The application for mediation of the benefit case requires the applicant to fill out the petition stating the following matters with his attorney's or his own signature or seal:
I. The applicant's name, date of birth, dwelling place, temporary living place and ID No. If the applicant is a corporation or an organization with managers or representatives, the corporation or organization's name, office or business address and the manager or representative's name, date of birth, dwelling place and temporary living place.
II. If the applicant has an attorney, he or she shall present a written form of authorization at the first place of application for mediation conduct. The authorization paper shall include the attorney's name, date of birth, dwelling place, temporary living place and ID No.
III. Claims
IV. Facts and reasons for mediation application
V. The date of receiving or knowing the insurer's original evaluation notification (MM/DD/YY)
VI. The evidence. If the evidence is a written document, the transcript or copy is required.
VII. Transcripts or copies of the insurer's original evaluation notification document and the related documents or materials
VIII. MM/DD/YY
The Subparagraph 4 of the preceding paragraph, facts & reasons shall be stated respectively and the related arguments shall be stated one by one; if the applicant is a foreigner, a Chinese version is required.

The insurer shall present the position paper stating the following matters in accordance with Paragraph 2, Article 8
I. The reasons not stated in the original evaluation notification documents.
II. The facts or legal arguments of the mediation application and the insurer's opinions.
III. Comments on all the arguments put forward by the applicant; those who hold the converse opinion shall attach the reasons to the position paper.
IV. The evidence available for the original evaluation notification.

The applicant shall apply to the NHI Dispute Mediation Committee in written form for reading, transcribing, copying or shooting the related documents with the exception of the following documents:
I. Draft documents for approval
II. Preparation or mediation documents for approval
III. Documents kept secret to protect the third party's legal rights and interests.
IV. Other documents kept secret based on laws or public benefits.

If necessary, the NHI Dispute Mediation Committee shall inform the applicant to express his or her opinions at the given place on the given day in conformity to the legal procedures and the application of the applicant.

One of the following cases will invalidate the mediation approval of the benefit case:
I. The petition unconformable with the legal procedure is unable to be corrected or fails to be corrected within the given period.
II. Overdue applications for mediation
III. Those who are not set forth in Paragraph 1, Article 3 put forward the application.
IV. Nonexistence of the original evaluation notification
V. Reapplications of mediation of an approved or withdrawn case.
VI. Disputes not concerning the matters referred to in Article 2.
If the invalid mediation approval referred to in Subparagraph 1 or 2 of the preceding Paragraph can prove that the original evaluation is illegal, the insurer or his higher authorities shall withdraw or modify the original evaluation in conformity to the legal procedures.

The NHI Dispute Mediation Committee shall disallow the mediation approval for those who put forward applications without reasons.
The NHI Dispute Mediation Committee shall withdraw all or one part of the original evaluation for those who put forward applications with reasons; and shall approve the evaluation modification directly or return it back to the insurer for re-evaluation within the given days according to the status.
If the insurer presents a position paper not in detail or fails to presents a position paper within the given days, the NHI Dispute Mediation Committee shall carry out the mediation approval directly in conformity to the legal procedures.

The approved benefit case requires the approval paper stating the following matters:
I. The matters referred to in Subparagraph 1, Paragraph 1, Article 14.
II. Texts, facts and reasons, among which the facts shall only cover the arguments, the invalid mediation approval referred to in Paragraph 1, Article 18 may not state facts with this Subparagraph as a proof.
III. The agency and its leading officer.
IV. MM/DD/YY
The approval paper shall state remedies, time limit and competent authorities for noncompliance.