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Require Evidence for Sickness Insurance Claim

Sickness/Injury

This document can be used as a template to claim damage due to a work injury. It sets out the particulars of the damage and the reasons why the damage occurred. This document can be used by the general workers/workmen. 

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01

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02

Fill Information

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03

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04

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Document Description

The document titled 'Require Evidence for Sickness Insurance Claim' is an important document that is used to request evidence for a sickness insurance claim. The document begins with the account holder's personal information, including their first name, last name, job, and company. It also includes the current date.

 

The document is addressed to a doctor and serves as a request for completion of an enclosed claim form for benefits during the period the account holder was in the hospital and later in a nursing home. The account holder has already filled in some details on the form to assist the doctor.

 

The document also mentions that the account holder has attached accounts covering both hospital and nursing home accommodation, specifying the start and end dates for each. The company requires the completed claim form to be returned to them, and the document includes an addressed envelope for this purpose.

 

The account holder requests the doctor to contact them if there are any queries.

 

Overall, this document is crucial for the account holder to provide evidence for their sickness insurance claim and request the doctor's assistance in completing the necessary form.

How to use this document?


To use the 'Require Evidence for Sickness Insurance Claim' document, follow these steps:

 

1. Fill in the account holder's personal information, including their first name, last name, job, and company.

2. Review the document and ensure that the current date is accurately stated.

3. Address the document to the appropriate doctor who treated the account holder during their hospital and nursing home stay.

4. Indicate that the purpose of the document is to request completion of the enclosed claim form for benefits.

5. Mention that the account holder has already filled in some details on the form to assist the doctor.

6. Attach the necessary accounts covering both hospital and nursing home accommodation, specifying the start and end dates for each.

7. Enclose an addressed envelope for the completed claim form to be returned to the company.

8. Request the doctor to contact the account holder if there are any queries.

 

By following these steps, the account holder can effectively use the document to request evidence for their sickness insurance claim and facilitate the completion of the claim form by the doctor.

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