Free Reconsideration Letter for Health Insurance [Sample]

Your Name
Your Address
City, State, Zip Code
Policy Number

DATE

Claims Director’s Name
Insurance Company’s Name
Insurance Company’s Address
City, State, Zip Code

RE: Appeal for reconsideration of a medical claim denied to Name of Patient, Policy Number.

Dear [Claims Director’s Name]:

This is a legal appeal letter about the denial of my [TREATMENT] claim. On [DATE], I received a refusal letter with the following reasons for denial: My wounded knee’s physiotherapy was an experimental treatment that had not been licensed by the FDA.

My doctor suggested the therapy for my injuries, so I’m appealing the refusal. Osteopaths and physical therapists regard it as a cutting-edge treatment that is very successful.

I’ve attached three publications from the New England Journal of Medicine authored by professionals in the field of sports injuries who claim that this treatment is more effective than any other for knee injuries. I’ve also attached a letter from my doctor explaining that this therapy was necessary because of my injury.

Please reconsider your decision to deny this treatment payment. If you require any additional information about the treatment or from my doctor, I would appreciate a written request. You can contact me at the aforementioned address or via email at the following address.

Thank you for your time and consideration of my request.

Sincerely,

Signature
Your Name
List of Enclosures: Medical Documents, Bills, Articles and Letters from Doctors