This is your Member Reference Number (MRN). You’ll need to provide this when you make an appointment with an HERO counselor or contact your HERO by phone.

Anthem provides automatic translation into multiple languages, courtesy of Google Translate. This tool is provided for your convenience only. The English language version is considered the most accurate, and in the event of a discrepancy between the translations, the English version will prevail. This translation tool is not controlled by Anthem, and the Anthem Privacy Statement will not apply. Please read Google's privacy statement. If you want Google to translate the Anthem website, select a language.

Benefits with HII

Your HERO program offers these great resources.

Write a Winning Demand Letter

To settle your insurance claim, you must craft a convincing demand letter. Here are some tips.

The demand letter is the centerpiece of the insurance claim negotiation process. In it, you set out to the insurance company your strongest arguments concerning:

  • what your injuries were and are
  • why the other person is legally responsible for your injuries
  • what your medical treatment was and how much it cost
  • what your income loss was
  • what other damages you suffered, and
  • why you qualify to make a claim against someone else under no-fault automobile insurance, if that applies. (For detailed information about no-fault automobile claims, see How to Win Your Personal Injury Claim, by Joseph L. Matthews (Nolo).)

Your letter should conclude with a demand on the insurance company for a lump sum to settle your entire claim.

What to Emphasize in Your Demand Letter

Before beginning to write your demand letter, review your notes from the days and weeks following the accident to remind yourself of the details your pain, discomfort, inconvenience, disruption of life, and medical treatments. (See Take Notes After an Accident or Injury.) Then concentrate on the following elements as you draft your letter.

Liability

Start by describing how the accident happened and why the insured person was at fault. In plain language, briefly describe where you were and what you were doing immediately before the accident, then how the accident occurred.

You should also mention any outside support you have for your theory such as a police report, building code section, or eyewitnesses' statements.

Comparative Negligence

In many accidents, there is some question about whether your own carelessness contributed to the accident even though the other person was primarily at fault. Raise this issue in your demand letter by denying that you were at all at fault. (For information about how your own carelessness may affect your insurance claim, and to learn the basic rules of comparative negligence, see Proving Fault in Personal Injury Accidents: General Rules.)

Even if you believe that you might have been partly at fault for the accident, do not admit any fault in your demand letter. Although you must consider your own carelessness in deciding what a fair settlement is, it is not your job to make comparative negligence arguments for the insurance company. If and when an insurance adjuster brings up the subject during settlement negotiations, you can debate the question then.

Your Injuries and Treatment

Describe your injuries and treatments and don't be shy. Emphasize your pain, the length and difficulty of your recovery, the negative effects of your injuries on your daily life, and any long-term or permanent injury especially if it is disabling or disfiguring, such as permanent stiffness, soreness, or scarring.

Of course, you shouldn't make things up or be overly dramatic. Insurance companies will turn a deaf ear to claims they believe are false. Use appropriate medical terms wherever possible for example, "narrowing of disk spacing" rather than "strained back."

Medical Expenses

Include a complete list of each medical provider who treated you and the total amount charged by each.

Lost Income

Make a brief statement of the amount of time you missed from work because of your injuries, and refer to whatever letter you have from your employer verifying your pay and missed time. If you are irregularly or self-employed, explain how you arrived at the total figure for lost income.

Other Losses

If you suffered extra or unusual discomforts, embarrassments, inconvenience, or losses as a result of your injuries, mention them in your demand letter.

Your Settlement Demand Figure

In the last paragraph of your letter, demand a specific sum of money as total compensation for your pain, suffering, lost income, and other losses. Set out a figure that is higher than what you think your claim is actually worth (a general rule is 75% to 100% higher than what you would be satisfied with); this allows you some room to negotiate with the insurance adjuster. (For help determining the settlement demand figure, see Nolo's article How Does an Insurer Value an Injury Claim?)

Attach Supporting Documents

Along with your demand letter, send the insurance company copies of documents, records, letters, bills or other writings supporting the things you describe in your letter. (Keep all originals for your own files.)

More Help With Demand Letters

Your demand letter is the most important part of obtaining a fair settlement for your accident injuries, so it pays to write it well. For help tailoring your letter to the specifics of your accident and injuries and for ways to make it convincing, including numerous sample demand letters, see How to Win Your Personal Injury Claim, by Joseph L. Matthews (Nolo). Or, for a simple, inexpensive demand letter, get Nolo's eForm Demand Letter.

http://www.nolo.com/legal-encyclopedia/write-winning-demand-letter-29858.html

More about this Topics

  • Buying a Used Car

  • How to Dispute a Billing Error on Your Debit or Credit Card Statement

  • Green Remodeling: Eco-Friendly Home Improvements

  • Managing High Medical Bills

  • Comparing Mortgages: Points, Interest Rates, and Fees

Other Topics

    • Asbestos and Mesothelioma Lawsuits: What to Expect
    • Sponsoring a Fiancé or Spouse for a Green Card
    • Damages in Medical Malpractice Cases
    • How to Apply for U.S. Citizenship
    • Trees and Neighbors FAQ
    • File a Consumer Complaint: Part 2
    • Warranties
    • Small Claims Court: Part 1
    • Employment: Consumer Tips
    • Small Claims Court: Part 2