Insurance Authorization Letter Template for Netherlands

1. Medical Information Release: Required when authorization involves access to medical records or health information

2. Third Party Authorization: Include when authorizing someone other than the policyholder to act on their behalf

3. Specific Procedure Details: Required for pre-authorization of specific medical procedures or treatments

4. Time Limitation Statement: Include when the authorization has a specific expiration date or time limit

5. Language Selection: Required when the policyholder needs documentation in both Dutch and English

1. Copy of Insurance Policy: Attachment of relevant insurance policy documentation

2. Identification Documents: Copies of required identification documents (passport/ID card)

3. Medical Documentation: Any relevant medical reports or documentation supporting the authorization request

4. Power of Attorney: If applicable, documentation authorizing a third party to act on behalf of the policyholder

5. Consent Forms: Any additional consent forms required by the insurance company or healthcare provider