What Goes Into a Demand Letter (and Why It Takes So Long to Send One)

Published June 29, 2021 · Injury Law Basics

"When are we going to ask them for money?" It is one of the most common questions clients ask, usually a few months into treatment, when the bills are piling up and the adjuster has gone quiet. The honest answer is: when we can prove every dollar we are asking for.

The settlement demand is the moment your injury case is presented on paper. Everything done in the months before it, from the first photographs to the last physical therapy note, either shows up in that package or does not. Here is what goes into one, why it takes the time it does, and what happens after it is sent.

A hypothetical to follow along

To make this concrete, consider a hypothetical client. This is not a real case; the names and numbers are invented for illustration.

Dana is stopped at a red light on North Main Street in Dayton when a pickup truck rear-ends her at city speed. Her car is a total loss. She goes to the emergency room that evening with neck and lower-back pain. Over the following months she treats with her family doctor, attends physical therapy, has an MRI showing a herniated disc, and receives two injections from a pain specialist. She misses six weeks of work as a dental hygienist. Eight months after the crash, her pain specialist says she has reached maximum medical improvement, with lasting restrictions on lifting and prolonged sitting.

Why the demand waits for maximum medical improvement

"Maximum medical improvement," or MMI, is the point at which your condition has stabilized, or your doctors can predict with reasonable confidence what your future looks like. Before MMI, nobody knows the most important numbers in the case: whether you will need surgery, how long you will be off work, and whether the injury is permanent.

Sending a demand at three months, before Dana's MRI and injections, would have meant asking for money based on a sprain diagnosis. The insurer would have been glad to pay a sprain number. Waiting is not delay for its own sake; it is how we avoid settling a herniated disc for the price of a stiff neck.

What goes into the package

A strong demand is a letter supported by an organized set of exhibits. For Dana, it would include:

1. Liability. The police report, the photographs of both vehicles, the citation issued to the other driver, and any witness statements. Rear-end crashes usually have clear liability, which our rear-end collisions page explains, but the letter still lays it out so no one has to guess.

2. The injury story. A narrative in plain language: who Dana was before the crash, what happened that night, what treatment she went through, and what her life looks like now.

3. Treatment summary. A chronological summary of every provider and visit, with the key findings: the ER notes, the MRI result, the specialist's diagnosis and opinion on permanence. The complete records go behind the summary.

4. Medical bills, billed and paid. An itemized list of every bill, with the amount charged and, where available, what was actually paid by health insurance or MedPay. The insurer will focus on paid amounts, so the demand addresses both.

5. Lost wages. A letter from Dana's employer confirming her rate of pay and the days missed, backed by pay stubs. For a self-employed person, tax returns and business records.

6. Future care. If her specialist expects more injections or physical therapy, or the possibility of surgery, the demand includes that opinion and its likely cost. Future care is often the largest number in a serious case.

7. Pain, suffering, and loss of enjoyment. This is the part of the demand that is not a receipt. It explains, with specifics, what the injury has taken: the nights without sleep, the hikes she cannot take, the toddler she cannot lift. Her own journal, statements from family and coworkers, and photographs make it real.

8. The number, and the reasoning behind it. The demand states an amount and explains how it relates to the evidence.

How the caps and comparative fault fit in

Two Ohio statutes shape every demand, even when they are not mentioned in it.

Under R.C. 2315.18(B)(2), noneconomic damages, meaning pain and suffering and similar losses, are generally capped at the greater of $250,000 or three times economic loss, up to $350,000 per plaintiff, unless the injury falls within the catastrophic exceptions in R.C. 2315.18(B)(3). Documenting every dollar of economic loss, including future care, does double duty: it is recoverable in full, and it can raise the ceiling on noneconomic damages. Our guide chapter on what your case is worth explains how the cap and its exceptions work.

Under R.C. 2315.33, an injured person's recovery is reduced by her percentage of fault and barred if her fault is greater than everyone else's combined. In a rear-end crash like Dana's, there should be no fault on her side. In other cases, the demand has to answer the comparative-fault argument before the adjuster makes it.

Policy limits and time-limited demands

Sometimes the value of a case clearly exceeds the at-fault driver's insurance. In that situation, a demand may offer to settle for the policy limits within a set period of time, with supporting proof that the case is worth more. A carefully drafted, reasonable time-limited demand puts the insurer to a choice. If it unreasonably refuses and a later verdict exceeds the limits, the insurer may face consequences for failing to protect its own insured.

These demands must be precise, and a sloppy one can backfire. They are also where your own underinsured motorist coverage enters the picture, because an at-fault driver's limits that are too low may open a claim under your policy.

Why the file has to be complete

The adjuster's job is to find the gap. A missing record, an unexplained month without treatment, a symptom that appears in the demand but not in the medical chart: each becomes a reason to offer less. I wrote last fall about why gaps in treatment hurt your case, and the demand is where that damage shows up. Gathering every record, every bill, and every wage document takes weeks after MMI. It is worth it.

What happens after the demand goes out

The insurer typically responds within 30 to 60 days. The first offer is almost always well below the demand, and sometimes well below what the file supports. Expect several rounds of negotiation. Our guide chapter on dealing with insurance adjusters describes the tactics you are likely to see.

If negotiation does not produce a fair number, the next step is filing suit, and the decision to do so is always yours.

Throughout, the statute of limitations keeps running. Under R.C. 2305.10(A), Ohio's general deadline for a bodily injury lawsuit is two years, and negotiation does not pause it. A demand must go out early enough to leave time to file if needed.

What this means for you

A demand letter is not a form. It is an argument, built from months of evidence, for what your injury is worth. The quality of that file, more than anything said on the phone, determines the number. If you are still treating, keep going, keep your appointments, and keep records. If you are nearing the end of treatment and no one is building the file, now is the time to start.