Letter Regarding Insurance Policy Stipulations And/Or Decision

[Your letterhead, if desired; if not, your return address]

[Date of letter-month, day, and year]

[Recipient's first and last names]
[Company name]
[Street or P.O. box address]
[City, State ZIP code]

Dear [recipient's name]:

We are writing regarding your homeowner's insurance claim number 3289389293 dated February 16, 2011. This claim pertains to a loss at your primary residence, which is insured by our company, on January 30, 2011. Per the stipulations on your homeowner's insurance policy number 89898829 with our company, this loss is not covered. Should you wish to appeal this decision, please send a formal written letter within the next 30 days to the address listed on this letter.

If you have any questions or need further information, call (800) 343-1212 between the hours of 8 a.m. and 5 p.m. EST.

Sincerely,

[Signature]

[Sender's first and last names]