By JuJu Davis, Former Bodily Injury Claims Adjuster | Founder, AI Arsenal Activators & Demand360

After five years on the other side of the desk as a bodily injury claims adjuster, I can tell you exactly what makes an adjuster put a demand letter in the “easy deny” pile versus the “let’s talk settlement” pile. The difference often comes down to details that get missed before the letter ever leaves the plaintiff’s office — details that paralegals are perfectly positioned to catch.

Here are five red flags adjusters flag immediately, and what to look for before you hit send.

1. Treatment Gaps Without Explanation
A gap in treatment is one of the first things an adjuster looks for. If your client stopped treating for three or more weeks during their recovery period and the demand letter doesn’t address why — vacation, insurance lapse, personal hardship — the adjuster will use that silence to argue the injuries weren’t serious. Always account for gaps explicitly. A one-sentence explanation in the demand narrative can protect thousands in settlement value.

2. Medical Specials That Don’t Match the Records
If the demand states $18,500 in medical specials but the billing records you attached only add up to $16,200, you’ve handed the adjuster a credibility problem. They will add it up. Discrepancies between the demand amount and the actual documentation — even small ones — signal sloppiness at best and inflation at worst. Always reconcile your totals before the letter goes out.

3. A Demand-to-Specials Ratio That Screams Inflation
Most carriers use internal benchmarks for what’s considered a reasonable demand relative to medical specials. When a demand is 10x or 15x the specials with no documented future treatment, surgery recommendation, or significant lost wages to justify it, adjusters flag it for pushback or litigation routing rather than desk settlement. Know your ratio going in and make sure the narrative supports it.

4. Missing or Vague Liability Support
A demand without a police report, witness statements, or a clear liability narrative puts the full burden of proof on the adjuster to build the case for settlement — and they won’t. If liability is even slightly contested, the demand needs to preemptively address it. Photos, diagrams, recorded statements, or an independent witness can make the difference between a fast settlement and a file that sits for months.

5. No Settlement Deadline — or an Unrealistic One
Demands without a deadline get deprioritized. Demands with a 10-day deadline on a complex multi-plaintiff file signal inexperience and often result in a denial on procedural grounds alone. The deadline needs to be firm enough to create urgency but reasonable enough to be taken seriously — typically 30 days is the industry standard for most BI claims.

A Final Note
The demand letter is often the first and most important impression a carrier gets of your case. Paralegals who understand what adjusters are looking for — and catch these issues before the letter goes out — directly impact case outcomes and firm revenue.

For firms handling high volumes of demand letters, AI tools are now available that can cross-reference documentation, flag inconsistencies, and score demand packages in under a minute. One such tool built specifically for the PI/claims space is Demand360 (demand-analyzer.vercel.app) — free to try, no login required.

JuJu Davis spent five years as a bodily injury claims adjuster before founding AI Arsenal Activators and Demand360, an AI-powered demand package analysis tool built specifically for the PI and insurance claims industry. She can be reached at [email protected].