When trying to settle a case before a lawsuit, many attorneys send a letter which explains why the other person (or business) is at fault.  This letter also outlines your medical treatment. You don't need to send a demand letter to get an offer from an insurance company. However, doing so shows them that you organized and intelligent. You don't have to ask the insurance company for a certain amount of money for pain and suffering damages.  Some experienced attorneys (including myself in some cases) don't ask for a certain amount.  I've settled many cases where I did not ask the insurance company for a certain amount of money for pain and suffering. In certain cases, it may be better not to ask for a certain amount of money for pain and suffering. Here is why: If you demand a specified amount of money, the defendant can use your demand as a basis to remove the case to federal court.  Some defendants, like Walmart and Target, prefer defending personal injury claims in federal court. They believe that there is a higher chance that the case gets dismissed.  This is particularly true for slip and fall cases. Here is a photo of an accident scene in a case where I sent a demand to settle. I included this photo in my demand. In the end, we settled for $300,000.