Insurance Policy Bond Lost Letter

To,

The Manager,
__________ (Name of Insurance Company),
__________ (Insurance Company Address)

Date: __/__/____ (Date)

Subject: Loss of Insurance policy bond, policy number ________ (policy number).

Sir/Madam,

I, _______________ (Policy Holder Name), son of/ daughter of/ wife of _______________ residing at ( Address) had taken an insurance policy from your insurance company on _______(Date of Insurance Policy Taken) bearing policy number __________ (Policy Number).

I hereby confirm that I had received the original Policy issued the Company, however, inadvertently I ________ (lost/misplaced) the policy. I have already searched for the policy but unable to find the same.

Therefore, I request you to issue to me a copy of the policy.

I undertake that if I found an original bond I will immediately return the same to Insurance company without any delay. Also will not misuse and hold the company responsible in any matter regarding the loss of original policy. I am enclosing _________ (undertaking/affidavit/photo/application form) along with the application.

Look forward to your kind support.

Thank you,

Signature: _____________
Your Name: __________
Policy Number: __________
Mobile number: _________