Insurance Appeal Letter

There are many different types of letter. Each letter is written with a clear purpose. The basic aim of every letter is 'Communication'. The only difference is that the communication via this letter is formal in some cases, and in some cases it is informal. Out of the different types of letters, here we would discuss on 'appeal letters' and 'insurance appeal letter' in specific.

An appeal letter is written to draw attention to a wrongly made decision with the intention of rectifying it. It is a formal letter written to request the reader to change any official decision taken by him/her. Also, known as 'Petition letter', it is sometimes written to enquire about the correctness or validity of any kind of judgment or decision taken by the reader. The characteristics of this letters are - It is Investigative, meticulous, and honest. It is basically written to challenge the official decision, thus it should have its facts in place, and should be interrogative.

Tips to write an Appeal Letter:

1. An appeal letter is written to make the reader or the person to whom the letter is addressed, to reconsider his/her decision. It should thus be formal and free from any emotional cues
2. The letter is aimed towards filing a petition, it should thus be formal
3. Put forth your side of the story with supporting facts and evidences
4. Follow the format of the appeal letter using the template of the letter used in that particular office, or a general appeal letter template
5. A printed or typewritten letter is preferable, than a hand written letter

Format of an Appeal Letter:

The format of this letter is similar to any formal letter. The important things that need to be mentioned in the letter are the case number, date of hearing and name of the judge/decision maker'.

The letter begins with the writer's introduction. It should also speak about the purpose of the letter. The first paragraph has to be precise, so that the reader gets the answer to two questions - 'Who and Why'.

The second paragraph should then elaborate on 'Why'. If you are writing the letter to challenge a decision, then you need to mention what happened, why you want the decision or case to be reconsidered, and mention the facts supporting your point of view. While writing the letter you must remember that the reader gets many such letters in a day. You thus, need to make your letter reader friendly, by presenting only the required information, and make it more legible by using bullets or numbers wherever necessary.

The last paragraph of an appeal letter is different from other formal letters. In the last paragraph, you have to summarize the letter. The facts or points that need to be highlighted should be repeated here again. Do not forget to thank the reader at the end.

The sample insurance appeal letter given below can be used as a reference to write an appeal letter.

AXA Medical Insurance,
Blueberry Towers,
Park Street,
Sun Road,
California - 51204

Re: Mrs. Vida Vella
Policy Coverage: Gold
Policy Number: CAO - 1241

Dear Mr. Mark,

Please accept this petition as Vida Vella's appeal to AXA Insurance's decision, to deny a claim for the recent hospitalization at Christ Hospital. Based on the denial letter sent by you, I understand that this claim does not include post hospitalization charges.

I (Vida Vella) was diagnosed with a 'muscle injury' in my shoulder on 5th September, 2011. To get it cured, I had to undergo a surgery which is followed by physiotherapy sessions. The entire expenditure on the surgery and the sessions till date is $100.00. The physiotherapy sessions were an inclusive part of the hospital treatment. Dr. John's letter attached herewith, shows that 'physiotherapy' was an intrinsic part of the treatment and was a must to completely cure the injury, and make the surgery successful.

I believe that while checking the documents for the claim, you did not get this letter, and thus considered 'physiotherapy' out from your claim.

I thus request you to reconsider the insurance claim, and read the doctor's letter, which mentions that physiotherapy was a part of the surgery and hospital treatments, and should be included in the medical claim. In case you need any further information, you can contact me (Vida Vella) on 444 -5015105 or email me at vida.vella@sing.com

Looking forward to get a positive response soon.

Thank you.

Sincerely,

Vida Vella

Enclosure:

1. Photocopy of the doctor's letter
2. Photocopy of denial letter
3. Photocopy of the policy
4. Photocopy of hospital bills

The above-mentioned sample Insurance appeal letter serves as a ready reference to write any appeal letter. Also, you can review Property Tax Appeal Letter and Scholarship Appeal Letter for more cover letter samples.