A letter of intent written to cancel health insurance policy undertaken by the insurer is a formal way of informing the authority of your decision. In this letter the insurer writes to the head of company or the person who controls this cancellation department. The letter gives all the relevant details such date of purchase, policy number and the date you wish to end the policy agreement.

Sample of health insurance cancellation letter


Mr Steve Jones

Managing Director,

Products division

Agri health Insurance Company Pvt Ltd

56c, new lane

San Francisco

Postal Code-500063

Dated: 1st February 2015

Subject: letter of cancel health insurance policy

Respected Sir,

This is in regard of cancellation of my health insurance policy undertaken by your firm on the 15th of January,2013. I, Gillian Martin, a grocery store owner had purchased this policy from your health insurance unit in San Francisco. I am cancelling this policy before its end date because of my inability to carry on with the premium payments.

The policy number of the policy taken is 5689. With this letter I am also attaching a copy of the payment receipts and the documents provided by your firm during the purchase of the policy. I would like to cancel the debits and monthly premiums charged from the 15th of February 2015. According to the insurance policy terms and conditions I am entitled to receive a portion of the unutilized premiums. I would also request you for a formal letter of acceptance of my policy cancellation along with a receipt of the unused amount within 30 days of receipt of this letter.

Yours sincerely,

Gillian Martin


Martin grocery Stores

San Francisco