A policyholder's request to cancel a new policy in its free-look period, or to surrender a policy for its value.
Date: 1 April 2026, at Ludhiana
TO:
The Manager, Policy Servicing
ABC General Insurance Company Limited
Regional Office, SCO 25, Sector 17-E, Chandigarh 160017
FROM:
Harjinder Singh Gill
House No. 412, Sector 38-A, Chandigarh 160036
Phone: 98765 43210
Email: harjinder.gill@example.com
SUBJECT: Request about policy no. P/141234/01/2026/003318
Sir / Madam,
1.1 I hold a life insurance policy, number P/141234/01/2026/003318, issued by you on 2 April 2026. I have paid premiums of ₹50,000 (Rupees Fifty Thousand only) in all.
1.2 The original policy document is enclosed.
1.3 No loan has been taken against the policy and it has not been assigned to anyone.
2.1 I cancel the policy within the free-look period and ask for the premium to be refunded.
2.2 I received the policy document on 3 April 2026, and I make this request within the free-look period that the policy allows.
2.3 My reason for not accepting the terms is: The premium payment term and the exclusions were not explained to me when I bought the policy.
2.5 I understand that you may deduct only what the policy and the rules allow, and I ask you to show each deduction in writing with the clause of the policy for it.
3.1 Please act on this request, register it from the day you receive it, and confirm in writing the date on which the policy ends.
3.2 Please tell me the amount payable and how it is made up, and send me no further premium notice.
3.3 Please pay the amount by transfer to the account held by Harjinder Singh Gill with HDFC Bank, Sector 40, Chandigarh, account ending 3391. I will give the full account number on your own form, not in this letter.
4.1 I am the policyholder and I sign this request myself. What I have written is true to the best of my knowledge.
- 1. Original policy document. 2. Insurer's surrender form, filled in. 3. Identity proof. 4. Cancelled cheque.
Yours faithfully,
_________________________
Harjinder Singh Gill
Policyholder
House No. 412, Sector 38-A, Chandigarh 160036
Date: 1 April 2026