Dental Insurance Claim Appeal Letter

By | October 20, 2014

An individual when filling the claim for the dental insurance needs to write a letter to the insurance company and the letter is called the dental insurance claim appeal letter. A dental insurance claim appeal letter template is the readymade document that provides structure for framing such letters.

Sample Dental Insurance Claim Appeal Letter:



__________________ [Name the individual authorised in the insurance company]

__________________ [The job title the authorised individual holds]

__________________ [Full name and correspondence address of the insurance company with whom the claim appeal is being filed]


Date: __/ __/ ____ [Date stamp of letter writing]

Subject:­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________ [Subject i.e. the compact statement of the purpose of the letter]

Respected _______________ [full name of the addressed authorised official]

I am ________________ [Sender’s own full name] and I have a dental insurance policy with _________________ [name of the insurance company].

I have recently got some ________________ [name of the surgery/ treatment] surgery/ treatment done from _______________________ [official name of the dentist or dental institution from where treatment was gotten]. This is an appeal letter to claim a full insurance for the amount of ___________________ [the amount of the bill paid by the claimant] i.e. the amount that I have paid for getting the treatment done. For confirmation purposes I have enclosed attested copies of the bill.

I urge you to look into the appeal and clear my insurance claim to the earliest. I can be contacted on ___________ [give contact details] for any further information is needed from my side.


___________________ [name of the claimant]

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