Use this letter to inform the insurance company of your representation of your client.

[Date]

Insurance Adjuster

Insurance Company

Address 1

Address 2

VIA FIRST CLASS MAIL

Our Client: [Client’s Name]

Your Insured:  [Insured’s Name]

Claim Number: #########

Date of Loss: ##/##/####

Dear [Adjuster Name]:

Please be advised that our office has been retained to represent [Client’s Name] for personal injuries sustained on or about ##/##/####.  

This firm has an agreement with our client whereby we are to receive thirty-three percent (33.33%) of any monies recovered through settlement; and forty percent (40%) of any amount recovered after filing suit in this matter.  This letter shall serve as our attorney’s lien.

As [Client’s Name] is now represented by counsel, we would request that all further communication with our client be directed through our office.

Please call my office if you have any questions.