Sometimes, you receive insurance claim letters, which were either not factually correct or do not have enough proof. Either way, for letters like these, there is no other option but to refuse their claim.
The most dignified way to refuse their claim is to write them a letter. Try to make it sound like it is unfortunate that you cannot accept their claim, instead of making it look like a victory. This way, you can let them know that you sent them the rebuttal for a valid reason and not because you are stingy.
When using a humble but firm tone in the letter, it makes it easier for the recipient to digest, and it finishes the story. If you use a cold lifeless tone, the recipient may feel you are just a robot that merely rejected their humanity, and they will be likely to send more and more letters.
Here’s a sample to give the above mentioned advice a practical example, you may customize this according to the situation and the policy of your company:
25 Brown Ave
Providence, RI 45887
March 28, 2017
Mr. Dustin Hubbard
Century Insurance AG
3516 Melm Street
Providence, RI 02908
Dear Mr. Hubbard:
This letter is to confirm the receipt of your medical claim letter on behalf of your client regarding their road accident two weeks ago. We have thoroughly gone through the proofs you have provided, and unfortunately cannot accept their medical claim.
According to your letter, your client was fully conscious and was not under the influence of mind-altering substances. However, having gone through his medical reports, we confirmed that he had a dangerous alcohol and THC level in his blood. We understand the mental and physical toll this incident has left on your client, and send our deepest sympathies. However, I am afraid we will not be able to fulfill their claim as we have lost dependability based on the fact that the accident was the fault of your client. Hence this ambiguity has led us to refuse the claim.
We understand that you may wish to contact us again to discuss this further, and we feel no problem in clearing any objections you may have. You may contact me at (000) 521-8545 for a meeting. Thank you for your patience.
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