Health Insurance Claim Letter for Reimbursement

By | February 12, 2015

The best thing about being insured is that you do not have to pay for your medical bills – or at least most of them. So if you have had the misfortune of being unwell or injured and have spent some time in hospital, your insurance carrier is liable to pay you back for out of pocket and medication expenses, depending on the terms of the policy that you hold.

But no insurance company is simply going to hand you the money – you have to work for it! Writing a claim letter to your insurance carrier is what is eventually going to help you get paid. Your letter should be clearly written, charting out the details of the medical expenses that incurred during your stay at the hospital or a doctor’s fee. Make sure that you provide your insurance policy number and if possible, quote a term from your policy that may be particular to your case.

A health insurance claim letter is addressed to a claims adjuster so make sure that you are aware of who your claims adjuster is. Also, ensure that you have all your fact right – do not claim for health benefits that you are not entitled to. Here is a sample health insurance claim letter for reimbursement that you may be interested in.

Health Insurance Claim Letter for Reimbursement

February 11, 2015

Ronald Collins
Claims Adjuster
NHA Health Insurance
182 Rome Street
Gary, IN 26354


Dear Mr. Collins:

Please refer to my policy number NHA6277-09, titled Felicity Mae. I am presently registered under the NHA Health Insurance Perfect Plan. I was recently on a business trip to New York and had terrible food poisoning due to which I had to be admitted to New Foundland Hospital for three days. While the hospital was kind enough to accept my insurance and agreed to send the bill directly to you, I had to pay for one procedure (stomach flush) and my medicines myself.

As per the terms laid out in my policy, I am entitled to any out of pocket medical expenses that may occur during the time I travel (please refer to clause 5.12). You will receive complete details of the time I spent at the hospital and the expenses that incurred from the hospital within seven days from today. I am enclosing two receipts – one for the stomach flush and the other for the medicines – with this letter for your reference. I would appreciate it if you would reimburse this amount to me on an immediate basis.

Thank you for your attention in this regard.



Felicity Mae
89 Pierce Street
Gary, IN 54629
Tel: (222) 222-2222