A claim under a personal accident policy or cover for death, disability or injury caused by an accident.
TO: The Claims Manager __________ __________
FROM: __________ __________ Phone: __________
SUBJECT: Personal accident claim under policy no. __________ for __________
Sir / Madam,
1. THE POLICY AND THE INSURED PERSON
1.1 I write as __________. The insured person is __________, who is covered with you under __________, policy no. __________.
2. THE ACCIDENT AND ITS RESULT
3. WHAT I ASK YOU TO DO
3.1 Please register this claim, give me the claim number in writing, send me your claim form, and tell me in one list every paper you still need, with the name and number of the officer handling the claim.
3.3 If you reduce or reject any part of the claim, please give me each deduction or reason in writing, with the clause of the policy you rely on.
4. WHERE TO PAY
5. WHAT I CONFIRM
5.1 What I have written is true to the best of my knowledge, and I have kept back no fact that you would reasonably want to know. I will give you the papers listed below and any further paper you reasonably ask for.