Reconsideration Letter For Insurance Claim: How To Write It Right!

A reconsideration letter to an insurance company is written to formally request a review of a decision made by the insurance provider. This might be due to the denial of a claim, the amount of coverage provided, or any other decision that the policyholder disagrees with. 

Writing a compelling reconsideration letter is crucial for persuading the insurance company to review and possibly reverse their original decision. Here’s a step-by-step guide to help you craft an effective letter:

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1. Start with the Basics

Begin your letter with the necessary formalities:

  • Your full name and address
  • Date
  • The insurance company’s name and address
  • The name of the representative or adjuster you’ve been in contact with (if applicable)

2. State the Purpose of the Letter

Clearly state the purpose of your letter in the opening paragraph. For example: “I am writing to formally request a reconsideration of the decision made regarding my claim number XYZ123.”

3. Provide Details of the Claim

Next, offer a brief summary of the claim:

  • The date of the incident or the period the claim covers
  • The type of policy you have
  • The reason given by the insurance company for denial or the particular decision you disagree with

4. Present Your Argument

This is the core section of your letter. Clearly and concisely present the reasons you believe the decision should be reconsidered. Here are some points to consider:

  • Were there any errors in the way your claim was processed?
  • Are there additional facts or evidence that were not considered initially?
  • Do the policy terms support your perspective?
  • Are there any extenuating circumstances that should be considered?

5. Attach Supporting Documents

If you have additional documents that support your case, mention them in the letter and attach them. This could include:

  • Medical reports
  • Police reports
  • Photographs
  • Receipts
  • Statements from witnesses or experts
  • Relevant portions of the insurance policy that support your claim

6. Be Professional and Courteous

Remember, the person reading your letter is more likely to be receptive if you maintain a calm, professional tone. Avoid using aggressive or accusatory language. Instead, focus on presenting the facts and explaining why you believe the decision should be reconsidered.

7. Include a Call to Action

End your letter by clearly stating what you want the insurance company to do, such as: “I kindly request that you review the attached evidence and reconsider the decision on my claim.”

8. Provide Your Contact Information

Ensure you provide a phone number, email address, or any other contact method where you can be reached in case the insurance company wants to discuss the matter further.

9. End with a Formal Closing

Close the letter with a formal salutation like “Sincerely” or “Regards,” followed by your signature and printed name.

10. Follow up

After sending your reconsideration letter, it’s a good idea to follow up with the insurance company after a reasonable period (e.g., two weeks) to ensure they received the letter and to inquire about the status of your request.

Sample Letter of Appeal for Reconsideration Insurance Claims

[Your Full Name]
[Your Address]
[City, State, Zip Code]

[Insurance Company Name]
[Insurance Company Address]
[City, State, Zip Code]

Attention: [Adjuster’s or Representative’s Name]

Subject: Reconsideration Request for Claim Number [Claim Number]

Dear [Adjuster’s or Representative’s Name],

I am writing to formally request a reconsideration of the decision made regarding my claim number [Claim Number]. The claim pertains to [brief description of the claim, e.g., “a car accident that occurred on [Date]”].

I was informed that my claim was denied due to [specific reason for denial]. However, I believe this decision may have overlooked certain crucial details. [Explain your reasons and provide evidence, e.g., “I have attached a medical report that clearly indicates the injuries were a direct result of the accident.”]

Please find attached the following documents that I believe will support my case:
1. [Document Name]
2. [Document Name]
(And so on)

I kindly request that you review the provided information and reconsider the decision on my claim. I believe that with these documents, it’s evident that my claim is legitimate and falls within the coverage of my policy.

Please do not hesitate to contact me at [Your Phone Number] or [Your Email Address] if you need any further information or clarification. I appreciate your time and consideration in this matter.


[Your Signature]
[Your Printed Name]

Frequently Asked Questions (FAQs)

Q: What is a reconsideration letter for insurance claim? 

Answer: A reconsideration letter for insurance claim is a formal written request sent by a policyholder to an insurance company, asking the company to review and potentially change a decision they’ve made regarding a claim. 

This letter is often used when a claim has been denied or if the policyholder disagrees with the amount or terms of the claim settlement.

Q: Why would someone need to write a reconsideration letter for insurance claim? 

Answer: Someone might need to write a reconsideration letter for insurance claim if they believe the insurance company made an error in processing the claim, overlooked crucial evidence, or if new information becomes available after the initial decision. 

The letter serves as an avenue for the policyholder to present their case and ask the insurer to re-evaluate the claim.

Q: How should one structure a reconsideration letter for insurance claim? 

Answer: A reconsideration letter for insurance claim should start with the sender’s contact details and the date, followed by the insurance company’s address. The subject should clearly state the purpose, such as mentioning the specific claim number. 

The body of the letter should briefly explain the reason for disagreement, present the supporting evidence, and end with a call to action. The tone should be professional and respectful, and any supporting documents should be attached.

Q: Can a reconsideration letter for insurance claim guarantee a reversed decision? 

Answer: No, a reconsideration letter for insurance claim does not guarantee a reversed decision. However, it ensures that the insurance company reviews the claim with the provided evidence and arguments. The outcome will still depend on the insurer’s evaluation and policies.

Q: How long should one wait before following up on a reconsideration letter for insurance claim? 

Answer: After sending a reconsideration letter for insurance claim, it’s advisable to wait for a reasonable period, typically two weeks, before following up. 

This gives the insurance company ample time to review the request and gather necessary information for a response.

Q: Is there a specific format or template for a reconsideration letter for insurance claim? 

Answer: While there isn’t a one-size-fits-all template, a standard format includes the sender’s details, the date, the insurance company’s address, a clear subject line, an explanation of the claim and disagreement, presentation of evidence, a call to action, and a formal closing. 

Some individuals opt to use templates or samples available online as a starting point, but it’s essential to tailor the letter to the specific situation and ensure it includes all relevant details.

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