15 Sample Complaint Letters Against Insurance Company

Sample 1: Complaint About Delayed Claim Processing

Dear [Insurance Company Name],
I am writing to formally express my frustration regarding the significant delay in processing my claim, #[Claim Number], which was submitted on [Date]. 

Despite multiple follow-ups, I have yet to receive a clear timeline or explanation. This delay has caused undue financial stress. I respectfully request immediate action on my case and a written update within 7 business days.

Sincerely,
[Your Name]

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Sample 2: Complaint About Denied Health Insurance Claim

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Dear Claims Department,
I was shocked to learn that my health insurance claim #[Claim Number] was denied due to “lack of medical necessity,” despite the fact that the procedure was doctor-recommended and pre-authorized.

I request a full review and reconsideration, along with a detailed explanation for the denial. If not resolved, I may escalate this to the state insurance commissioner.

Kind regards,
[Your Name]

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Sample 3: Complaint Regarding Poor Customer Service

To Whom It May Concern,
I’m writing to express my disappointment with the customer service I’ve received from your representatives. On multiple occasions, I’ve encountered unprofessional behavior and conflicting information about my auto insurance policy. Please investigate these interactions and provide clarity on my coverage terms.

Sincerely,
[Your Name]

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Sample 4: Complaint About Unfair Claim Settlement Offer

Dear [Adjuster’s Name],
After reviewing your proposed settlement for claim #[Claim Number], I believe the offer is unreasonably low given the extent of the damage to my property. I am requesting a reevaluation, including consideration of the third-party repair estimates I have attached.

Best regards,
[Your Name]

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Sample 5: Complaint About Lack of Communication

Dear [Insurance Company Name],
I am writing to express concern over the lack of communication from your office regarding my claim #[Claim Number]. It has been over three weeks since my last contact, and I have not received any updates. Please provide a detailed status report at your earliest convenience.

Thank you,
[Your Name]

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Sample 6: Complaint About Delayed Reimbursement

Dear Billing Department,
Despite submitting all required documents over a month ago, I have not received the reimbursement for my out-of-pocket medical expenses related to claim #[Claim Number]. This delay is unacceptable and must be addressed immediately.

Sincerely,
[Your Name]

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Sample 7: Complaint Regarding Policy Cancellation Without Notice

Dear [Insurance Provider Name],
I recently discovered that my policy #[Policy Number] was canceled without prior written notice. This has placed me in a vulnerable position without coverage. I am requesting immediate reinstatement or a clear explanation for the cancellation.

Respectfully,
[Your Name]

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Sample 8: Complaint About Misrepresentation of Coverage

Dear [Insurance Representative],
When I enrolled in your plan, I was informed that certain procedures would be covered. However, I’ve since been denied reimbursement based on exclusions never disclosed to me. I feel this constitutes a misrepresentation and request a formal investigation.

Regards,
[Your Name]

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Sample 9: Complaint About Repeated Errors in Claims Processing

Dear Claims Supervisor,
There have been multiple errors in processing my claims, resulting in incorrect billing and unnecessary delays. Despite several calls and resubmissions, the issue remains unresolved. I urge your office to conduct an internal review and correct these errors immediately.

Sincerely,
[Your Name]

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Sample 10: Complaint About Discrimination or Unfair Practices

Dear [Insurance Company Name],
I believe I have been treated unfairly in the handling of my claim, potentially due to discriminatory practices. I request a full explanation and review of my file. If not resolved, I intend to file a formal complaint with the appropriate regulatory authorities.

Thank you,
[Your Name]

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Sample 11: Complaint About Refusal to Cover Prescription Costs

Dear Pharmacy Claims Unit,
I was denied coverage for a necessary prescription despite my doctor’s authorization and the medication being listed on your approved formulary. Please review this matter urgently and provide written justification for the denial.

Best,
[Your Name]

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Sample 12: Complaint About Damage Appraisal Discrepancy

Dear [Adjuster Name],
The appraisal amount you’ve provided does not reflect the actual cost of repairing my vehicle. I have obtained independent estimates that clearly show a higher value. Please reevaluate your assessment and adjust the claim amount accordingly.

Sincerely,
[Your Name]

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Sample 13: Complaint About Delay in Life Insurance Payout

To Whom It May Concern,
My family filed a life insurance claim after the death of my spouse, [Name], over [X] weeks ago. We have complied with all documentation requirements, yet no payment has been issued. This delay is distressing and unacceptable.

Please respond urgently,
[Your Name]

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Sample 14: Complaint About Unexplained Premium Increase

Dear [Insurance Provider Name],
I noticed a significant and unexplained increase in my premium for policy #[Policy Number]. I request a written explanation for this adjustment, including the factors that influenced this decision.

Sincerely,
[Your Name]

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Sample 15: Complaint About Claim Closure Without Notification

Dear Claims Manager,
I was surprised to find out my claim #[Claim Number] was closed without any communication or resolution. I never received any explanation or decision notice. Please reopen the claim and provide a full status report.

Best regards,
[Your Name]