Uninsured Motorist Sample Demand Letter

There are over 4 million uninsured motorists in California. If you were in a car accident that was not your fault and the responsible party doesn’t have auto insurance, you may submit a claim to your own insurance company under the terms of your policy.

To give you a head start, we’ve created a sample demand letter that you can use to send to your insurance company.

Download Sample Demand Letter

Download this free demand letter (RTF format) and customize it to your needs.

Uninsured Motorist Sample Demand Letter

Sample California Demand Letter for Your Reference

Here is the sample demand letter that you read over before you download.


Adjuster’s Name
Insurance Company Name

Re: Uninsured party: John Doe (name of party at fault)
Insured: Your Name
Date of injury: Month/Day/Year
Claim #: #########

Dear (Adjuster’s Name):

As you are aware, I was involved in an automobile accident on XX/XX/XXXX in which my vehicle was struck from behind by an uninsured motorist. I have recently finished my treatment and have enclosed all records, specials and reports on the incident for your review.


As established in the police report (attached hereto and marked as Exhibit A), I was driving down Capitol Avenue in downtown Sacramento, CA when another motorist, John Doe, failed to observe the red light ahead and plowed into the back of my Toyota Camry. Even though we both stopped and he apologized profusely for hitting me, he did not have any car insurance. I immediately called 9-1-1 and a member of the Sacramento Police Department was dispatched to the scene of the accident where he took the attached report. He gave Mr. Doe a ticket for his driving infraction and after confirming that Mr. Doe did not have insurance, he cited him for that as well. Under California Vehicle Code Section 16029, it is illegal to drive a vehicle without evidence of financial responsibility as you can see from the attached police report.

It is unmistakable that Mr. Doe was negligent. He owed me a duty to occupy the road with due care. He failed to do so when he did not yield at the red light and slammed into the back of my vehicle. As a result, he was given a ticket. Accordingly, he is liable for my injuries. [Explain all of the significant facts and then conclude with a statement that the uninsured driver is liable.] However, because Mr. Doe does not have insurance, I am forced to make an uninsured motorist claim under the terms of my own policy.


As a result of this incident, I suffered neck, back and shoulder strain. I was transported by ambulance to Methodist Hospital, where doctors gave me a neck brace and gave me some prescription Tylenol for all of my injuries, and advised me to rest for the next 7 days (Medical records attached hereto and marked as Exhibit B).

I made an appointment with my primary care doctor, Dr. Care. She saw me three times and took her own set of x-rays (Medical records attached hereto and marked as Exhibit B). Dr. Care then referred me to an orthopedist, Dr. Bones. I saw Dr. Bones three times as well. (Medical records attached hereto and marked as Exhibit B). He referred me to a physical therapist, Dr. Relax, for my neck and back and he gave me a list of exercises to do at home; Dr. Relax saw me three times a week for the next 4 months. (Medical records attached hereto and marked as Exhibit B). [Summarize your medical treatment. You don’t need to give all of the details. Just describe the main points of your treatment.]

My neck and back pain got worse for the first 7 days before getting better. After a couple of weeks, I started to experience a little improvement. The accident prevented me from doing things around the house for about 4-5 weeks. However, I was out of work for 8 weeks because of the injuries. I am an administrative assistant and simply could not sit for long periods of time with my neck and back pain. [You want to explain clearly and concisely your injuries.]


My medical bills total $15,510 and I have paid $1,000 out of pocket. My health insurance company paid the remainder of the medical bills, but have sent me a letter claiming a lien of $8,000 on any settlement that I may get. [If you have to repay your health insurance (and you almost always have to), make sure you tell the adjuster.]

My medical bills were as follows:

Ambulance ride: $910.00
Methodist Hospital: $6,200.00
Dr. Care: $1100.00
X-rays for Dr. Care: $300.00
Dr. Bones: $4,500.00
Dr. Relax: $2,500.00

TOTAL: $15,510

[You always want to put together a chart listing your medical bills. Do not make the adjuster read through them to figure out the total.]


I am an Administrative Assistant and I earn $800 per week; I missed 8 weeks of work as a result of the accident. I have attached a letter from the orthopedist explaining that I needed to stay out of work for that time. Accordingly, my lost earnings claim is $6,400. [State your lost earnings claim briefly and clearly. Make sure that you have a doctor’s note substantiating the need to miss work for the entire time that you were out.]

Taking into account Mr. Doe’s absolute liability and my damages in this case, I demand $XX,XXX to settle this case.

Very truly yours,

[your signature]

Your Name

Other Demand Letter Resources

The Definitive Guide to Personal Injury Demand Letters

The Six Essential Elements of a Personal Injury Demand Letter

Anatomy of a Personal Injury Demand Letter

California Demand Letters Made Easy

3 Typical Insurance Company Responses to Your Demand Letter

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