EvenUp SampleDemand.pdf

Standard Demand Package Sample for Attorneys

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Demands

AI+You AI+Expert Review
Sections&Features Express Simple Basic+ Standard
Turnaround Time 20-60 minutes <2 days 2-4 days 5-7 days
Diagnosis/ICD Codes √ √ √ √
Objective Tests √ √ √* √*
Interventional Treatments √ √ √* √*
Executive Medical Summary √ X X X
Detailed Medical Summaries X X X √
Facts&Liability √ X √ √
Exhibit Management √ √ √ √
Past Medical Expenses √ √ √ √
Future Medical Expenses √ X √ √
Pain&Suffering Narrative √ X √ √
Loss of Earnings X X X √
Loss of Household Services X X X √
Verdict Analysis X X X √
Punitive Damages X X X √
Per Diem Analysis X X √ √
Red Flags, Problems,and Priors X X √ √

*available upon request


Table of Contents

Sample Demand Facts & Liability Injuries & Treatments Damages Demand to Settle

5-23 5 8 14 22


VIA CERTIFIED MAIL

VIA FAX

GEICO County Mutual Insurance Company

[Carrier Address]

RE: My Client:

Date of Loss:

Your Insured:

Claim No.:

Policy No.:

Dear Ms.

and All Insurance Company Decision-Makers:

Your records should reflect that our firm represents (“ Ms. ” or “our client ”) regarding her respective legal interests as to an incident that occurred on August 13, 2024, involving (“ Ms. ” or “your insured ”).

Our firm is currently in a position to resolve our client’s claims and, in connection therewith, submits the following information and documentation in a good-faith effort to resolve this matter.

Pursuant to Tx. R. Evid. Rule 408, the information and materials accompanying this letter are for settlement purposes only and may not be used at trial unless obtained through the legal process.

We expect that you will provide our firm with a list of any additional items you need in order to properly and fully evaluate this settlement demand by . We will make a good-faith effort to respond to any requests you make for additional information regarding this demand. We also ask that this demand be immediately forwarded to all insurance company decision-makers and, of course, the insured policyholder.


1. FACTS & LIABILITY

On August :A5' 2024, Ms. was the restrained driver of a vehicle traveling eastbound on East Freeway in Houston, Harris County, Texas. At the same time, Ms. was the driver of a vehicle traveling directly behind Ms. ’s vehicle. Suddenly and without warning, Ms. failure to control her speed and struck Ms. ’s vehicle from behind. Upon impact, Ms. was violently jostled back and forth in a rapid motion and slammed the back of her head against the seat of the vehicle. The collision resulted in Ms. sustaining significant personal ijuries and other damages.

1 As exposed in the Texas Peace Officer’s Crash Report, Officer Jesika Wade of the Harris County Sheriff’s Office investigated the collision and determined that Ms. was the sole party responsible for the collision due to her failure to control speed, lack of attentiveness, and failure to maintain an adequate distance from the vehicle ahead.

The conditions for establishing liability are clear. Ms. owed a duty of care to the other drivers on the road. A driver of a motor vehicle shall not follow another vehicle more closely than is reasonable and prudent, having due regard for the speed of other vehicles, as well as traffic conditions and the condition of the roadway. Tex. Transp. Code § 545.062(a). A driver who operates his or her vehicle in a careless or imprudent manner, or without due regard for road, weather and traffic conditions then existing, commits the act of careless driving. See, e.g., In re Gamble, 676 S.W.3d 760, 787 (Tex. App. 2023) (Texas drivers must exercise reasonable,

1 Exhibit 1 - Texas Peace Officer’s Crash Report due care, and prohibits all drivers from operating motor vehicles upon public roadways in a manner that creates an unjustifiable risk of harm to other motorists, pedestrians, or property; this general duty includes compliance with Texas’s “rules of the road”). A driver who operates his or his vehicle and who fails to give full time and attention to the operation of his or her vehicle, or where a driver fails to maintain a proper lookout while operating his or her vehicle commits the act of inattentive driving. See, e.g., Arcides v. Rojas, 677 S.W.3d 154, 161 (Tex. App. 2023) (internal citations omitted) (“Every Texas motorist proceeding along a public roadway is under a duty, at all times, to maintain a proper lookout for his own safety, and may not proceed blindly and in disregard of dangers that might reasonably be anticipated to exist. … The duty to maintain a proper lookout while driving encompasses the duty to observe, in a careful and intelligent manner, traffic and the general circumstances in the vicinity.”). On the date of loss, Ms. failure to control speed, lacked attentiveness, and did not maintain an adequate distance from the vehicle ahead, which directly caused the collision. As a result of Ms. ’s acts and/or omissions on August 13, 2024, Ms. suffered significant personal injuries and damages for which Ms. is undoubtedly liable.

2 As evidenced by the photographs below, the August 13, 2024, collision resulted in substantial property damage with resultant significant bodily injury.

2. INJURIES & TREATMENTS

2 Exhibit 2 - Property Damage Photographs


The below tables are non-exhaustive lists/summaries of the injuries and treatments Ms. sustained as a direct and proximate result of the August 13, 2024, collision.

ICD Code Description
M25.521 Pain in Right Elbow
M25.522 Pain in Left Elbow
M47.812 Spondylosis Without Myelopathy or Radiculopathy, Cervical Region
M50.20 Other Cervical Displacement, Unspecified Cervical Region
M51.24 Other Intervertebral Displacement, Thoracic Region
M54.2 Cervicalgia
M54.6 Pain in Thoracic Spine
M99.07 Segmental and Somatic Dysfunction of Upper Extremity
S13.4XXA Sprain of Ligaments of Cervical Spine
S16.1XXA Strain of Muscle, Fascia and Tendon at Neck Level
S23.3XXA Sprain of Ligaments of Thoracic Spine
S23.41XA Sprain of Ribs
S29.012A Strain of Muscle and Tendon of Back Wall of Thorax
S33.5XXA Sprain of Ligaments of Lumbar Spine
S39.012A Strain of Muscle, Fascia and Tendon of Lower Back

2.1. Objective Tests

MRI of the Cervical Spine - 10/01/2024 (Exhibit 11 - p. 111)

● Cervical kyphosis.

● C3-C4: 1 mm broad-based disc herniation that effaced the thecal sac.

● C4-C5: 1 mm broad-based disc herniation that effaced the thecal sac.

● C5-C6: 2 mm broad-based disc herniation causing central canal stenosis and bilateral neural foramina narrowing.

● C6-C7: 2 mm broad-based disc herniation causing central canal stenosis and bilateral neural foramina narrowing.

MRI of the Thoracic Spine - 10/01/2024 (Exhibit 11 - p. 112)

● T6-T7: 1 mm disc bulge that effaced the thecal sac.


● T7-78: 1 mm disc bulge that effaced the thecal sac.

● T8-T9: 1 mm disc bulge that effaced the thecal sac.

● T9-710: 1 mm disc bulge that effaced the thecal sac.

● 1.6 cm left renal cyst.

2.2. Interventional Treatments

East Side Surgery Center

● Cervical Facet Joint Injection at C5-C6 - 11/25/2024 (Exhibit 15 - p. 130-131)

AFC Urgent Care
Timeline August 14,2024
No. Visits 1
Summary On August 14,2024,Ms. presented to Ms.Sharon Johnston,N.P.,for urgent medical treatment and care.Upon arrival,Ms. complained of pain in her right elbow and upper back.After a clinical examination,Ms.Johnston prescribed Naproxen and Methocarbamol and instructed Ms.to follow up in three days.
Documents Exhibit3-AFC Urgent Care-Bills Exhibit4-AFC Urgent Care-Records
Allied Medical Centers
Timeline August 28,2024- October 9,2024
No. Visits 4
Summary On August 28,2024,Ms. presented to Mr.Jason Lee,N.P.,for medical treatment and care.Upon arrival,Ms. complained of pain in her neck,back,and right elbow.After a clinical examination,Mr.Lee prescribed Ibuprofen and recommended a TENS unit,ice/heat pack,Biofreeze,and electrodes.Mr.Lee referred Ms.to physical medicine and instructed her to return for a follow-up visit.Mr.Lee opined that it was medically probable that Ms.’s injuries and associated limitations were a direct result of the August 13,2024,incident at issue.
On September 11,2024,Ms. returned to Mr.Lee for a progress examination.Upon arrival,Ms. complained of pain in her neck,upper back,and middle back.After a clinical examination,Mr.Lee referred Ms.

Documents for an MRI of the cervical and thoracic spine, prescribed Ibuprofen,and recommended that Ms. continue her current treatment plan.
Documents On September 25,2024,Ms. presented to Mr. Lee,for a medical progress examination.Upon arrival,Ms. complained of pain in her neck,back,and right elbow.After a clinical examination,Mr. Lee recommended that Ms. continue her current treatment plan and return for a follow-up visit in two weeks.
Documents On October 9,2024,Ms. returned to Mr. Lee for a progress examination.After a clinical examination and review of her diagnostic imaging,Mr. Lee diagnosed Ms.with a herniated nucleus pulposus of the thoracic and cervical spine.Mr. Lee referred Ms.to pain management and recommended that she continue with her current treatment plan.
Documents [NTD]:Please note,the medical records appear to suggest Ms.refused a prescription for medication during the September 25,2024,appointment.We have not included this information within the summary above but recommend you review and revise as required.]
Exhibit 5-Allied Medical Centers-Bills Exhibit 6-Allied Medical Centers-Records
Qualcare Rehabilitation
Timeline September 3,2024-November20,2024
No. Visits 17
Summary On September 3,2024,Ms. presented to Dr.Razak Balogun,D.C.,for chiropractic evaluation and treatment.Upon arrival,Ms. complained of pain in her neck,middle back and lower back.After a complete and thorough physical examination,Dr.Balogun recommended a treatment plan that consisted of but was not limited to,the following:manual massage,electric stimulation and ultrasound therapy.
Summary On November 20,2024,Ms. returned to Dr.Balogun for a progress examination.Ms. received therapeutic exercises.Ms. remained symptomatic for pain in her neck.After completing the examination,Dr.Balogun recommended Ms. return for follow up treatment.

Documents [NTD] Please note, the records are not very detailed with regards to the complaints of the patient, and medical opinions. We have gleaned all available information from the records. Moreover, there do not appear to be discharge records. Please review and supplement your records, or otherwise amend the summaries above, as required.
Documents Exhibit 8-Qualcare Rehabilitation-Bills Exhibit 9-Qualcare Rehabilitation-Records
One Step Diagnostic
Timeline October 1, 2024
No. Visits 1
Summary On October 1, 2024, Ms. underwent diagnostic imaging, which revealed, in relevant part, the following:
•MRI of the Cervical Spine:
○Cervical kyphosis.
○C3-C4:1mm broad-based disc herniation that effaced the thecal sac.
○C4-C5:1mm broad-based disc herniation that effaced the thecal sac.
○C5-C6:2mm broad-based disc herniation causing central canal stenosis and bilateral
neural foramina narrowing.
○C6-C7:2mm broad-based disc herniation causing central canal stenosis and bilateral
neural foramina narrowing.
•MRI of the Thoracic Spine:
○T6-T7:1mm disc bulge that effaced the thecal sac.
○T7-78:1mm disc bulge that effaced the thecal sac.
○T8-T9:1mm disc bulge that effaced the thecal sac.
○T9-710:1mm disc bulge that effaced the thecal sac.
○1.6cm left renal cyst.
Documents •Exhibit 10 - One Step Diagnostic-Bills
•Exhibit 11 - One Step Diagnostic-Records
Greater Houston Pain and Injury
Timeline October 22,2024-December 23,2024

No. Visits 3
Summary On October 22,2024,Ms. presented to Dr.Andrew McKay,M.D.,for a pain management consultation and treatment.During the initial consultation Ms. complained of headaches and pain in her neck.After a clinical examination and review of Ms.’s diagnostic imaging,Dr.McKay diagnosed Ms.with cervical facet joint syndrome and recommended left-sided cervical facet joint injections atC5-C6with intravenous sedation and post-injection physical therapy.Dr.McKay instructed Ms.to follow up in one month.
On December 23,2024,Ms. returned to Dr.McKay for a pain management progress examination.After a clinical examination,Dr.McKay recommended that Ms.continue with her home exercise program and instructed her to return to the clinic as needed.
Documents Exhibit12-Greater Houston Pain and Injury-Bills Exhibit13-Greater Houston Pain and Injury-Records
East Side Surgery Center
Timeline November 25,2024
No. Visits 1
Summary On November 25,2024,Ms. presented to Dr.AndrewMcKay,M.D.,at which time she underwent aleft-sided cervical facet joint injection at theC5-C6level.Ms. tolerated the procedure well and was discharged instable condition.
Documents Exhibit14-EastSideSurgeryCenter-Bills Exhibit15-EastSideSurgeryCenter-Records

3. DAMAGES

3.1. Total Projected Claim Value

Elements of Damages
Economic Damages
Past Medical Expenses $29,775.99

Future Medical Expenses $39,690.00
Non-Economic Damages
Pain and Suffering,Physical Impairment,and Mental Anguish $229,120.00
Total Damages $298,585.99

3.2. Past Medical Expenses

To date, Ms. has incurred medical expenses as itemized below.

Provider Treatment Period Amount Charged Amount Accepted Supporting Document(s)
AFC Urgent Care 8/14/2024 $169.00 $169.00 Exhibit 3
Allied Medical Centers 8/28/2024-10/9/2024 $2,086.99 $2,086.99 Exhibit 5
Simon's Pharmacy 8/28/2024 $250.00 $250.00 Exhibit 7
Qualcare Rehabilitation 9/3/2024-11/20/2024 $4,285.00 $4,285.00 Exhibit 8
One Step Diagnostic 10/1/2024 $8,200.00 $8,200.00 Exhibit 10
Greater Houston Pain and Injury 10/22/2024-12/23/2024 $6,000.00 $6,000.00 Exhibit 12
East Side Surgery Center 11/25/2024 $5,985.00 $5,985.00 Exhibit 14
US Anesthetic Services 11/25/2024 $2,800.00 $2,800.00 Exhibit 16
Total $29,775.99 $29,775.99

If you dispute any of Ms. ’s medical treatment or bills as unnecessary or unreasonable, please specify the disputed items in writing. Otherwise, we will assume you agree with the necessity and reasonableness of her medical treatments and bills.


3.3. Future Medical Expenses

Ms. will require additional future treatment as identified below.

[ NTD : Please note, to more appropriately justify the non-economic damages sought, we have extended the timeline of treatment for conservative care to two years. Please review and revise if required.]

Procedure Years Per Year Cost Total
Cervical Facet Joint Injection C5-C63 1 2 $12,685.00 $25,370.00
Pain Management Visit4 1 4 $850.00 $3,400.00
Continued Chiropractic Care5 2 12 $330.00 $7,920.00
Primary Care Visits6 2 6 $250.00 $3,000.00
Total $39,690.00

Healthcare and medication costs are expected to rise, and we reserve the right to update or extend our estimate to account for further care needs.

3.4. Past and Future Pain and Suffering

The State of Texas allows for our client to be compensated for non-economic damages. Non-economic damages as defined by Texas Civil Practice and Remedies Code - CIV PRAC & REMS § 41.001 (12) means damages awarded for the purpose of compensating a claimant for physical pain and suffering, mental or emotional pain or anguish, loss of consortium, disfigurement, physical impairment, loss of companionship and society, inconvenience, loss of

disregard for dangers that might reasonably be anticipated to exist. … The duty to maintain a proper lookout while driving encompasses the duty to observe, in a careful and intelligent manner, traffic and the general circumstances in the vicinity.”). On the date of loss, Ms. failure to control speed, lacked attentiveness, and did not maintain an adequate distance from the vehicle ahead, which directly caused the collision. As a result of Ms. ’s acts and/or omissions on August 13, 2024, Ms. suffered significant personal injuries and damages for which Ms. is undoubtedly liable.

2. INJURIES & TREATMENTS

2 Exhibit 2 - Property Damage Photographs