Application for Clearance of Medical Bills

Application for Clearance of Medical Bills

The Finance Manager/Accounts Manager/Higher Authority,

Organization Name….



Subject: Request for Clearance of Medical Bills


Respected Sir/Madam,


With due regard, it is stated that I have submitted the medical bills of my (family member) treatment one week ago. According to company’s policy I am provided with the medical allowance and medical bills payment facility after probation period. As it’s been a year working here and being permanent employee now, I want to benefit the facility.

Recently, my (family member) was admitted in hospital due to her (disease name) and the bills are to be cleared by company’s panel. It is requested that kindly clear the submitted bills as soon as possible owing to hospital’s rules and regulations. Copies of bills are attached with the application. I shall be obliged for this and will remain beholden.


Thanking you ahead of time.


Yours Sincerely,

Name of Employee….

Jon Designation….

Date with Sign…..