Health Insurance Termination Letter

[Sender’s Name]

[City, State and Zip Code]

[Email Address]

[Date]

[Insurance Company’s Name]

The Health and Life Insurance Department

[City, State and Zip Code]

[Mobile/Fax Number]

Re: Health Insurance Cancellation

To Whom It May Concern,

I am writing to inform you that I, [Sender's Name] of health insurance policy number [#], have decided to terminate my policy. This termination will take effect from [Date] after the final premium payment.

The reason for my insurance termination is [Reason for Termination]. The decision has been arrived at after several consultations and evaluations. Please send a written confirmation of cancellation and removal of my information from your system upon receipt of this letter.

Please pay any surrender amounts to my account, [Account Nummber]. Please complete this request as soon as possible.

Sincerely,

[Sender’s Signature]

[Sender’s Name]