The intent of writing a claim letter to an insurance company is to inform the organization about your situation and ask for a settlement.
However, our experience of getting money from an insurance company is not always delightful. They often try to find our mistakes of not following their terms and conditions. Eventually, they try to deny or negotiate our claim citing simple mistakes.
We should, therefore, be extra careful so that the purpose of writing such a letter should not go in vain. Writing a claim letter is not difficult at all. However, there are some crucial points that we should always remember.
In this article, I will guide you through the proper way of writing such a Claim Letter to an Insurance Company.
Usually, we write a letter to an insurance company in our volatile situation. This could be to get compensation after losing our near one or to reduce substantial medical expenses.
If you are insured against such mishap, you should be compensated according to your insurance plan.
A claim letter is your first and one of the most essential documents to ensure a smooth transaction. Therefore, it should clearly mention some crucial points such as your Policy Number, Date of Initiation and Expiry, Type of Claim, Your Identity, and the Claim Amount.
Tips for Writing Claim Letter to Insurance Company
- The claimant should write the letter as early as possible after the occurrence of the incidence.
- Mention the intend of writing your claim letter.
- State the incident clearly with the date of occurrence.
- Most importantly mention your Policy number and Your Identity.
- A medical claim letter is different from an accidental claim letter.
- There may be some lock-in period for medical claim (we often call medical claim as mediclaim) and any claim made within this period is not considered eligible.
- Mentioning details of your insurance agent could be helpful.
- This is an official letter. Keep it short and concise.
6 Death Cases Not Covered by Insurance
Terms and conditions of life insurance depend on several factors. However, there are some common situations where the possibility of rejecting your life insurance claim is high. Here are six such situations when your insurer may deny your request.
- Murder of the policyholder in criminal activity
- Death under the influence of alcohol or narcotic substances
- Death in life-threatening activities like extreme sports
- Death of the policyholder due to pregnancy complications or due to child-birth
- Due to a natural disaster like flood and earthquake
- Not disclosing the habit of smoking while availing insurance
Letter 1: Sample Insurance Claim Letter by Beneficiary After the Death of Policyholder
The Branch Manager [or Concerned Person]
ABCD Life Insurance Company
Subject: Insurance claim of policy number ………………..
This is to inform you regarding the sad demise of my father ……………….. (His name) who was a term policyholder with your company with the policy number ………… dated……………. My mother ……………(Her name) is the sole beneficiary, and she requires monetary help urgently.
Therefore, I request you to kindly process our documents earliest and reimburse an amount of …………… as per insurance contract. The detailed insurance documents, along with a photocopy of his death certificate and the identity card of my mother are hereby attached with this letter.
Availing mediclaim facility is different from other insurance claims.
Below, I am providing a sample to avail the cashless facility instead of getting reimbursed after paying out for the same. Therefore, he/she needs to inform the Third Party Administrator (TPA) or the insurer well before, usually 48 hours, the date of hospitalization. This is an example of planned hospitalization.
However, in case of accidental hospitalization, intimation within a day of admission is considered to be good. Moreover, he/she can approach the hospital to complete the process on behalf of him/her.
Letter 2: Sample Intimation Letter to Insurance Company for Mediclaim
ABCD TPA Pvt Ltd
[Full postal address of the TPA]
Subject: Intimation letter for mediclaim of Policy Number ……………….
Sir / Madam,
This is to inform you that my father ………… (his name), holding the policy number ……….. has been diagnosed with the problem of heart blockage. After consulting with Dr. …….. (name of doctor), a renowned cardiologist, we realized that the surgery should be completed as early as possible. Therefore, we have decided to admit him to ABCD hospital, which happens to be one of your network hospitals, for the surgery under Dr. …….. (name of doctor). The operation is expected to be done on 6th September.
I, therefore, request you to intimate my insurance company so that my claim may be settled in due time. I am attaching the photocopies of the medical advice letter, health insurance policy details, and his health card.
Details of Insurance
Letter 3: Sample Insurance Claim After Car Accident
I would like to inform you that my car (Registration No. …….), insured by your company vide Insurance Policy No. (Policy number-) has met a serious collision yesterday. Though I was not injured much by the mishap, my car has suffered a lot of damage in its back. The driver from the opposite side was definitely driving recklessly and rear-ended my car. I have consulted my local mechanic, and he has given me an estimation of Rs. 45,000 for a full repair.
Therefore, I claim for its renovation as allowed under your Insurance Policy guarantee.
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