Insurance Claim Letter [Samples]

Learn how to write an insurance claim letter. Use our sample insurance claim letters as templates for your insurance claim letter.

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health insurance claim letter sample

Your Name
Your Address
City, State, Zip Code

DATE

Insurance Administrator’s Name
Insurance Company’s Name
Insurance Company’s Address
City, State, Zip Code

Dear [Name of Administrator]:

This letter is to formally request reimbursement for medical expenses for policy [NUMBER]. I was visiting New York City on [DATE] where I fell and broke my wrist. 

I was treated at [NAME OF HOSPITAL], and because I was from out-of-state, I needed to pay the bill in full. The amount was $3500 for x-rays, a bone specialist and one night in the hospital.

According to the terms of my policy, I contacted my primary healthcare physician within 24 hours of the accident. I have enclosed all the documents related to my treatment. 

I understand that I have a $500 deductible on my policy. I am requesting you to reimburse me $3000 in keeping with my health care coverage.

I can be reached at [555-123-4567] or at [name@email.com] if you have any questions. Thank you for your quick attention to this.

Sincerely,

Your Signature
Your Printed Name
List of Enclosures

Insurance Claim Letter For Damaged Car

Your Name
Your Address
City, State, Zip Code

DATE

Name of Insurance Adjuster
Name of Insurance Company
Address of Insurance Company
City, State, Zip Code

RE: Claim letter for car accident for claimant number [INSURANCE NUMBER]

Dear [Name of Agent]:

This letter accompanies my formal claim to cover the cost of repairing my car [MAKE, MODEL AND YEAR], after a car, [MAKE MODEL AND YEAR] ran into my parked car damaging the rear end. 

My car was parked by the curb in front of my house at the above address, when [NAME OF DRIVER] failed to stop and crashed into the back of my car. 

I bought my new car last year and planned to keep it for at least 10 years. I called the police and have included their accident report with my claim request forms.

I am hoping to get a financial settlement from the at-fault driver’s insurance company, but I need my car for work, so I had it repaired as soon as I could. In spite of this, I still missed five days of work. 

I have included the bills for repair and request that you pay out the amount of $5,000 for the repairs and loss of pay. When I receive compensation from the other insurance company, I will repay the amount.

Please respond within 30 days after receiving this letter. I can be reached at Phone Number or at Email Address.

Sincerely,

Your Signature
Your Printed Name
List of Enclosures: police report, repair bills

Insurance Claim Letter For flood damage

Your Name
Your Address
City, State, Zip Code

DATE

Name of Insurance Agent
Name of Insurance Company
Address of Insurance Company
City, State, Zip Code

RE: Flood Insurance Coverage

Dear [Name of Agent]:

I am writing to report flood damage that occurred to my home on [DATE]. During the overnight hours, a fierce storm swept through our area. 

These torrential downpours flooded our basement and ruined our carpeting, drywall and some of our furniture. 

There were many homes affected in our area. We called in a professional extraction company to try to save as much of our stuff as we could, however they were not successful due to the amount of damage.

Some of the electrical outlets and switches are not working in this affected area. Since the costs of these repairs are significant, we need to make a claim against our policy. Our policy number is [459FGT903K]. 

It is my understanding we have [$10,000] in flood insurance with a [$500] deductible. I want to clear this matter up quickly. 

Please contact me at the earliest convenience to set up a time for an adjustor to come out and view the damaged areas. I can be reached anytime on my cell phone at, [555-209-8790]. I look forward to hearing from you soon.

Sincerely,

Your Signature
Your Printed Name
List of Enclosures

Insurance Claim Letter For car accident

Jonathan Holmes
7600 Old Church Way
Cleveland, Ohio 49875

August 6, 2020

State-Wide Insurance
2399 Slate Ridge Blvd.
Reynoldsburg, Ohio 43068

To Whom It May Concern:

Our 2012 Honda Accord was in an accident on July 30, 2020. My wife, Susan, was driving at the time. She was traveling East bound on Brice Rd. in Reynoldsburg when a man ran a red light and smashed into the back end of our car. She had to be taken to the ER where she suffered a broken right arm and whiplash.

The repair estimate to fix our car is $5,498. The medical bills from Susan’s injuries are $3.980. Together with her pain and suffering, we are asking for a lump sum of $12,000 to settle this matter.

Susan will have to take sometime off work to heal and this has been a horrible event for her to deal with. Depending on how the arm does, we could be looking at surgery.

Our goal is to settle this matter quickly and efficiently. We have attached the police report, as well as supporting statements from 2 witnesses. Susan was not at fault and was driving along minding her own business. We look forward to solving this matter quickly.

Sincerely,

Jonathan Holmes
List of Enclosures

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