Insurance Claim Rejection Appeal

Your name*

Policy number*

Insurance company name*

Rejection letter reference and date*

Reason given by the insurer for rejection*

Your grounds for appeal*

Format:

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To, [insurer_name] Subject: Appeal against rejection of claim under Policy No. [policy_number] Dear Sir/Madam, I refer to your letter [rejection_reference], rejecting my claim under Policy No. [policy_number] on the ground that: [rejection_reason_stated]. I wish to appeal this decision on the following grounds: [appeal_grounds] I request that you reconsider my claim in light of the above, failing which I shall be constrained to approach the Insurance Ombudsman or the appropriate Consumer Disputes Redressal Commission for relief. [policyholder_name]

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Insurance Claim Rejection Appeal

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