Sample Application for Clearance of Medical Bills. If any employee wants to request for the clearance of medical bills from his company, he may use the provided format of application for clearance of bills. This is possible only in case if company is ready to bear all the medical expenses. Easy format is given below.

Application for Clearance of Medical Bills

The Finance Manager,
Falcons Association.

Subject: Request for Clearance of Medical Bills

Respected Sir,

With due esteem and regard it is stated that I have submitted the medical bills of my mother’s 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 avail the facility.

Recently, my mother was admitted in hospital due to her kidney transplant 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,

Sunny Merchant,
Assistant Finance Manager.
Falcon’s Association.