Appeal Claim Letter

By | October 8, 2013


Lenny Bin

Claims Departments Head

All Well Insurance Services

21 Yankee Doodle Lane

Utah, West Wisconsin 4390

Dated: 25th of August 2013

Subject: Appeal claim for insurance

Respected Mr. Bin,

This letter is in regards to the medical insurance (account number 56789) that I hold with your insurance company. I would like to make an appeal in order to claim for the expenses incurred for my medical treatment.

Recently I had a heart problem and had to be admitted to the Hilton Group of Hospitals located at 65 Time Square Avenue, Utah, West Wisconsin 4345. I was diagnosed with an arterial blockage and had to undergo an open heart surgery as suggested by the cardiologist. As per the policy the insurance company has to bear ninety percent of medical expenses. The total bill including my surgery cost, medicines and hospital expenses amount to $5000.

I would request you to consider my appeal and process my claim as soon as possible. I am enclosing the following documents along with the letter for your reference:

  • Medical test reports
  • Pharmacy bills
  • Surgery reports
  • Doctor’s prescription

Please let me know if I need to submit any other document.


Nancy May Austen