Sample Demand Letter – Auto Accident, Hit as Pedestrian

As a pedestrian, if you were injured by a driver of an automobile, you can file a personal injury claim with the driver’s insurance company in order to receive compensation for your medical costs and lost wages. The first thing you need to do to file a personal injury claim is write and send a demand letter that includes all of the details of your claim. This demand letter will be referenced often throughout the negotiations of your claim.

Your demand letter should emphasize the fault of the driver and include attached medical records and a detailed account of your injuries.

Sample Demand for Getting Hit by a Car as a Pedestrian

This is a sample demand letter that includes all of the details and information you should include in a demand letter of your own.


[Your Name]
[Your Address]
[Your City, State, and Zip Code]
[The Date]

[Name of the Claims Adjuster]

[Their 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 number if a claim number has already been assigned to you, and you have already been contacted about the matter.)

Date of Loss: [Date of Accident or Incident in which the Collision Took Place]

Dear Mr./Mrs. [Name of Claims Adjuster],

In response to our previous correspondence on April 28, 2015, please accept this letter as a formal demand for settlement in the matter mentioned above.

I have finished medical treatment after the injuries I sustained because of the negligence of your insured, Georgia McConnell. Your insured hit me with their car as I was walking in a main part of town in [insert location]. Ms. McConnell veered off of the road and into the sidewalk, hitting me with her car and breaking my leg. Evidence from the local police station in [insert location] shows that the insured was sending a text message on her phone while driving, and being distracted caused her to hit me. These facts act as proof that Ms. McConnell demonstrated her negligence and responsibility for my injuries.

On March 3, 2015, I shopping at [insert location], which is a heavily populated area downtown. Ms. McConnell ran through a red light in the center of town, swerved to avoid hitting oncoming traffic, and ran off of the road and onto the sidewalk, hitting and injuring me. My right leg was completely crushed from the weight of the car, and I waited for thirty minutes in severe pain for an ambulance to get through heavy traffic to pick me up.

I was taken by ambulance to Jones General Hospital at [insert address], where I was treated by ER physician Dr. Jane Yancy for my broken leg and some cuts and bruises. She performed x-rays on my leg, treated the broken bone, and prescribed me a prescription pain medication [name the medication]. She also recommended that I use crutches to get around and that I stay home from work for two weeks to rest.

The expenses for my medical treatment are outlined in the attached medical bills, including:

Ambulance: $250.00

Jones General Hospital: $425.00

Dr. Jane Yancy, ER Physician: $349.00

X-Rays: $145.00

Prescription Pain Medication: $96.00

Crutches: $39.00

TOTAL: $1,304.00

Due to the negligence of your insured, Ms. McConnell, I experienced severe pain and also lost two week’s worth of my salary at my place of employment. Because of these outlined medical expenses and damages, I am seeking compensation in the amount of $5,000.00.

Please respond to this letter in no more than 30 days. I appreciate your timely response.

[Your Signature]
[Your Name – printed]


Keep in mind that asking for an amount of compensation that is larger than your total amount of medical costs, you are leaving room to negotiate for a fair settlement.

Getting Help with a Personal Injury Claim

You should also consider retaining a personal injury lawyer who specializes in these types of cases to help you throughout the claims process. A lawyer will help you write your demand letter, gather your medical evidence, and ensure that you receive the compensation you need and deserve.

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