Insurance Claim Delay Demand Letter PDF

Request a written decision, payment, or status update when your insurance claim has been delayed.

No storage. PDF only. This template is not legal advice.

Claimant details

Provide your contact info for the sender block of the letter.

Full name

Phone (optional)

Email (optional)

Mailing address

Include insurer name, adjuster or department, and mailing address.

Insurer name

Adjuster or department (optional)

Insurer mailing address (optional)

Reference the policy, claim numbers, and timeline dates.

Policy number (optional)

Claim number (optional)

Date of loss (optional)

Claim filed date (optional)

Last contact or update date (optional)

Summarize the delay, what you want in writing, and any response deadline.

Delay summary

Requested action

Response deadline (optional)

Delivery method (optional)

Signature date

Status notes (optional)

PDF downloads to your device to send by mail, email, or portal.

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Review details before sending; nothing here is legal advice or a substitute for local forms.