California UM/UIM Страхование Отказ Требование

[YOUR NAME] [YOUR ADDRESS] [CITY, STATE ZIP] [YOUR PHONE NUMBER] [YOUR EMAIL] [DATE] ЗАКАЗНЫМ ПИСЬМОМ С УВЕДОМЛЕНИЕМ О ВРУЧЕНИИ [INSURANCE COMPANY NAME] [CLAIMS DEPARTMENT] [INSURER ADDRESS] [CITY, STATE ZIP] Re: Demand for Payment of UM/UIM Benefits Insured: [YOUR NAME] Policy Нет.: [POLICY NUMBER] Требование Нет.: [CLAIM NUMBER] Date of Loss: [DATE OF ACCIDENT] Dear Claims Manager: I am writing to formally demand payment of Uninsured/Underinsured Motorist benefits under the above-referenced automobile страхование policy. As detailed below, [INSURANCE COMPANY NAME] has failed to fairly evaluate and pay my valid UM/UIM требование, in нарушение of California Страхование Code Section 11580.2 and the duty of добросовестность and fair dealing. FACTUAL BACKGROUND On [DATE OF ACCIDENT], at approximately [TIME], I was operating my [YEAR, MAKE, MODEL] vehicle on [STREET/HIGHWAY] in [CITY], California. The at-fault driver, [AT-FAULT DRIVER NAME], operating a [DESCRIPTION OF OTHER VEHICLE], [DESCRIBE HOW ACCIDENT OCCURRED - e.g., ran a red light and collided with the driver's side of my vehicle / rear-ended my vehicle while I was stopped at a traffic light / crossed into my lane and struck my vehicle head-on]. The collision was caused solely by the халатность of [AT-FAULT DRIVER NAME], as documented in the police report, Report Нет. [POLICE REPORT NUMBER]. The at-fault driver was cited for [VIOLATION, IF ANY]. Investigation has confirmed that the at-fault driver [was uninsured at the time of the accident / carried ответственность страхование with limits of only $[AMOUNT], which is insufficient to compensate me for my убытки]. This triggers my UM/UIM coverage under my policy with [INSURANCE COMPANY NAME]. POLICY COVERAGE My automobile страхование policy, Policy Нет. [POLICY NUMBER], was in full force and effect on the date of the accident. I have paid all premiums and have complied with all policy conditions, including timely notice of the требование. The policy provides UM/UIM coverage with limits of [COVERAGE LIMITS - e.g., $100,000 per person / $300,000 per occurrence]. Under California Страхование Code Section 11580.2, UM coverage is mandatory in California and must be included in every automobile ответственность policy unless validly waived in writing on a form specified by the statute. Нет such waiver exists for my policy. MY INJURIES AND TREATMENT As a direct and proximate result of this collision, I sustained the following injuries: [LIST INJURIES - e.g., - Cervical disc herniation at C5-C6 - Lumbar strain/sprain - Left shoulder rotator cuff tear - Post-traumatic headaches - Anxiety and sleep disturbance] I received emergency treatment at [HOSPITAL NAME] on the date of the accident. Since then, I have undergone extensive medical treatment including: [DESCRIBE TREATMENT - e.g., - Orthopedic evaluation and treatment with Dr. [NAME] - MRI of cervical and lumbar spine - 36 sessions of physical therapy - Pain management with epidural steroid injections - Ongoing treatment for persistent symptoms] My treating physicians have documented that all of my injuries were caused by this accident and that I will require future medical treatment including [DESCRIBE EXPECTED FUTURE TREATMENT]. DAMAGES My documented убытки are as follows: MEDICAL EXPENSES: Emergency room and ambulance: $[AMOUNT] [PROVIDER NAME] - Orthopedic care: $[AMOUNT] [IMAGING CENTER] - MRI studies: $[AMOUNT] [PHYSICAL THERAPY PROVIDER]: $[AMOUNT] [ADDITIONAL PROVIDERS]: $[AMOUNT] Prescription medications: $[AMOUNT] Future medical care (per Dr. [NAME]): $[AMOUNT] __________ TOTAL MEDICAL EXPENSES: $[TOTAL MEDICAL] LOST WAGES: I was unable to work from [START DATE] to [END DATE], a period of [NUMBER] weeks. My average weekly earnings were $[AMOUNT], as verified by my работодатель. Итого lost заработная плата: $[TOTAL LOST WAGES] PAIN AND SUFFERING: I have experienced and continue to experience significant physical pain, including daily discomfort rated [X]/10, difficulty sleeping, and limitations on my daily activities. I am no longer able to [DESCRIBE ACTIVITIES YOU CANNOT DO]. I have also suffered эмоциональные страдания including anxiety about driving and depression related to my diminished quality of life. Based on the severity and permanence of my injuries, my pain and suffering убытки are valued at $[AMOUNT]. TOTAL DAMAGES: $[GRAND TOTAL] [IF UIM CLAIM: Less amount received from at-fault driver's policy: ($[AMOUNT]) NET UIM CLAIM: $[NET AMOUNT]] YOUR COMPANY'S IMPROPER HANDLING OF MY CLAIM Despite my timely notice, complete documentation, and clear entitlement to UM/UIM benefits, [INSURANCE COMPANY NAME] has [denied my требование / offered only $[LOW AMOUNT] to settle my требование]. This conduct is unreasonable and constitutes недобросовестность. [DESCRIBE SPECIFIC недобросовестность CONDUCT - select and customize as applicable: - Your company denied my требование without conducting a reasonable investigation - Your company ignored the opinions of my treating physicians - Your company relied on a biased IME that contradicts my documented medical records - Your company failed to respond to my требование within the time required by California regulations - Your company offered an amount that no reasonable insurer would believe adequately compensates my injuries - Your company misrepresented the policy coverage to justify the отказ] This conduct violates California Страхование Code Section 790.03(h), which prohibits unfair claims мировое соглашение practices, and breaches the duty of добросовестность and fair dealing established by the California Supreme Суд in Gruenberg v. Aetna Страхование Co. (1973) 9 Cal.3d 566 and Quintano v. Mercury Casualty Co. (1995) 11 Cal.4th 1049. ТРЕБОВАНИЕ I hereby demand payment of $[ТРЕБОВАНИЕ AMOUNT] within thirty (30) days of the date of this letter. This amount represents fair компенсация for my injuries and losses, [less the offset for amounts received from the at-fault driver's insurer if applicable]. If I do not receive satisfactory payment by [DEADLINE DATE - 30 days from letter date], I will take the following actions: 1. Demand binding арбитраж в соответствии с California Страхование Code Section 11580.2(i) to recover my full UM/UIM benefits up to policy limits; 2. File a недобросовестность судебный иск in the California Superior Суд seeking: - Brandt адвокат fees в соответствии с Brandt v. Superior Суд (1985) 37 Cal.3d 813 - Consequential убытки caused by your company's wrongful conduct - эмоциональные страдания убытки - Punitive убытки в соответствии с гражданский кодекс Section 3294 3. File a исковое заявление with the California Department of Страхование documenting your company's unfair claims мировое соглашение practices. I urge you to reevaluate this требование fairly and make a reasonable мировое соглашение offer. Your company's continued недобросовестность handling of this требование will only increase your ultimate exposure. Please direct all further communications regarding this требование to the address above [or to my адвокат: [ATTORNEY NAME, ADDRESS, PHONE]]. С уважением, _______________________________ [YOUR NAME] Приложения: - Medical records and bills (Exhibit A) - Proof of lost заработная плата (Exhibit B) - Police report (Exhibit C) - Photos of injuries and vehicle damage (Exhibit D) - Correspondence with your company (Exhibit E) - Proof of at-fault driver's страхование status (Exhibit F) cc: [ваш адвокат, IF APPLICABLE] California Department of Страхование (if исковое заявление filed)