Once an injury or loss has occurred, it is important to notify the insurance company covering the incident. A letter outlining details of the incident and the intensity of physical and mental injuries incurred will need to be sent to the insurance company in question to initiate the payment process.
Claim letters may be written by the policy holder or a representative. If the policy holder is not well enough to write one (following the injury), a pre-designated representative may present the case. An individual’s lawyer can also perform this task.
The content of a claim letter needs to follow standard protocols; the letter needs to be addressed to the adjuster, provide information of the policy holder policy number and detail the incident that occurred. An individual’s insurance policy might cover only certain aspects of loss so you will need to be informed of what they are liable for. You cannot ask them for coverage that was not part of the original insurance contract so studying the insurance papers before you begin is a good idea.
Below is an example of a claim letter sent to a client’s insurance company by a representative:
October 25, 2014
Mr. Larry Ben
Jackson Health and Life Insurance
553 Warwick Road
Princeton Junction, NJ 89110
Subject: Claim Notice of Policy # JHLI 82037-45
Dear Mr. Ben:
This is with reference to Ms. Jillian Fernandez who holds policy number JHLI 82037-45 with Jackson Health and Life Insurance. Ms. Fernandez is a victim of a car accident which occurred on September 4, 2014 at Yardville Hamilton Square at 1800 hour. She fractured one of her ankle due to accident.
As Ms. Fernandez’s legal representative, I have been asked to handle all legal matters on her behalf since she is physically unable to handle them herself at this point in time. Ms. Fernandez’s policy is updated and all premiums have been paid off. This claim notice relates to the coverage that her policy provides her for “injury or loss” as indicated in your policy notebook (page 8, line 22).
Copies of Ms. Fernandez’s medical bills for the three weeks that she spent at Yale Medical Facility are enclosed with this letter. It will provide you with all the details that you will need to process payment for this claim. Also enclosed is a letter from her surgeon who has charted out the need for her to be fitted with a prosthetic foot if she wants to continue working at her present position at Jackson Fields Inc. Denial of this service will lead to her being unable to work and subsequent loss of income.
Please indicate your interest in the resolution of this matter and provide details of perusal so that we can take this further. Since time is of extreme essence, I would appreciate a response from you within 10 days of receipt of this letter.
Dan and Dan Associates
758 Deerfield Road
Princeton Jackson, NJ 55998
Tel: (111) 111-1111
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