Free Insurance Claim Letter for Reimbursement Template
Insurance Claim Letter for Reimbursement
[YOUR NAME]
Virginia Beach, VA 23450
222 555 7777
[YOUR EMAIL]
September 20, 2055
Garfield Williams
LudoSpace
Claims Department
Raleigh, NC 27601
Subject: Request for Reimbursement for Medical Expenses
Dear Mr. Williams,
I am writing to request reimbursement for medical expenses incurred under my policy, number ABC123456. On September 10, 2055, I received medical treatment for a broken ankle sustained in an accident. The total expenses for the treatment amount to $1,200.
Attached are copies of the medical bills, receipts, and other supporting documents related to this claim. The detailed breakdown of the expenses is as follows:
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Emergency Room Visit: $500
-
X-rays and Diagnostic Tests: $300
-
Orthopedic Specialist Consultation: $200
-
Cast and Follow-Up Appointments: $200
I kindly request reimbursement of the total amount of $1,200. Please process this claim at your earliest convenience. Should you require any additional information or documentation, please feel free to contact me at 222 555 7777 or [YOUR EMAIL].
Thank you for your prompt attention to this matter.
Sincerely,
[YOUR NAME]
