Medical Insurance Claim Complaint Letter – Sample Application for Insurance Claim Complaint

Table of Contents:

• Sample Letter
• Live Editing Assistance
• How to Use Live Assistant
• Additional Template Options
• Download Options
• Share via Email
• Share via WhatsApp
• Copy to Clipboard
• Print Letter
• FAQs

Complaint Letter regarding claim approval

To,
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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FAQs

• 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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