Free Personal Injury Claim Letter Template
Personal Injury Claim Letter
[YOUR NAME]
Tampa, FL 33601
[YOUR EMAIL]
222 555 7777
September 20, 2064
Amelia Pagac
Claims Adjuster
SkeleTime
Pembroke Pines, FL 33028
Subject: Personal Injury Claim – [YOUR NAME]
Dear Ms. Pagac,
I am writing to formally notify you of a personal injury claim resulting from an incident that occurred on August 15, 2064, at the intersection of Main Street and Elm Street in Florida. On that day, I was involved in a motor vehicle accident caused by another driver running a red light.
As a result of the incident, I sustained a fractured left arm and whiplash. I have received treatment at Springfield General Hospital, including X-rays, a cast, and physical therapy. The injury has led to significant pain and limited mobility, affecting my daily activities and work.
I am seeking compensation for the following damages:
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Medical Expenses: $5,000 (includes hospital bills, X-rays, and physical therapy sessions)
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Lost Wages: $2,500 (lost income due to inability to work for 3 weeks)
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Other Expenses: $300 (transportation costs for medical appointments)
Enclosed with this letter are copies of the medical records from Florida General Hospital, receipts for medical expenses, and a report from the Florida Police Department.
I kindly request a prompt response to this claim and look forward to discussing this matter further. Please feel free to contact me at 222 555 7777 or [YOUR EMAIL] should you need any additional information.
Thank you for your attention to this matter.
Sincerely,
[YOUR NAME]
