[Your Name]
[Street Address]
[City, State ZIP]
[Phone] · [Email]
[Today's Date]
SENT VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
[Responsible Party Name]
[Street Address]
[City, State ZIP]
RE: Demand for Payment of Property Damage
| Date of Loss: [Date of Loss] Loss Location: [Loss Address] | Police Report No.: [Report Number], [Police Department] Amount Demanded: $[Total] |
Dear [Responsible Party Name]:
I am writing to request payment for damage to my property at [Loss Address] on [Date of Loss].
What happened
On [Date of Loss], at about [Time], the vehicle you were driving, a [Year, Make, Model] with [State] plate [Plate Number], left the roadway and struck my property. [Police Department] responded to the scene, and report number [Report Number] documents the accident. According to the report, you were cited for [Citation, e.g., failure to maintain control of vehicle]. That incident caused the damage described below.
The damage
- [Damage to my home, which my homeowner's insurance covered after I paid a $[Deductible] deductible.]
- [Other damage, e.g., a mature tree was struck and had to be removed.]
- [Other damage, e.g., landscaping shrubs were destroyed and had to be replaced.]
- [Other damage, e.g., the lawn was left with deep ruts that had to be regraded.]
My homeowner's policy excludes [landscaping, trees, and shrubs], so I paid for these repairs out of my own pocket.
My out-of-pocket costs
| Item | Amount |
|---|---|
| Homeowner's insurance deductible (dwelling damage) | $[Deductible] |
| [Cost, e.g., tree removal and stump grinding] | $[Amount] |
| [Cost, e.g., shrub replacement, materials and installation] | $[Amount] |
| [Cost, e.g., lawn regrading and rut repair] | $[Amount] |
| Total | $[Total] |
Enclosed documents
- Police report no. [Report Number]
- Photographs of the damage
- Repair and landscaping estimates
- Homeowner's policy declarations page showing the $[Deductible] deductible
- Proof of payment to [Company Names]
My request
I am asking you to pay $[Total] by [Date, 30 days out], which is 30 days from the date of this letter.
If you had auto insurance at the time of the accident, please forward this letter to your insurance carrier right away. Please also send me your insurer's name, your policy number, and any claim number, so I can work with them directly.
Please make payment payable to [Your Name] and mail it to the address above.
If I do not receive payment or a response by [Date, 30 days out], I will pursue other options available to me to recover these costs. I would prefer to resolve this directly and without further action.
Thank you for your prompt attention to this matter.
Sincerely,
______________________________
[Your Name]
Enclosures ([Number])