Re: Policy No. <Policy number>
This is to inform that I would like to make a claim on the above-referenced policy of
insurance. On <date>, I was in an automobile accident with <name(s)> at
<location of accident>. <name(s)> <is/are> insured as follows:
<name of driver>
<name of their insurer>
<their policy number>
A police report <was/was not> obtained at the time of the accident. The report is
number <report number> and can be obtained through <name of agency that took the
report> <report of any injuries>.
I would, therefore, request that <company name> adjust any claims arising out of
this accident. In case you need any additional information, feel free to contact me. I
shall look forward to hearing from you at the earliest.