Free Disability Insurance Claim Letter Template
Disability Insurance Claim Letter
January 12, 2051
ZenSync
876 Celestial Circle, Unit 88
Starlight Square, CA 12345
Dear Claims Department,
I am writing to formally submit a claim for disability benefits under my disability insurance policy (Policy Number: 987654321) due to a severe back injury that has significantly impacted my ability to work.
On August 15, 2050, I experienced a workplace accident that resulted in a severe herniated disc. Since that time, I have been unable to perform my job duties as a Warehouse Manager at HealSync. Attached to this letter, you will find medical documentation from my healthcare provider, Dr. Ethan Lopez, outlining the nature of my condition and the treatment I have received.
The following documents are included to support my claim:
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Medical reports and treatment records from Dr. Ethan Lopez.
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A statement of my current medical condition.
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Physical therapy records documenting my treatment plan.
I kindly request the processing of my claim and the initiation of benefits to assist me during this challenging time. Should you require any further information or additional documentation, please do not hesitate to contact me at 222 555 7777 or [Your Email].
Thank you for your prompt attention to this matter. I look forward to your response.
Sincerely,
[Your Name]
