August 11, 20xx
Mr. Parker O’Brien
P.O. Box 23111
Santa Fe, NM
Re: Your insured: Southern Hotels
Date of injury: February 16, 20xx
Your file number: 3DD-456767 [NOTE: Always use the insurer’s file number on all correspondence]
Dear Mr. O’Brien:
I have finished my medical treatment, and so I am enclosing all of my medical records and bills on this case.[NOTE: You always want to make sure that the adjuster has all documentation relating to your injury when you send a demand letter. The adjuster will not make a settlement offer until he/she has your entire medical file.]
As you know, I was injured when I fell on the stairs at the Southern Hotel in Santa Fe. I was a guest in the hotel and was on my way to breakfast the first morning that I had stayed there. I was walking down the flight of stairs from the second floor to the first floor when I fell on the third step from the bottom. I was holding onto the handrail with my right hand and was holding a magazine in my left hand. I was wearing sandals. It seemed like I missed a step with my right foot and I somehow went all the way to the bottom. As your manager knows, I had to call for help because I had broken my right ankle. Your manager called an ambulance, and I was taken to the hospital, where I had a cast put on my right ankle.
I wasn’t sure at the time why I had fallen, and that is probably what your manager documented me as saying. But I asked my wife to go back to those stairs and make some measurements to see if we could figure out what happened. Based on her measurements, it is pretty obvious why I fell. Each riser from the second floor down to the first is the same height, down to the third step. The third step was a different height. In fact, it was an inch shorter. That is why I fell. I couldn’t understand it at the time, but your staircase is a recipe for disaster. I fell because I lost my rhythm because the riser height changed without notice. [NOTE: In a slip and fall case, you always want to explain as best you can exactly why you fell.]
I contend that your hotel was negligent with respect to its ownership and upkeep of its property by having different riser heights on its staircase. That constitutes ordinary negligence as well as a violation of section 122.044 of the state building code. I have attached a copy of this section of the building code. [NOTE: Your discussion of liability should be short and to the point. First, you should explain how you got hurt. Second, you should explain exactly why you claim that the defendant was negligent or liable. If you are relying on a local ordinance or building code, you should make it easy for the adjuster and attach a copy. Learn more about Liability for Staircase Accidents.]
Obviously, my vacation was ruined. My wife and I went home the next day. I treated with a local orthopedist, Dr. Connell, for two months. When the cast came off, I did physical therapy for another month to try to get back the strength and flexibility in my ankle.
I am a exterior painter and am on my feet and up on ladders all day. I could not work while I was in a cast, and so missed two months of work total.
I was not in pain, but I just couldn’t do anything with my foot in a cast. By three months from the date of the injury I was 95% recovered. I missed the remainder of the ski season because of this injury. I lost two prepaid ski trips and could not get my money back. That was extremely upsetting. [NOTE: You want to explain clearly and concisely your injuries, your medical treatment, and your pain and suffering. Don’t exaggerate.]
My medical bills total $10,000. I paid $1,000 in co-pays. My health insurance paid the remainder of the bills, but sent me a letter in which it claims a lien of $4,000 on any settlement I may get. I have attached copies of my medical records. [NOTE: If you have to repay your health insurance (and you almost always have to), make sure that you tell the adjuster. Insurers will take that into account in formulating an offer.]
My medical bills were as follows:
Dr. Connell (orthopedist) 3,000
Santa Fe Ambulance 1,000
Santa Fe General Hospital 2,500
Southern Physical Therapy 2,500
Southern Radiology 1,000
TOTAL $10,000.00 [NOTE: You always want to put together a little chart listing your medical bills. Don’t make the adjuster read through all of the bills in order to figure out how much they are. Remember, you want to make things easy for the adjuster.]
I work for Williams Painting earning $1,000 per week. Attached is a letter from Dr. Connell saying that I needed to stay out of work for two months. Accordingly, my lost earnings claim is $8,000. [NOTE: State your lost earnings claim briefly and clearly. Make sure that you have a doctor’s note saying that you needed to be out of work for the entire time you missed.] As I mentioned, I lost two prepaid ski trips, which cost $2,000. I am claiming those losses as damages. My total special damages (medical bills, lost earnings, and out of pocket damages) are $20,000.
Taking into account your insured’s liability and my serious damages in this case, I demand $70,000.00 to settle this case. Please advise as to your thoughts on this matter. [After sending the letter, you should give the adjuster three or four weeks to respond. If you don’t hear from the adjuster in a month, then give him/her a call.]
Very truly yours,