To,

Terry Rod

Claims Department Head

Feel Good Health Insurance

45 Irish Type Street

North Carolina, North Dakota 7890

Dated: 12^th of February 2012

Subject: Claim for my medical expenses

Respected Mr. Rod,

I am writing this letter to claim for the amount that I had incurred as medical expenses in the beginning of this month. I am a holder of medical insurance in your organization with policy number being MI-099-9999-978.

I experienced chest pain on 2^nd of February 2012 and as a result I had to be admitted in a hospital for various tests which includes ultra sonography and a cardio test. The hospital in which I was admitted is BM Cardio which is a registered hospital in your medical list.

I would request you to look into this matter and compensate me with the amount spent. I am enclosing the medical bills as well as test reports along with the letter.

Regards,

John Mayo.