Request Letter to Add Member in Mediclaim Policy

__________ (Client Registration Unit/Manager),
______________ (Name of the Company),
______________ (Address)

Date: __ /__ /____ (Date)

____________ (Name),
____________ (Address)

Subject: Addition ______ (Son/Daughter/Member) in the med claim policy

Respected Sir/Madam,

I want to bring in your notice that I am _________ (Name), holding a mediclaim policy worth ___________ (Amount) affiliated with your company having scheme __________ (family/floater) policy.

I am requesting approval of the addition of _____ (Son/Daughter/Member)in the policy. Here are all the details:
Policy Number:
Issue Date:
Expiry Date:
Name of the Policyholder:
Name of the Additional Member:
Current Address:

I hereby enclosing _________ (Cheque/DD/any other payment details) for the additional payment of the new member. I am also attaching the additional member’s birth certificate for reference.

I would be thankful for your corporation, I am providing my contact details below for your further reference.

Yours ___________ (Sincerely/Faithfully),
____________ (Name),
____________ (Contact Details),
____________ (Signature)

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