Ref: [insert reference number] [insert date]
Your Ref: TBA

[Insert the name of the Insurance Company]
[Insert the address including physical address]
[Insert the phone number]
Dear Sir,
RE: INSURANCE CLAIM RELATING TO MOTOR VEHICLE REGISTRATION [INSERT
REGISTRATION NUMBER]
Reference is made to the above matter wherein I address you as hereunder.
That on or about the [insert date], I registered with and took out an accident insurance policy with your
company with regards to my vehicle registration number [insert details]. That the insurance was
required to cover myself and my vehicle for any accident whatsoever. That on the [insert date] I paid for
the said insurance in full and had a legitimate expectation that I would be covered in case of any
accident.
That on the [insert date] I was involved in an accident at [insert details where the accident occurred
including State and town]. As per your company’s instructions, I lodged a claim on the [insert date] vide
claim number [insert date]. That following the claim I lodged, your company picked up the said car from
the yard where it was located after the accident happened and your claim adjuster informed me that I
will have access to the said car at all times to retrieve my belongings that were in the car. I was also told
the car would not be moved and would be in the same city that the accident happened. On the [insert
date] and various other dates, I requested to have access to the said vehicle and collect my personal
items, which request was denied by your company.
That sometime in March of 2022, your company denied my claim and failed to issue out a payment as
was the agreement when I took up the insurance and instead returned the premiums I had paid. After
the mental torture and anguish that I suffered with regards to following up the claim, I informed your
company’s claims adjuster to give me back the vehicle, the same was denied. After I was informed that
the claim had been denied by yourselves, I was informed to pick my vehicle from [insert the location
where the vehicle was located] as opposed to where the accident had happened. Furthermore, your
company has engaged in unauthorize use of my credit file, details are within your knowledge.
Your actions amount to a breach of contract in civil law and criminal in the sense that you obtained
funds on false pretext. The same actions are punishable by law within the concurrent jurisdiction of both
the criminal and civil courts. Despite my constant demands and reminders, you have failed, refused
and/or neglected to accept the claim, failed to return the vehicle, and/or pay the damages.
I therefore Demand from you, which we hereby do, your immediate and unconditional acceptance of
the claim together with accrued interest charged at 12% monthly from the date of the accident and
unconditional return of the said vehicle to me within seven 7 days, failure to which I shall to file suit

without any further reference to your company and commence criminal proceedings at your own risk as
to legal and reputational costs and other incidentals. Please note that any amount received shall be
accounted for in reduction of the claim but without prejudice as to my right to file suit.
Yours Sincerely,

[insert your name]

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