TPHI Termination Letter

When terminating your third-party health insurance, you can use this TPHI Termination Letter to inform your insurance company and effect the termination.

[Sender’s Name]

[City, State and Zip Code]

[Date]

[Insurance Company’s Name]

The Health Insurance Department

[City, State and Zip Code]

[Mobile/Fax Number]

Ref: Third-Party Health Insurance Termination Letter

To Whom It May Concern,

This informs you that I will be terminating my third-party health insurance effectively from [Date]. I have the policy number [#] and took out this insurance on [Date].

The reason for termination is [Give Reasons]. I believe this is the right action to take under these circumstances.

Please confirm receipt and contract termination in writing on or before [Date]. Remove all my information from your system to this effect. Your prompt assistance in this matter will be highly appreciated.

Sincerely,

[Sender’s Signature]

[Sender’s Name]