[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]:

I received your letter dated April 5, 2010, which states that my application for health insurance coverage had been denied. Thank you for informing me about this decision. However, I would like to respectfully ask that you reconsider this decision and that you consider me again as a candidate for health insurance coverage.

Although I have a pre-existing condition, my medical care for this condition costs very little in terms of doctor visits and tests. In addition, I do not take any medication for this condition, so there is no medical or insurance expense for medicine involved in managing this condition.

Please let me know if you need additional information from me and whether you have reconsidered your decision. I look forward to hearing from you soon. Thank you in advance for your consideration.

Sincerely,

[Signature]

[Sender's first and last names]