sample letter to the health insurance company complaining about claim approval, complaint letter for medical insurance claim approval format, how to write a complaint letter regarding insurance
When drafting a complaint letter regarding a medical insurance claim, it's important to maintain clarity, politeness, and provide all necessary details. Clearly state your complaint regarding claim approval, including the reference ID, date of application, and total claim amount. Provide comprehensive details about the patient, hospitalization, and enclose relevant documents to support your claim.

Table of Contents:

Complaint Letter regarding claim approval

The ________ (Customer Support Officer/ Concerned Authority),
________________ (Insurance Company Name),
________________ (Address)

Date: __/__/____ (Date)

Subject: Complaint regarding claim approval

Respected Sir/Madam,

My name is __________ (Name) and I hold a policy of your company having the policy number _________ (Policy Number). The name of the policy is ________________ (Policy Name – If any) and I reside at______________ (Address).

I am writing this letter to complain about _______________ (Non-Payment/ Delayed Payment/ Less Payment/ Mention your complaint) for Reference ID: _________________ (Reference ID). I on __________ (Date) applied for a claim of a total amount of Rs. __________ (Amount) for the patient with the details mentioned below.

The following are the details of the patient:
Name: _______________
Gender: _______________
Address: _______________

The patient was hospitalized in ____________ (Hospital Name), in ___________ (Room type) due to the reason _______________ (Reason Of Hospitalization).

I am also enclosing the ____________ (Copy of bill/ ID Proof/ Application Form/ Address Proof/ Form duly filled and attested by hospital/Any other document Required).

I shall be thankful and obliged if you look into this matter and take some action as early as possible.

Thanking you,
______________ (Signature)
______________ (Name),
______________ (Contact Number)

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  • Q: What should I include in my complaint letter about a denied medical insurance claim?
    • A: Provide details such as your policy number, reference ID, date of claim application, total claim amount, patient's information, reason for hospitalization, and enclose relevant supporting documents.
  • Q: How should I address the recipient of my complaint letter?
    • A: Begin with "Respected Sir/Madam" or "Dear Sir/Madam" followed by a brief introduction of yourself and your complaint.
  • Q: Is it necessary to mention the reason for hospitalization in the complaint letter?
    • A: Yes, providing the reason for hospitalization helps the insurance company understand the nature of your claim and its validity.
  • Q: What documents should I attach to my complaint letter for supporting my claim?
    • A: Attach copies of bills, ID proofs, application forms, address proofs, or any other documents required by the insurance company to support your claim.
  • Q: How long does it typically take for an insurance company to respond to a claim complaint?
    • A: Response times vary, but insurance companies usually aim to address complaints promptly within a few business days to weeks.

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