Request Letter Insurance Claim

Sample / Template Request Letter Format for Insurance Claim Form against employee Accident Insurance Policy in word/.doc

RCL/LIC/13-14/

May 03, 2013

The Sr Divisional Manager

LIC India

Voltas House, 45/1 Nariman Point

Mumbai – 587 878

Dear Sir,

Sub:  Intimation Letter

Ref :  Policy No. --------------------------------------

This is to inform you that our employee Ms. Mira Khan – Manager met with an accident on 30th of April 2013, while she was coming to office, where she got various cuts & wound in her body.

You are requested to send us the Claim Form and direct us for other necessary requirements.

Thanking You

Yours Faithfully

For Rocket Sales Ltd

Authorised Signatory