This letter is a convenient way to formally notify an insurer, agent, or individual that a claim for damages has been submitted. Includes spaces to describe the accident as well as date, time of day, and location.
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This Printable Business Form Template belongs to these categories: medical
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123 Main St.
Anytown, CA 95928
(555) 555-1212
August 14, 2010
Andy Anderson
345 Any Place.
Anytown, CA 95928
Dear Mr. Anderson:
This letter is to notify you of a claim submitted against you for damages as a result of the accident and/or injury described below. I believe that you
or your agents/representatives are liable.
Accident description:
Date:
Time of Day:
Location:
Please make sure that your insurance agent or attorney contacts me immediately, so that we can reach a speedy resolution. I can be reached via cell
phone at (555) 555-1212.
Sincerely,
Danny Daniels
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