What a demand package contains Two hundred pages that set the offer.
A demand is a letter with a file behind it. A complete personal injury demand package has a table of contents, each tab holds specific records, the page count comes from the records rather than the argument, and California regulations set what the insurer has to do when it arrives.
On this page
A demand package is a letter with an organized file behind it. The letter argues fault, injury, and money in a few pages. The file proves each of those with the records: the report, the photographs, the emergency department chart, every provider in date order, the imaging, the operative reports from any surgery, the future care opinion, the itemized billing, the wage proof, and the coverage.
What a demand package is
Every category below describes a type of document, not a client's file, and nothing here values a case. The valuation side is in our post on what a car accident case is actually worth.
What each tab of the demand holds
We use the structure below, tab by tab. The order is deliberate: liability first, because an adjuster who is not convinced on fault will not read the medical section carefully, and money last, because a number is only as good as the pages in front of it.
| Section | What goes in it | What it is doing |
|---|---|---|
| Cover letter | The demand itself, a few pages | The only part that gets read first |
| 1. Liability | The incident or collision report, scene photographs, a diagram, witness statements | Settles fault before anyone talks about money |
| 2. The legal standard | The statutes and jury instructions the case will be judged under | Names the test, so the argument is not opinion |
| 3. Emergency care | Ambulance run sheet (the crew's report), emergency department records, first imaging | Ties the injury to the day it happened |
| 4. Treatment | Every provider in date order, with each discharge summary on top | Shows the course of care, not only a total |
| 5. Diagnostics | MRI, CT and x-ray reports, nerve studies, the films where they matter | The objective findings |
| 6. Procedures | Operative reports, injection records, implanted hardware | The most consequential facts in the file |
| 7. Future care | A treating physician's written opinion on what still has to happen | Turns a closed bill into a future cost |
| 8. Billing | An itemized ledger by provider, plus every lien asserted | Separates billed, paid, and still owed |
| 9. Wage loss | Employer letter, pay records, tax returns for the self-employed | Proof instead of an estimate |
| 10. The human record | Statements from the injured person and the people who see them daily | What a chart cannot show |
| 11. Coverage | The declarations page or the written limits disclosure | Sets the ceiling on the conversation |
The page count is not the point, and it is not padding either. A serious injury generates a lot of paper on its own: an emergency department chart, a few months of physical therapy notes, two imaging studies, an operative report, and a billing ledger will pass 200 pages without a single filler exhibit. A thin package usually means one of two things. Either the case is small, or the records were never ordered.
The three arguments in the cover letter
The letter carries three arguments and nothing else. Fault, stated as what the other party did and which rule that violated, with the exhibit cited beside each fact. Injury, stated as a chronology: what was found on day one, what treatment followed, what resolved, what did not, and what the treating physician expects. Money, stated as categories with sources, not as one round figure.
Two habits separate a letter that works from one that gets skimmed. The first is that every factual sentence points to a page number in the file, so nothing has to be taken on faith. The second is that the letter concedes the bad facts. An adjuster who finds a gap in treatment, a prior injury to the same body part, or a disputed traffic movement that the letter never mentioned stops believing the rest of it. Naming the problem and answering it is worth more than hoping it goes unnoticed.
The order the exhibits go in
Records go in chronological order inside each provider, and providers go in the order the patient saw them. Every page is numbered, and the index at the front lists the tab, the provider, and the date range. That is clerical, and it decides how carefully the file gets read, because an adjuster with forty files will read an indexed package and skim an unindexed one.
The billing tab is where most self-prepared demands fall apart. A hospital statement shows a balance. A demand needs the itemized bill, the amount any health plan paid, the write-offs, and the liens asserted against the recovery, because those are four different numbers and they lead to four different results at the end. The lien side matters as much as the demand figure: our post on what a health plan lien can take walks through the statutory cap that applies to it.
What the insurer must do with it
The Fair Claims Settlement Practices Regulations, in title 10 of the California Code of Regulations, set the handling standards. They apply to a claimant, which section 2695.2 defines to include both a first party claimant and a third party claimant, and defines a third party claimant as any person asserting a claim against any person or the interests insured under an insurance policy. In plain terms, they cover you even though the policy is not yours.
| Trigger | What the insurer must do | By when | Source |
|---|---|---|---|
| Any communication that reasonably suggests a response is expected | Furnish a complete response based on the facts then known | 15 calendar days | 10 CCR 2695.5(b) |
| Notice of claim | Acknowledge receipt, provide forms and instructions, begin the investigation | 15 calendar days | 10 CCR 2695.5(e) |
| Proof of claim | Accept or deny the claim, in whole or in part | 40 calendar days | 10 CCR 2695.7(b) |
| More time needed | Written notice specifying what else is required, then again every 30 days | Within the 40 days, then every 30 | 10 CCR 2695.7(c)(1) |
| Acceptance and a signed release | Tender (send) payment | 30 calendar days | 10 CCR 2695.7(h) |
Two more provisions are worth knowing by number. Section 2695.7(d) requires an insurer to conduct and diligently pursue a thorough, fair and objective investigation, and forbids it to persist in seeking information not reasonably required for or material to the resolution of a claim dispute. Section 2695.7(g) says no insurer shall attempt to settle a claim by making a settlement offer that is unreasonably low.
Behind the regulations sits Insurance Code section 790.03, whose subdivision (h) defines as an unfair practice "[k]nowingly committing or performing with such frequency as to indicate a general business practice" a list of claims settlement practices, among them "[f]ailing to acknowledge and act reasonably promptly upon communications with respect to claims" and "[n]ot attempting in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear." The words "general business practice" are the reason a single slow adjuster is a complaint to the Department of Insurance rather than a lawsuit, a distinction we take apart in our post on bad faith in California.
When to wait before sending the demand
- Treatment is not finished. A demand sent while a surgeon is still deciding is a demand that undervalues the case by whatever comes next. Wait for the written opinion.
- Liability is disputed. No volume of medical records fixes a fault problem. If the fault argument is real, the missing exhibit is evidence, not paper: a scene inspection, a download, a second witness.
- The policy is smaller than the case. When the available limit is below the value of the injury, the demand becomes a policy limits demand, an offer to settle for everything the policy holds, and its job changes. Our post on California minimum insurance limits covers what those limits are.
- The defendant is a public entity. A government claim runs on the Government Claims Act, and a demand package does not substitute for the written claim or extend its six month deadline.
- Liens are unresolved. A number agreed without knowing what the health plan or hospital will take is a number nobody can distribute.
When a documented demand produces an unreasonable response, the escalation is not a longer letter. It is a lawsuit and then a formal settlement offer under Code of Civil Procedure section 998. A section 998 offer is served in a pending case, not less than 10 days before trial or arbitration begins, and it states the terms and conditions of the judgment. It stays open until trial or for 30 days, whichever comes first, and it is not admissible at trial.
The consequence is what gives it force. Under subdivision (c), a plaintiff who rejects a defendant's offer and then fails to obtain a more favorable judgment does not recover postoffer costs and pays the defendant's costs from the time of the offer, and the court may add a reasonable sum for the defendant's postoffer expert witness costs. Subdivision (d) runs the other way: where a defendant rejects the plaintiff's offer and fails to obtain a more favorable judgment, the court may require the defendant to pay the plaintiff's postoffer expert witness costs. That is the move a well built demand package sets up, because the 998 offer is only credible when the file behind it already is.
Questions about demand packages
How long should a demand letter be?
When should the demand go out?
Do I have to include my medical records?
How long does the insurer have to respond?
Should I put a deadline in the demand?
Can I write my own demand package?
What makes a demand worth 200 pages
The records, not the letter. The page count comes from the emergency department chart, the therapy notes, the imaging reports, the operative report, the itemized ledger, and the wage proof, assembled in an order someone can read. A demand that arrives without those is asking an adjuster to take an injury on trust, and adjusters do not.
If you are gathering your own file, start today by requesting complete records and itemized billing from every provider you saw, including the ones you saw once. Those requests take weeks. If you would rather someone else build it, our page on how this firm works explains what we do with a case, and our guide to maximizing a car accident settlement covers the decisions that change the number before the demand is ever written. There is no fee unless we recover.
