Blog
November 4, 2026
von
Andrej Evtimov
Five moves you can expect in a demand, and the evidence that answers each one.
Most plaintiff demand tactics are ordinary advocacy, and the claim file is where an adjuster answers them. This post pairs five common tactics with the dated, documented evidence that answers each one.
A demand letter is an opening move, and the file is where you answer it
Plaintiff demand tactics are mostly ordinary advocacy. A claimant's attorney is paid to raise the value of a case and to move the carrier onto the claimant's timeline. The adjuster's job is not to push back harder. It is to answer each tactic with dated, documented facts from the claim file.
The pressure shows up in the data. The Insurance Research Council (IRC) studied more than 7.4 million auto injury claims closed with payment between mid-2017 and mid-2022. Across all coverages, attorney representation rose from 40% to nearly 50%, and litigation rates rose from 10% to 18%. Average bodily injury (BI) payments climbed from about $14,000 to more than $20,000 in the same period.
The same IRC release adds a counterpoint. Represented BI claimants waited a median of nearly 440 days for closure. That is more than double the wait for unrepresented claimants. After fees, represented claimants netted $1.40 per dollar of medical bills, against $1.80 for unrepresented claimants. The figures show a gap in outcomes. They do not show why it exists.
Five plaintiff demand tactics, and what the file shows
Each tactic below is paired with the evidence in the file that answers it. Rules differ by state, so check your own jurisdiction and your guidelines before you rely on any of this.
1. The high anchor
The first number in a negotiation shapes the range that follows. In a mock-juror study published in 2000, Roselle Wissler and Mollie Marti found that larger plaintiff damages requests raised awards, until the request became extreme. The request moved what jurors saw as an acceptable range. It did not change how severe they judged the injury to be.
Mock jurors are not adjusters, but the lesson carries over. A number that goes unanswered can become the reference point. Answer it with a comparison built into the file before the first call:
- Demand total, billed specials and paid specials, side by side.
- Wage loss with proof of earnings.
- Any future care, with the name of the physician who recommended it and the date.
The IRC data gives one outside benchmark. BI claimants received about $2.00 in settlement for every $1 of medical bills paid. This settlement-to-medical ratio rose from $1.80 in mid-2017 to more than $2.30 in mid-2022. That is an average across millions of claims. Use it to see where a demand sits, not to set the number.
2. The short fuse
A time-limited demand offers to settle within policy limits if the carrier pays inside a fixed window, often with extra conditions. The pressure is the clock. In some states, a missed within-limits demand can raise the carrier's exposure to a judgment above the limit. Ask coverage counsel how your state treats it.
The file shows whether the carrier had a fair chance to evaluate the claim inside the window.
Check these items:
- The date the demand was received, not the date printed on the letter.
- What was enclosed, and which documents were missing.
- The date each document arrived. The NAIC model regulation says each relevant document in the file should be noted as to date received, processed or mailed.
- Every written request for missing records, with its date.
Law on these demands varies by state. In Georgia, the Court of Appeals decided Anderson v. Jones in 2022. It held that the 30-day minimum in O.C.G.A. § 9-11-67.1 also applies to the other conditions of acceptance. A three-day condition was unenforceable. The statute has been amended over time, so check the current text. For a day-by-day view, see the 30-day playbook for time-limited demands.
3. Early treatment, built before the demand
Medical specials drive the value of a BI demand, so the timing of treatment matters. The IRC surveyed more than 2,000 U.S. adults in July 2026. It found that nearly half of claimants who hired an attorney did so within days of the accident. About eight in 10 of those who consulted or hired one reported being referred to a medical provider.
Early representation and attorney referrals are generally lawful, and they are not improper on their own. Rules vary by state. What the file should show is the sequence. Put three dates in one line: the accident, the first treatment visit and the letter of representation. For example: loss on March 3, first visit on March 5, letter of representation on March 6. Then note the referral source, whether care sits under a letter of protection, and what was billed against what was paid.
Florida gives a useful model for what to ask. Under section 768.0427(3) of the 2025 Florida Statutes, a claimant who claims expenses under a letter of protection must first disclose:
- a copy of the letter;
- itemized, coded billing records;
- the price paid by any factoring company that bought the accounts;
- whether the claimant had health coverage at the time; and
- whether the claimant was referred for treatment, and by whom.
The statute applies in Florida only and may change, so check the current text. Outside Florida, the same list works as a request checklist. Two related guides cover the billing side: letters of protection and billed versus paid and duplicate charges and upcoding in a medical specials package.
4. The curated record set
A demand package is a selection, not the medical record. It holds the pages that support the story the demand tells. The file shows what is missing.
Compare the providers and records in the package with the providers and records the file already knows about:
- Emergency department and triage notes from the day of loss.
- Primary care and pharmacy records from before the loss.
- Prior imaging, so a new MRI can be compared with an old one.
- Gaps between visits that the narrative does not explain.
A missing prior record is a question to ask in writing, with a date, not a conclusion to draw. Read an MRI report with that history beside it. A related guide to acute versus degenerative findings in an MRI report shows what to look for.
5. The paper trail
Some claimant letters ask for status updates, set short response dates and restate earlier requests. Many are routine. Some also document how fast the carrier responded. The file shows whether each response was dated and complete.
The NAIC model regulation sets two standards that matter here. An insurer should acknowledge a notice of claim within 15 days. Claim file documentation should also be detailed enough to rebuild the insurer's activities on the claim. States adopt their own versions, so day counts differ. The model also says it does not create a private cause of action.
Still, a file that cannot be rebuilt is hard to defend in any later dispute. Log each call, letter and request on the day it happens. Record who was told what. In the IRC data, litigation rates reached 18% of claimants by 2022. A reader other than you may one day read that log.
Put the evidence on one page
- High anchor. What it aims to do: Set the reference number. What the file should show: Demand vs billed vs paid specials, with support for future care.
- Short fuse. What it aims to do: Force a decision on a deadline. What the file should show: Date received, enclosures, dated requests for missing records.
- Early treatment. What it aims to do: Raise medical specials. What the file should show: Accident, first visit and representation dates; referral source; billed vs paid.
- Curated records. What it aims to do: Control the story. What the file should show: Records known to exist vs records in the package; priors; gaps.
- Paper trail. What it aims to do: Frame delay. What the file should show: Dated contact log; acknowledgment dates; written requests.
Building this page by hand across a long file takes time that an adjuster with a full desk may not have. Tools built for bodily injury claim file review, such as amaise, process unstructured claim documents. They flag key details for the adjuster. The adjuster still reads the source and makes the call. For auto cases, see the platform's page on auto liability claims.
Common questions
Are these tactics improper?
Mostly no. A high opening number, a deadline and a selective package are all part of ordinary advocacy. A reply built on dated facts helps support the carrier's position and treats the claimant fairly. If you see conduct that looks improper, follow your guidelines and involve counsel.
Does a high demand create bad-faith exposure on its own?
Not on its own. Exposure depends on state law, the policy limit, the facts in the file and how the carrier handled the claim. A missed within-limits demand can matter in some states. Ask coverage counsel about yours.
What should an adjuster do first when a demand arrives?
Stamp the date received and calendar every deadline. Log the demand, list what was enclosed and request any missing records in writing. Then follow your guidelines on notifying the insured and counsel.
Key takeaways
- Most plaintiff demand tactics are ordinary advocacy. Answer them with dated facts from the file, not with pushback.
- A high anchor needs a side-by-side of the demand, billed specials, paid specials and support for future care.
- A short deadline needs a stamped receipt date, an enclosure list and dated requests for missing records.
- Early treatment and curated record packages call for a timeline (accident, first visit, representation) and a records-gap comparison.
- A dated contact log lets the carrier rebuild its handling of the claim if a dispute follows.
