[date]
West Palm Beach Florida car accident Insurance Company Call 1-800-74-TRIAL
Re: Your Insured/My Client: _____
Date of Loss: _____
Dear Sir/Madam:
Please be advised that this office represents _____ in her claim for injuries arising from an automobile accident which occurred on [date]. Pursuant to the attached authorization signed and notarized by your insured, please send to me a complete copy of your insured’s policy of insurance that was in effect on the date of the (West Palm Beach Florida car accident). Also send a certified copy of the declaration page from the policy which outlines the benefits she had on the day of the (West Palm Beach Florida car accident). We also want to know whether it was a coordinated or uncoordinated policy of insurance with regards to medical and wage loss benefits. Please make sure all of this information is provided within the next 14 days.
Please consider this a demand and claim for both Uninsured motorist benefits and/or arbitration and Underinsured motorist benefits and/or arbitration, if either is applicable. If either is applicable, I am appointing [name, address], as my arbitrator.
Please be further advised that at this time, our office does not retain an attorney’s lien on any and all proceeds with regards to PIP benefits. An attorney lien is claimed on the Uninsured/Underinsured portion of the policy, if applicable.
I am looking forward to hearing from you or your counsel within the next fourteen (14) days. Thank you very much.
Very truly yours,
LAW OFFICES OF _____
__________________________