Example Letter #1

I have just received your letter informing me that my insurance policy will not cover my daughter’s surgery because you consider the surgery to be “elective” and we did not obtain authorization in advance. It never entered my mind that anyone would consider surgery that would prevent her paralysis and eventual death by suffocation to be “elective.” Surely someone made a mistake in writing us this letter, or in defining what is “elective.”

I trust you have copies of her medical records in your possession. If not, I will have the neurosurgeon send them to you. I request that you review her case to see that her condition clearly was “life-threatening” and therefore not “elective.”

She now has a chance to lead a relatively normal life, for which we are grateful. To say we have no claim to insurance coverage for her surgery is to add severe insult to injury. I am confident that you will agree once you have seen the documentation. I will await your response before taking other action.

Example Letter #2

After the fire at my Springfield residence, three independent contractors, including your own adjuster, estimated the damages to my home to be about $25,000. Therefore, I am sure you can imagine my dismay when I received your settlement of $14,000 for my losses on policy #5555, which should cover 100% of the damages.

In case this discrepancy is the result of a simple oversight, I am resubmitting copies of the estimates I sent to you a month ago, including your own adjuster’s statement of the damage. Please send me the correct amount as soon as possible, so I can complete the repairs. I hope to hear from you soon.