Request Letter for Insurance Penalty Charges Waiver – Penalty Fee Waiver Letter Sample

To,
The Customer Relations Officer,
____________ (Insurance Company Name),
____________ (Address)

Date: __/__/____ (Date)

Subject: Request for a penalty waiver

Respected Sir/Madam,

I would like to state that my name is __________ (Name) and I carry a __________ (medical/ vehicle/ life – Mention) insurance policy of your company ___________ (Company Name) from last ____________ (months/ years – Duration) having policy number __________ (Policy Number).

I regret to inform you that a payment of Rs. _______ (Amount) for _________ (monthly/ Quarter/ Annual) cycle was due on __/__/____ (Date) but due to the reason _______________ (Reason: unavailability of funds/ Out of town/ Forgot), I failed to pay the above-said installment. I have always paid the installments on time.

It would be humble if you kindly consider this as a genuine reason and accept my sincere apology. I request you to kindly waive the penalty applicable for the delayed amount of payment. I will make sure this will never be repeated and the current pending installment will be done by __/__/____ (Date).

Thanking you,

Yours Truly,
____________ (Signature),
____________ (Name),
____________ (Contact Number)