After my clients have completed their course of medical treatment following an accident, there comes a time to present the case for settlement to the responsible party's insurance company.
Prior to this time, the lawyer is indeed in contact with the insurance company and keeps them posted. However, a formal "demand package" isn't usually presented until my clients have finished their treatment and/or reached a plateau where no further treatment is going to help.
The lawyer will then put together a "demand package" - this package contains several times including, but not limited to the following:
1) A letter to the insurance adjuster establishing liability adverse to their client and arguing the damages of the case - both economic and non-economic damages (the latter are also known as "pain and suffering" or "general" damages). The letter is basically an "argument" to the adjuster. It should be persuasive but not long-winded. Remember, adjusters are handling hundreds of files at any given time so they don't have time or energy to read a novel.
2) Photos of the accident - the photos need to help the adjuster understand the severity of the impact. If the photos show little damage, I generally won't include photos that can backfire on my client. Photos should tell a story. Remember, pictures "tell a thousand words," so the photos sent need to help tell the story.
3) Property damage estimate - if the estimate shows significant property damage, frame damage, etc., it should be included to further show the adjuster the extent of the damage. Sometimes, photos don't tell the whole story so the esimate can help. The property damage estimate might reveal damage that's hard to see.
4) Medical reports - Not just medical records but also reports that contain narratives - explanations from the doctors as to what the injuries were, what treatment was done, and any prognosis.
5) Medical bills - Billing from all medical providers, from the ambulance, hospital, ER, orthopedic, chiropractic, physical therapy, MRIs and other scans, etc. This is NOT "explanation of benefits" forms or co-pays. Your co-pay is not your billing.
6) Lost earnings verification. If you are asserting lost earnings, you need to provide the adjuster with adequate documentation that supports your claim for lost wages.
There are sometimes other documents that are included with the demand package, depending on the particular case. The adjuster will review the package and generally call the lawyer with further questions and/or an offer. The lawyer and the client then discuss the offer and how to respond.
by Robert Mansour
Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia,