Sample Letter Of Explanation To Insurance Company
Subject: Claim [Claim Number] – Explanation of [Reason for Explanation]
Dear [Insurance Company Name] Claim Department,
This letter is to provide a detailed explanation regarding claim number [Claim Number], specifically addressing [Reason for Explanation]. I understand that additional information is needed to fully process my claim, and I am happy to provide the necessary details to facilitate a swift and accurate resolution.
Before I delve into the specifics, I want to reiterate my commitment to providing accurate and truthful information to [Insurance Company Name]. My intention is to cooperate fully and ensure a transparent claims process.
Background of the Claim:
As you know, this claim stems from [Briefly describe the event leading to the claim, e.g., a car accident, a house fire, a water leak]. This incident occurred on [Date of Incident] at approximately [Time of Incident] at [Location of Incident]. The incident resulted in [Briefly describe the damages or losses sustained, e.g., damage to my vehicle, damage to my home, medical expenses]. A police report was filed (report number: [Police Report Number]), and a copy was previously submitted with my initial claim.
Specific Explanation of [Reason for Explanation]:
The reason I am writing to you today is to clarify [Specifically state the reason for the explanation. This could be one of several things. Examples are provided below. Choose the one that applies to your situation and expand upon it with specific details]:
Option 1: Explanation of a Delay in Reporting the Incident:
I understand that there was a delay in reporting the incident to [Insurance Company Name]. The primary reason for this delay was [Provide a clear and concise explanation for the delay. Be honest and provide any supporting documentation if available]. For example:
“…due to the severity of my injuries sustained in the accident. I was immediately transported to [Hospital Name] and remained under medical care for [Number] days. My focus was solely on my recovery, and I was unable to handle the administrative tasks associated with filing a claim until [Date]. I have attached a copy of my medical records from [Hospital Name] to support this explanation.”
Or:
“…because I initially believed the damages were minor and would be easily covered out-of-pocket. However, upon closer inspection and after obtaining several estimates, it became apparent that the repair costs would exceed my initial expectations significantly. I realized that filing a claim was necessary at that point. I apologize for any inconvenience this delay may have caused.”
Or:
“…because I was out of the country on a pre-planned business trip. I was unreachable by phone and had limited access to email. I immediately contacted [Insurance Company Name] upon my return on [Date] and filed the claim. I can provide documentation of my travel itinerary if required.”
Option 2: Explanation of Discrepancies in the Claim:
I understand that there might be some perceived discrepancies in the information I provided in my initial claim. I would like to clarify [Specifically identify the discrepancy and explain the reason for it. Be precise and provide supporting evidence]. For example:
“…regarding the estimated value of the damaged [Item]. The initial estimate I provided was based on [Source of initial estimate]. However, after consulting with [Expert/Appraiser Name], a professional appraiser specializing in [Type of Item], it became clear that the initial estimate was significantly undervalued. I have attached the appraiser’s report, which provides a more accurate assessment of the item’s value, taking into account its [Specific characteristics influencing value].”
Or:
“…concerning the description of the events leading up to the accident. While I stated in my initial claim that [Initial statement], I have since recalled additional details that may provide a more complete picture of what occurred. Specifically, [Provide the corrected or additional information and explain why it wasn’t included initially]. I believe this additional information is crucial for a fair assessment of the claim.”
Option 3: Explanation of Pre-Existing Conditions or Prior Incidents:
I am aware that my claim may be affected by [Pre-existing condition or prior incident]. I want to provide full transparency and explain the circumstances surrounding this. [Provide a detailed explanation of the pre-existing condition or prior incident, including dates, details, and any relevant documentation]. For example:
“…regarding the previous water damage claim I filed in [Year]. That claim was for [Briefly describe the prior incident] and was caused by [Cause of the prior incident]. The issue was resolved by [Actions taken to resolve the prior incident] and I have documentation from [Company/Contractor] confirming the repairs were completed. While I understand this may raise concerns, I want to assure you that the current water damage is unrelated to the previous incident and is due to [Cause of the current incident].”
Or:
“…concerning my pre-existing back condition. While I have a history of back pain, this current injury is a direct result of the [Describe the incident causing the current injury, e.g., car accident]. I have attached a report from my physician, Dr. [Physician’s Name], which clearly distinguishes between my pre-existing condition and the new injury sustained in the accident. Dr. [Physician’s Name] can be reached at [Phone Number] for further clarification.”
Continuing My Explanation (Regardless of the Option Chosen):
I understand that providing this explanation is crucial for the assessment of my claim. I have made every effort to be as thorough and accurate as possible in my description. I believe this explanation, along with the supporting documentation I have attached, will provide a clearer understanding of [Reason for Explanation] and allow you to process my claim fairly.
Attached Documents:
To support my explanation, I have attached the following documents:
- [Document 1 – e.g., Medical Records from Hospital Name]
- [Document 2 – e.g., Appraisal Report from Expert/Appraiser Name]
- [Document 3 – e.g., Repair Confirmation from Company/Contractor]
- [Document 4 – e.g., Physician’s Report from Dr. Physician’s Name]
- [Document 5 – e.g., Travel Itinerary]
- [Document 6 – e.g., Additional Photos of Damage]
Conclusion:
Thank you for your time and consideration in reviewing this explanation. I am available to answer any further questions or provide additional information that you may require. I can be reached by phone at [Your Phone Number] or by email at [Your Email Address]. I appreciate your prompt attention to this matter and look forward to a favorable resolution to my claim.
Sincerely,
[Your Full Name]
[Your Address]
[Your Phone Number]
[Your Email Address]
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Sample Letter Of Explanation To Insurance Company :
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