Complaint Letter to the insurance company for a complicated process to claim

by

To,

[Designation of addressee]

[Name of insurance company]

Respected Sir,

I am a policy holder at your health insurance company with policy number ____. I am writing this letter to inform you about the difficulties I am facing to process my medical claim. As per the policy, I am entitled for hospitalization at your affiliated hospitals with the insurance coverage amount of ______. Last month [mention the case] and it was an emergency, we could not go for cashless hospitalization as it needed immediate treatment. The medical and recovery process took around fifteen days. I had all my bills cleared for claim at your company. 

Regarding the claim, I even called your company for assistance but the customer service representative could not address my issue properly as he told there is some ambiguity related to the medical conditions and rules. So I decided to visit your [Name of location] office for further clarifications. To my disappointment, the officials could not also solve the issue and they told me to contact the operational head. When I contacted the operational head, he was clueless and did not provide me any assistance.

My claims are still pending and I am at huge financial distress. Kindly help me out to process them at the earliest opportunity. Awaiting your prompt action. Thanks in advance.

Yours truly,

[Name of Sender]

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