Sample of an Insurance Appeal Letter
April 28, 2012
Fifth Avenue, West Street, 524-C
Re: John Smith
Policy Number: 56475
Kindly accept this letter for making available the medical insurance for Mr. Smith, as it had been denied and now he needs the insurance claim immediately. This letter also serves as the follow-up of the message that you sent regarding denial of the insurance.
You already are aware of the medical issues of Mr. Smith. He was diagnosed with an unstable cardiac condition and has been suffering since quite a while now. Dr. Jones is the examiner for Mr. Smith and issued the reports on January 23, 2011.
For further insight for the details of the medical condition, please see the enclosed letter from the doctor, who has also mapped out the medical history of the patient.
We could not provide you with all the relevant data before and now have enclosed all the important reports that you will need to make the eventual decision.
I hope that you will very soon grant us the required assistance and reconsider that the decision that you had made earlier.
Mr. Smith will be anxiously waiting for your reply.
Template of an Insurance Appeal Letter
Your city, state, ZIP
Re:Patient: [patient name]
Name of insurance company
Insurance company address
City, state, ZIP
Dear [Mr./Ms./Director of Claims name, if available],
The letter is to request you for refreshing the status of the medical insurance of Mr. [ name ], who needs to be admitted instantly owing to the acute medical condition.
For further assistance, I have enclosed all the relevant medical documents along with the up coming schedules of the patient so that you can provide the insurance well in accordance.
We need to coordinate the hospital and insurance payment plans so kindly reply timely.
Looking forward to your response,