 2, 2015, I was driving at 15 MPH east along Division St., a two-lane residential street. Ms. Farrell was driving west along the same road when she suddenly veered into my lane, giving me no time to avoid her car or prevent the collision. Our cars hit head-on, breaking my windshield and jolting me forward suddenly against my seat belt and air bag. I suffered severe neck pain and multiple lacerations on my face and arms from the broken glass.

I was taken by ambulance to Antelope Valley Urgent Care, where I was seen by Dr. Charles Garcia. Dr. Garcia performed x-rays, administered 3 stitches for my lacerations, treated a torn ligament in my neck, and prescribed me a neck brace and [name the medication] for the pain. I was ordered to stay home for three weeks from teaching at Chaparral Elementary to recover from my injuries.

Here are attached my medical bills, which further describe the cost of my treatment.

Ambulance Transportation: $350.00

Antelope Valley Urgent Care: $721.00

Dr. Charles Garcia: $492.00

X-Rays: $170.00

Neck Treatment and Neck Brace: $89.00

Stitches for Lacerations: $56.00

Prescription Pain Medication: $180.00

TOTAL: $2,058.00

Due to Ms. Farrell’s negligence, I additionally lost three weeks salary, which amounts to $3,200.00. This, along with the pain and suffering I still cope with, leads me to request $13,000.00 in compensation.

I hope to receive a timely response in no later than 30 days from the date of this correspondence.

[Your Signature]

[Your Name – printed]


Note: by requesting an amount larger than your lost wages/medical bills, you allow necessary room for negotiation.

Seeking Additional Help from an Attorney

Demand letters are just one part of the claim process. For expert legal advice regarding each aspect of your personal injury case, contact a personal injury attorney. They will not only ensure a smooth legal process, but they greatly increase your chances of receiving the compensation.

Call Now For a Free Case Evaluation: 844-650-3888