This form is a sample letter in Word format covering the subject matter of the title of the form.
[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Insurance Company Name] [Insurance Company Address] [City, State, ZIP] Subject: Notice of Cancellation — Insurance Policy [Policy Number] Dear [Insurance Company Name], I am writing to officially request the cancellation of my insurance policy [Policy Number], effective [cancellation date]. I regret to inform you that due to unforeseen circumstances, I am no longer able to continue with this policy and coverage provided by your company. As per the terms and conditions outlined in our policy agreement, I am adhering to the specified notice period of [number of days] days required for cancellation. Reason for Cancellation: [Explain the reason for the cancellation in detail. This may include changes in personal circumstances, financial struggles, or the availability of a more suitable insurance policy from another provider.] Replacement Insurance Coverage: [If applicable, provide details regarding the new insurance policy you have acquired to replace the one being canceled. Include the policy number, effective date, and the name of the new insurance provider.] Refund Information: [I would like to request a refund for the remaining unused premium. Please provide the details of the refund process, including any necessary paperwork or documentation that needs to be completed on my end.] Contact Information Update: [If there are any changes in your contact information, such as address, email, or phone number, provide the updated details to ensure effective communication.] Please confirm the cancellation and the refund request in writing and provide the acknowledgment of the same at your earliest convenience. If there are any additional steps or information required from my end, please let me know promptly. I appreciate your prompt attention to this matter. Your insurance services have been satisfactory in the past, and I will consider your company for any future insurance needs. Thank you for your understanding and cooperation. I look forward to receiving the confirmation and finalizing the cancellation process accordingly. Sincerely, [Your Name]
[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Insurance Company Name] [Insurance Company Address] [City, State, ZIP] Subject: Notice of Cancellation — Insurance Policy [Policy Number] Dear [Insurance Company Name], I am writing to officially request the cancellation of my insurance policy [Policy Number], effective [cancellation date]. I regret to inform you that due to unforeseen circumstances, I am no longer able to continue with this policy and coverage provided by your company. As per the terms and conditions outlined in our policy agreement, I am adhering to the specified notice period of [number of days] days required for cancellation. Reason for Cancellation: [Explain the reason for the cancellation in detail. This may include changes in personal circumstances, financial struggles, or the availability of a more suitable insurance policy from another provider.] Replacement Insurance Coverage: [If applicable, provide details regarding the new insurance policy you have acquired to replace the one being canceled. Include the policy number, effective date, and the name of the new insurance provider.] Refund Information: [I would like to request a refund for the remaining unused premium. Please provide the details of the refund process, including any necessary paperwork or documentation that needs to be completed on my end.] Contact Information Update: [If there are any changes in your contact information, such as address, email, or phone number, provide the updated details to ensure effective communication.] Please confirm the cancellation and the refund request in writing and provide the acknowledgment of the same at your earliest convenience. If there are any additional steps or information required from my end, please let me know promptly. I appreciate your prompt attention to this matter. Your insurance services have been satisfactory in the past, and I will consider your company for any future insurance needs. Thank you for your understanding and cooperation. I look forward to receiving the confirmation and finalizing the cancellation process accordingly. Sincerely, [Your Name]