Request Letter for Surrender of Insurance Policy


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

Date: __/__/____ (Date)

Subject: Surrender request for Insurance policy number ________ (policy number).


Respectfully, I _________ (Your Name) am holding insurance policy from your insurance company ______________ (Insurance company name) taken on _______(Date of Insurance Policy Taken) and having policy number __________ (Policy Number). The same is due for  maturity on _______(Policy Maturity Date). I want to surrender the policy due to ___________ (reason for surrender)

I request you to kindly complete the formalities of the claim of policy and transfer the surrender policy amount of this policy to my account no. ____________ (account number), which is already updated in records and terminate the aforesaid policy.

I am enclosing _________ (insurance policy bond paper/policy surrender request/ (bank account statement/cancelled cheque/bank passbook copy), photo, insurance application form) along with the application.

Your immediate action will be highly appreciated.

Thank you,

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

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