Regarding: just for insurance numbers, which begin with B07.
Extension application must be sent before expiration of insurance.
Versicherungsnummer Care Expatriate
Extension application before expiration of insurance/Gesundheitsfragen - Care Expatriate
Dear Sir or Madam,
I hereby request an extension of
months for the above-mentioned insurance policy. The policy was originally to expire on ...
.
Please send me a written confirmation of the policy extension.
Hereby I give you the following information:
Have there been any medical treatments or examinations since expiration of the insurance or are any of those planned or recommended? Ja Nein
Do any complaints/illnesses or – in case of female persons – does a pregnancy exist at present? Ja Nein
Only for sojourn in Germany: Do you plan to stay longer than 5 years in Germany? Ja Nein
If any of the question 1. + 2 was answered with „Yes“, we need more details (type of complaints / disease, date / time period, name, adress of physician):
If you need more place for description, please use a separate sheet of paper!
I confirm that I have answered the questions completely and truthfully. I am aware that the insurer may rescind the policy in the event of false or incomplete information and that I may lose the right to benefits under the policy. I have noted and understand the legal consequences set out below.
Legal consequences: The insurer's right to rescind the policy is precluded if the policyholder has breached his duty to notify neither with malicious intent nor in gross negligence. In this case, the insurer has the right to cancel the policy with notice of one month. The insurer's right to rescind the policy and its right to cancel as set out above are precluded if it would have issued the policy in knowledge of the circumstances not reported, even if under other conditions. At the request of the insurer, such other conditions shall form an essential element of the policy from the current insurance period in the event of a breach of duties for which the policyholder cannot be held responsible.
