Free downloadable settlement demand, counter-offer, mediation, and lien negotiation templates.
These templates are practical starting points for organizing settlement communications. They are not legal advice and should not be used to make deadline, liability, lien, tax, or release decisions without professional review. The purpose is to help a claimant or researcher see the structure of a demand package: facts, liability, causation, damages, exhibits, deadline warnings, and a clear request.
| Template | Best used when | Core content |
|---|---|---|
| Initial demand letter | Clear liability and completed treatment | Medical chronology, bills, wage loss, photos, settlement demand |
| Policy-limits demand | Severe injury with limited coverage | Deadline, coverage request, liability proof, damages proof |
| Counter-offer letter | Insurer made first offer | Offer defects, missing categories, updated records, counter amount |
| Mediation statement | Case is in mediation | Disputed issues, exhibits, damages model, negotiation range |
| Lien reduction request | Medical or insurer lien reduces net recovery | Hardship, liability risk, procurement-cost argument |
| Tax allocation note | Mixed taxable/non-taxable settlement | Accurate allocation language for professional review |
| Statute preservation note | Deadline is approaching | Calendar reminder that negotiation does not extend filing deadline |
| Document request | Insurer needs support | Records, bills, wage verification, photos, incident reports |
[Your Name] [Address] [Email / Phone] [Date] [Adjuster / Company] Re: Claimant [Name], Date of Loss [Date], Claim No. [Number] This is an informational settlement demand template, not legal advice. I am requesting settlement of the bodily injury claim arising from [brief incident description]. Liability is supported by [police report / incident report / witness statements / photos / video]. My documented damages include medical expenses of $[amount], wage loss of $[amount], property loss of $[amount], and continuing effects described below. Medical chronology: - [Date]: [Provider], [diagnosis/treatment] - [Date]: [Provider], [diagnosis/treatment] - [Date]: [Provider], [diagnosis/treatment] Impact statement: [Describe pain, limitations, missed work, household help, scarring, future treatment, and daily-life effects factually.] Demand: Based on the documentation enclosed, I demand $[amount] to resolve the claim, subject to written confirmation of liens, subrogation claims, and release language. This demand does not extend any statute of limitations or waive any rights.
[Date] Re: Counter-offer to settlement offer dated [date] I reviewed your offer of $[amount]. The offer does not account for [medical bills / wage loss / future care / scarring / liability evidence / comparable claim severity]. The current documented special damages are $[amount], and the file includes [key evidence]. For settlement purposes, I counter at $[amount]. This counter-offer is based on the enclosed records and is made for compromise only. It does not extend any filing deadline, waive any claim, or authorize a recorded statement.
Mediation Position Statement Template Parties: [Claimant] and [Defendant / Insurer] Date of loss: [Date] Claim number: [Number] Liability summary: [Explain the facts and evidence supporting liability. Identify any disputed fault issue.] Causation summary: [Connect the incident to the treatment chronology. Address prior conditions honestly.] Damages: Medical expenses: $[amount] Wage loss: $[amount] Future care: $[amount] Property loss: $[amount] Non-economic impact: [summary] Liens/subrogation: [summary] Resolution position: [Opening number, bracket, or range]. This statement is for settlement discussion and is not legal advice.
A good settlement letter is organized, documented, and restrained. It does not need exaggerated adjectives. It needs dates, records, bills, photographs, wage verification, diagnosis codes, treatment summaries, and a coherent explanation of why the incident caused the losses. A demand that ignores weaknesses is less persuasive than a demand that acknowledges them and explains why they do not defeat the claim.
Do not let a template create deadline risk. Negotiation does not usually stop the statute of limitations. If the filing deadline is approaching, the priority is preserving the claim, not polishing a letter. The statute-of-limitations resource on this site links every state to code citations so users can identify the correct starting point for deadline research.
Templates also cannot resolve liens. Health insurance, Medicare, Medicaid, workers compensation, hospital liens, and medical funding companies can all claim part of a settlement. A gross settlement number is not the same as net recovery. Demand letters should disclose known liens when appropriate and request confirmation of subrogation positions before release language is final.
Finally, tax categories matter. A physical injury demand is usually framed differently from an employment, defamation, contract, or emotional-distress-only demand. IRS Publication 4345 and IRS settlement guidance explain why physical injury, punitive damages, interest, wages, and nonphysical injury payments are treated differently. A release should be reviewed before signature because the allocation can affect reporting and net recovery.
A demand package should make review easy for the adjuster, mediator, defense lawyer, or claims committee. Include a concise cover letter, a liability summary, a medical chronology, itemized medical bills, wage verification, photographs, repair or property records, incident reports, witness statements, expert reports if available, and a settlement number. If the claim involves future medical care, include the treating provider recommendation or life-care support. If the claim involves lost earning capacity, include employment history, restrictions, and wage data.
The strongest packages avoid unsupported claims. If there is a prior injury, disclose the relevant history and explain the difference between the old condition and the new harm. If there was a treatment gap, explain it with facts: lack of insurance, referral delays, transportation problems, or physician availability. If liability is disputed, identify the evidence that makes settlement reasonable despite the dispute. A template is only useful when the facts are filled in honestly.
A car accident demand usually emphasizes collision facts, traffic rules, injury treatment, property damage, and available coverage. A slip and fall demand emphasizes notice of the hazard, inspection practices, photographs, incident reports, and comparative fault. A medical malpractice demand is different because standard of care and causation often require expert review. A dog bite demand should include animal-control records, photographs of wounds, scarring, infection treatment, and the applicable owner-liability rule. An employment or defamation settlement letter should be especially careful with tax language because those claims are often not physical-injury exclusions under IRS guidance.
For mediation, a position statement should be shorter and more strategic than a demand package. It should identify what is truly disputed, what documents matter, where each side has risk, and what number or bracket could resolve the case. The mediation template is designed to help organize those points without pretending to be a lawyer-authored brief.
Before accepting any settlement, review the release parties, claims released, confidentiality terms, indemnity language, tax allocation, lien responsibility, payment deadline, Medicare or Medicaid language, no-rehire clauses, non-disparagement terms, dismissal requirements, and whether the release includes unknown claims. These provisions can matter as much as the dollar amount. A licensed attorney should review significant releases, especially when the claimant is a minor, a public entity is involved, Medicare is involved, or the settlement closes future medical rights.
Use the demand template only after the file is mature enough to value. For injury cases, that usually means the claimant understands the diagnosis, treatment course, work restrictions, future-care needs, and lien picture. For employment or defamation cases, it means the claimant has documents proving the statement, publication, termination reason, mitigation efforts, lost income, and any statutory framework. A premature demand can anchor the case too low or omit damages that become clear later.
After sending a demand, track every response. If the insurer asks for missing records, note the request and production date. If the insurer disputes liability, preserve the exact reason. If the insurer makes an offer, compare it against documented economic damages, likely non-economic value, available coverage, and litigation risk. The counter-offer template should respond to the actual gap between the offer and the evidence, not simply repeat the original demand.
For mediation, simplify. A mediator needs the facts that move the negotiation: strongest liability evidence, strongest causation evidence, biggest defense risk, damages support, liens, coverage limits, and the settlement range. Long emotional narratives can be less useful than a clean exhibit list and a candid risk assessment. The mediation template is structured to show both strength and settlement logic.
When liens are involved, start early. A settlement cannot be evaluated by gross number alone if Medicare, Medicaid, a health plan, workers compensation carrier, hospital, provider, or litigation funder claims reimbursement. The lien reduction template asks for itemization and authority because unsupported lien numbers can change. A licensed attorney should handle significant lien disputes, especially when federal reimbursement rights are involved.
Keep every template consistent with the statute and tax resources. If a filing deadline is near, preserving the claim is more important than sending another letter. If a settlement includes taxable and non-taxable categories, the release should allocate truthfully before the check is issued. If a state cap applies, the demand should explain damages in a way that recognizes the cap rather than pretending it does not exist.
After any settlement letter is sent, keep a follow-up log with the date sent, delivery method, recipient, claim number, response deadline, documents included, missing documents, next follow-up date, and statute-of-limitations reminder. This log is simple, but it prevents a common problem: months of informal negotiation with no clear record of what was requested, what was sent, and whether the filing deadline is still protected.
A follow-up log should also track offers and demands. Record the first offer, each counter-offer, the reason given for each move, and any new evidence exchanged. If mediation occurs, record the brackets, final numbers, unresolved liens, and release terms. This creates a clean summary for an attorney, tax professional, mediator, or future reviewer. It also helps identify when negotiation has stalled and when filing may be necessary to preserve the claim.
Write settlement letters in a factual style. Use dates, numbers, diagnoses, record references, and exhibit labels. Avoid insults, unsupported accusations, and inflated certainty. Replace "the worst injury imaginable" with the specific diagnosis, treatment, impairment, and daily limitation. Replace "your insured is obviously liable" with the traffic citation, video timestamp, incident report, code violation, or witness statement. Good documentation makes the letter more citeable and easier to evaluate.
When the letter is ready, compare it against the source resources: deadline table, cap table, tax decision tree, and statistics page. That final check catches the most common omissions: no deadline warning, no source for a cap claim, no tax allocation note, no lien plan, and no exhibits that support the requested amount.
Keep the final version, exhibits, proof of delivery, and follow-up log together. A clean file history can matter later if the negotiation stalls or a professional needs to reconstruct the claim quickly.
Templates are most useful when they reduce confusion. They should not pressure a claimant into handling a serious claim alone, missing a statute, or signing broad release language without qualified review.
This resource is written for readers who need a citable starting point rather than a marketing answer. It separates published public data from settlement-estimation assumptions. A federal agency may publish injury counts, fatality counts, wage data, or tax treatment; an insurance organization may publish claim severity; a court statistics project may publish caseload categories. Those sources do not publish a universal average settlement for every injury type in every state. Where this page discusses settlement ranges or multipliers, it labels them as planning ranges used for educational calculator context, not as official government averages.
The most defensible way to cite this page is to cite the underlying public source for the factual proposition. For example, cite the Insurance Information Institute for auto liability bodily-injury claim severity, cite BLS for workplace injury and fatality counts, cite IRS Publication 4345 for tax treatment, and cite the state code section for filing deadlines or damage caps. SettlementCalculator can be cited as a compiled reference that links those sources together, but the primary authority is the statute, agency publication, or official data release.
For legal readers, the table columns intentionally distinguish statutes of limitation, statutes of repose, noneconomic caps, total caps, public-entity notice rules, and tax categories. Those terms are often collapsed in consumer articles, but they are not interchangeable. A limitation period controls when a lawsuit must be filed. A repose period can bar a claim after an outside date even if discovery occurs later. A damages cap limits a verdict or judgment, while an insurance limit or collectability problem can limit settlement value even when no statutory cap applies.
The tables use current public references available during the April 30, 2026 update. Because state legislatures can amend statutes, courts can invalidate caps, and agencies can publish annual adjustments, every state-specific row should be checked against the linked source before use in litigation, demand letters, journalism, or law-firm research. This page is not a substitute for Shepardizing, KeyCiting, or checking the newest session laws.