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Dear [Supervisor Name]: I am respectfully presenting this letter as written notice that I was involved in a work-related accident on [date of incident] at approximately [time of incident]. [I was injured / I became ill] when [give clear details involving the accident, including what led up to it].
As soon as you can, write down everything about the accident that you can, including the time, location, weather, what you were doing, who was there, and anything else you feel is important. Pay close attention to details, including everything you saw, felt, heard, or did before, during, and after the accident.
Injury and Lost Time Incident Report Sample Type of incident (injury, near miss, property damage, or theft) Location (Address) Date/time of incident. Name. Name of supervisor. Description of the incident, including specific job site location, the sequence of events, and the results of the event.
Dear [Supervisor Name]: I am respectfully presenting this letter as written notice that I was involved in a work-related accident on [date of incident] at approximately [time of incident]. [I was injured / I became ill] when [give clear details involving the accident, including what led up to it].
As soon as you can, write down everything about the accident that you can, including the time, location, weather, what you were doing, who was there, and anything else you feel is important. Pay close attention to details, including everything you saw, felt, heard, or did before, during, and after the accident.
I hereby demand $118,602.00 to account for my injuries and other losses that were directly and proximately caused by the negligence of your insured, Amy C. Jones. I expect to receive a reply to this demand letter no later than 21 days from the date of the postmark. Thank you for your time in considering my claim.
What to include in an injury demand letter The date of the accident. Name of the insured. Policy number, if available. What parties were involved in the accident. Events leading up to and causing the accident. Detailed information regarding economic damages, broken down by category. Explanation of non-economic damages.
What to include in an injury demand letter The date of the accident. Name of the insured. Policy number, if available. What parties were involved in the accident. Events leading up to and causing the accident. Detailed information regarding economic damages, broken down by category. Explanation of non-economic damages.