Legal analysis: 1. Application for advance payment of insurance certificate: ReportNo.: 1. Time, cause and course of the accident: 2. Information of the injured: name: age: hospital: department: hospitalization number: diagnosis: treatment mode: 3. Prepaid the insured/driver/injured person to apply for compulsory insurance pad to pay the hospitalization expenses of the injured person. Insurer's statement: This payment is paid in advance for compulsory insurance. If the advance amount is greater than the actual compensation amount due to insurance liability, accident liability, change of treatment method, etc., the applicant shall voluntarily return the excess compensation. If you don't take the initiative to return, the insurance company will return the compensation through litigation. All losses caused thereby shall be borne by the applicant. Prepayment Applicant: Date: YY Month Day.

Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations.