Hardship Letter Examples

   Medical Expedited Appeal

{Your Name}
{Your Address}
{Your Phone #}


Dear {Insurance Representative}:

I am writing with regards to a claim filed by {Provider} on {date} for {Patient}. The claim number is {number} and the total amount billed was {amount}. I have been informed that my disability claim was denied, and therefore all coverage of {claim one} and {claim two} have been denied as well.

The coverage rejection sent to me on {date} indicated that my disability claim was denied due to {reason}. I would like to ask you to reconsider, as I believe that my situation is more severe than you realize. Attached is a physician's statement affirming that my {condition} makes me unable to {work, stand, etc.}. As I am currently unable to work, I have no means of paying my medical bills, making rent, and buying food.

{Brief description of condition and validity of claim}.

If you are unwilling or unable to reconsider this claim, please send me the name and contact information for the representative who rejected my request, as I require further information on the process involved.


{Sender Name}

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Index of Hardship Letter Examples