Complaint Letter for Health Insurance Services

Health is attributed to a sound and fit body that is free from all kinds of disorders. And hygiene refers to those measures that prevent illness and diseases. Health and hygiene together give a peaceful happy life free from all worries. When proper care of health is taken, everything seems joyous. And ill-health leads to frustration and worries even if life is fruitful. Good health is tetra times better than being a millionaire. Nowadays, a lot of companies are providing the facility of health insurance.

A health insurance company provides insurance against any medical expenses incurred by individuals. These companies can be governmental, private, or non-profit. The health insurance policy is a contract between the provider and an individual. This contract is renewable monthly or annually. Such companies can be found through any advertisement mode like print media, newspapers, etc.

The companies provide a proper plan like pre-paid services regarding various health issues. When some problem is found regarding the insurance, a complaint must be lodged to sort out the issue.

1-

I got a health insurance policy from you in [name of the year]. I have been paying all the dues for the past [number] years. Last month I had a road accident as I was coming back from the office. I ended up with broken ribs and the tibia of my left leg was fractured. When I tried to claim my insurance policy they informed me that it did not cover the post-surgery costs of the hospital stay.

This is extremely unfair as I have been regular in my payments and I had obtained this policy for emergency situations like this. The hospital stay cannot avoid due to the nature of my injuries and I cannot afford it if you deny my claim. I am forwarding my reports and prescription please get your medical team to assess these on their own and provide me with the required funds.

Looking forward to a positive response from your side.

2-

I [name] got a health insurance policy from you five years ago and I have been very regular in the payment of dues. Four months back I was diagnosed with diabetes. When I forwarded my claim application, I was told that everything would be sorted within a month and payments would start from next month. However even after all this time, I have not received any money and whenever I call, your agent tells me that the documents are being processed.

Diabetes is considered the most expensive chronic disease. The cost of insulin, syringes, test strips, doctor visits, laboratory tests everything adds up to about [amount] per month. A person who is relying on his salary to make the ends meet cannot afford to bear the expenses of this disease. Please speed up the processing so that I can get my medication on time without worrying about the expenses.

Looking forward to your positive response and swift action.

3-

Sea View Apartments
Michael M. Bullock
Block 13B, Skylarks Avenue, New Jersey.

[DATE]

Mr. Robert W. Xavier
St. Joseph Hospital
16 Fleet St. Red Cross Avenue, New Jersey.

Dear [Recipients Name],

I am writing to complain about the health insurance services. I have received the bill for my wife’s major accident from St. Joseph hospital today. The bill mentioned that my insurance company just paid 15% of the bill. It sounds much terrible. As per the signed contract, my pre-paid insurance is bound to pay 95% of the bill in case of major accidents.

This 15% does not make any difference. All local hospitals are offering 10% off in case of major accidents without having an insurance policy. Then my policy sounds useless in comparison to such benefits being offered locally. I request you to pay the rest of the bill as per the signed contract. And please pay the rest of the bill. I must suggest you review the policy to avoid such inconvenience in the future.

I hope for prompt action.

With Regards,

Michael M. Bullock.