How to write the application for social security for hospital employees?

So-and-so medical insurance bureau leader:

Hello!

I am the insured (ID number or medical insurance number). I was admitted to the hospital because of a certain disease. Because I was seriously ill, the medical expenses have exceeded 10 thousand, which is really beyond my family's affordability. Please take care of the leadership and reimburse me.

(It can be written a little more sensational)

I am here to convey

Salute!

Applicant: XXX

Date of application: year month day

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.