Dear

RE: __(Policy Holder Name)__ - __(Reference #)__

We are now in receipt of your __(payment/medical reports/etc.)__, which fulfills the policy conditions and requirements. Therefore, effective __(date)__, the __(type)__ insurance coverage on the above mentioned policy has been reinstated.

Please be aware that your policy term extends to __(date)__ and includes coverage under the following sections:

List coverage types and amounts here

We refer you to your policy wording for specific details of your __(type)__ insurance coverage.

Yours truly,