Refund Letter Format

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Sample Template Example of Request Letter to Insurance Company / Banks/ School for Refund letter Payment / Cash Refund in India in word / .doc


FROM :
Neetu Singh,
14/1 Barah Khamba Raod,
P.O : New Delhi ,
New Delhi – 102 021
MOB: -----------------

To                                                                                                                                                    Dt. 29.11.2013
The Branch Manager,
Life Insurance Corporation of India Ltd
………………………………………….Branch
ADDRESS

Dear Sir,

Sub: My Proposal for a Term Insurance.

I am to inform you that though my permanent resident is in Mumbai, I am working in Delhi for last six years.

In last March, 2013 when I visited Mumbai I have submitted a proposal for  a Term Insurance to your office after filling in the required form  alongwith  one cheque for Rs.9700.00 ( Rs nine thousand seven hundred only ) for the  initial premium  on the proposed policy.

Since I left Mumbai, the medical required for acceptance of the policy could not be done in Mumbai . I was told that medical could be done from Delhi and your local office at Delhi will contact me.

The cheque handed over to LICI representative alongwith the proposal application was realized by you on 28.04.2013 from my SBI Bank ( a/c no ------------- ) Delhi before any medical test . As your Delhi office has not contacted me, the medical test could not be completed  for acceptance of my proposal  and no policy has been issued by you. Meanwhile as I am desirous to have such policy I have already obtained a Term Insurance from other Insurer.

So, I request you for immediate refund of the amount lying with you. For your ready reference I enclose herewith  a photo copy of my account statement showing therein the said amount of Rs.9070.00 , cheque no --------- ( which I handed over to you ) and date of your  realization i.e. 28.04.2013.

I shall deem it a favour, if you please arrange for issue of a cheque in my favour to my above mentioned Mumbai address by registered post.

Thanking you,
Yours faithfully,



( Neetu Singh )
Mobile No. ---------------

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