[Date]

[Insurance Company Name]

Attn: [Adjuster Name], Claims Department

[Address]

Dear [Adjuster Name],

I represent [Client Full Name] in connection with injuries sustained in a slip and fall accident on [date] at [property name and full address]. This letter constitutes a formal demand for compensation on behalf of my client for all damages arising from this incident.

On [date] at approximately [time], my client was [describe what client was doing on the premises — e.g., shopping in the grocery section, walking toward the checkout area] at [property name]. My client slipped on [describe the specific hazardous condition — e.g., a puddle of liquid that had accumulated near a refrigeration unit, a wet floor where no warning sign had been placed, a broken tile near the entrance] and fell, sustaining the injuries described below.

The hazardous condition that caused my client's fall was created by and/or known to the property owner. [Describe the specific notice basis — e.g., the liquid had been present for approximately 45 minutes prior to the incident as documented in the attached surveillance footage, Exhibit 1. No wet floor sign or warning cone was in place at the time of the incident, as documented in the incident report attached as Exhibit 2.]

The property's maintenance records, attached as Exhibit 3, confirm that [describe maintenance record finding — e.g., the area had been identified as a recurring hazard in prior inspection reports, no corrective action had been taken as of the date of the incident].

A witness to the incident, [witness name or description], observed [describe witness account — e.g., that the liquid had been present for an extended period prior to my client's fall] and provided a written statement attached as Exhibit 4.

The property owner's failure to maintain the premises in a reasonably safe condition and failure to warn of the known hazardous condition constitutes negligence. That negligence was the direct and proximate cause of my client's injuries and all resulting damages.

My client was transported by ambulance to [Hospital Name] where they were evaluated and diagnosed with [specific diagnoses — e.g., a left ankle fracture, lumbar strain, and contusion of the left knee] (Exhibit 5, Emergency Room Records dated [date]).

Imaging performed at the emergency department confirmed [specific imaging findings — e.g., a displaced fracture of the left lateral malleolus requiring surgical intervention] (Exhibit 6, X-Ray Report dated [date]).

My client subsequently underwent [describe surgical procedure if applicable — e.g., open reduction and internal fixation of the left ankle fracture] performed by [surgeon name] at [facility] on [date] (Exhibit 7, Operative Report).

Following surgery, my client completed [number] weeks of physical and occupational therapy with [Provider Name], completing [number] sessions (Exhibit 8, Physical Therapy Records). The treating orthopedic surgeon has indicated in their most recent report dated [date] that my client has reached maximum medical improvement with [describe permanent conditions — e.g., a permanent functional limitation of the left ankle, reduced range of motion, and the likelihood of post-traumatic arthritis requiring ongoing management] (Exhibit 9, Treating Physician Report).

On behalf of my client, I hereby demand the sum of $[Total] to settle this claim in its entirety. This demand is supported in full by the documentation contained in the attached exhibit packet. The demand figure reflects the full scope of my client's documented losses and is anchored to the supporting exhibits throughout.
Please respond in writing within 30 days of the date of this letter. If I do not receive a response within that period, my client reserves the right to pursue all available legal remedies including litigation.

Sincerely

[Attorney Name]

[Firm Name]

[Bar Number]

[Address]

[Phone]

[Email]

This sample is for illustrative and structural reference only. Every section must be populated with case-specific facts supported by attached documentation. Actual settlement values vary by jurisdiction, case facts, and individual circumstances.