These sample letters can be used in various circumstances you may encounter that require you to communicate with insurance companies. Insured's ID Number.(Patient's Medicare Health Insurance Claim Number - HICN). A policy in which the insured and the insurer agree on the value of the property insured, that value being payable in the event of a total loss. The. Below is an outline of the Small Vessel Sea Service Form. Please read the form carefully. Clicking on the links will take you to information such as claims filing instructions, printable forms, and examples of certain required documentation. Please show your Blue Cross and Blue Shield identification card to the hospital or doctor. Most providers will file for you. Your "Evidence of Coverage" (EOC) provides details about what the plan covers, how much you pay, how the plan works, and more.