To issued by you in respect of

To The Branch Manager (Insurance Company) (Address) Ref: Sad demise of my husband ____________ who was the holder of Insurance Policy No. Dear Sir, With extreme regret I have to inform you that my husband ____________ who was the holder of Insurance Policy No. ____________ expired on ____________ (Date).In this connation, I am enclosing the death certificate dated____________ in original, since I, the undersigned, am the nominee of the said Policy, as mentioned therein; I am the legal claimant of the insured amount of the Policy after the death of my husband. To this effect I am sending herewith the certificate dated ____________ issued by the local Councilor, Apart from the above, I am also sending herewith the following documents: (a) Policy No ____________ in original, (b) Receipt issued by you in respect of last premium paid.

I would now request you to take expeditious action in sending cheque for ____________ (Amount) towards the insured amount of the Policy to our Banker for crediting to our Savings Account, under intimation to me. The name and address of our Banker and Savings Account No. are as follows: ____________ (Banker Name) ____________ (Bank Name) Savings Account No____________ Thanking you, Yours faithfully, (Your Name)

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