Appeal Letter to Insurance Company

Paying your insurance premium regularly does not guarantee the cover up of all sorts of damage or loss that one has incurred. However, being the client of the insurance company does give you the right to appeal for the denial of the insurance.

Writing an appeal letter is one of the best ways to revise your insurance status. Make sure that you do not miss out on the full name, complete address, accurate policy number, claim number along with the date of the loss or damage.

Your reason for disagreement should be downright clear and has to be followed up by a recommendation. Do not write to them only about your own concern, help them out with the options that can be considered.

Do not become emotional while writing the letter even though you are highly likely to be angry and annoyed, keep a professional tone. Write in after a thorough homework on knowing your rights and also the facts that serve your cause.

While opening the letter, make it clear that you are appealing for the denial. Mention the treatment routine that you were following while with the same policy and also attach medical records which will help your cause.

Instructions

  • 1

    Sample for the Appeal Letter to Insurance Company


    May 4, 2011

    John Smith
    23rd West Arcade, Main Square,
    Getty City, 67578
    4355-4664-001

    Providing Policies
    3rd Floor, South West Tower,
    Crammed Corner
    Inner City, 75787

    Re:       Patient: Trump Trunk
    Policy Number: 68387-D
    Treatment Dates: October 25, 2011- December 9, 2011
    Billed Amount: $3,300

    Dear Mr. Hopkins,

    My uncle has been a cardiac patient since the last four years now and has been visiting the National Hospital regularly. The doctor has recently suggested a change in routine due to his condition getting critical gradually.

    This is a stage that anyone could have predicted, so kindly keep the acuteness of the situation in mind and reconsider the denial.

    I have enclosed all the relevant medical documents and the certification of the doctors in order to convince you.

    Waiting for your response,

    John Smith

  • 2

    Template for the Appeal Letter to Insurance Company


    Date

    Your name
    Your address
    Your city, state, ZIP
    Your phone number
    Attn: Claims Director name
    Claims Director title

    Name of insurance company
    Insurance company address
    City, state, ZIP
    Re:      Patient: patient’s full name

    Policy Number: policy number
    Treatment dates: list all individual dates and date ranges of treatment
    Billed Amount: total amount billed by your doctor(s)

    Dear (write in the name of the Claims Director if possible)

    I am writing in this appeal because my cousin has reached a critical stage in the disease and now needs constant medical supervision. Keeping the severity of the condition in mind, please reconsider you decision of denying the insurance.

    I will wait highly anxiously for your response.

    Sincerely,

    Your signature
    Your typed name

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