After having filled out the online form, you will receive a printable insurance certificate by e-mail, if all information are complete and valid. You can generally already use this to apply for or extend the visa or residence permit. Help: auxiliary information you will find touching the next to the respective fields.
Enabling JavaScript is required for the application form to work. Below you get specific instructions on enabling JavaScript in your browser. If your browser isn't listed, please consult its help resources. Internet Explorer 6.0+ Click the Tools menu. Select Internet Options. Click the Security tab. Click the Custom Level button. Scroll down until you see the 'Scripting' section. Select the 'Enable' radio button for 'Active Scripting.' Click the OK button. If you see a confirmation window, click the Yes button. Firefox 3.6+ Click the Tools menu. Select Options. Click the Content tab. Select the 'Enable JavaScript' checkbox. Click the OK button.
The policyholder / contracting party is the person concluding this contract for himself or for another person.
If the policyholder’s name is not on the letter box, please enter the displayed name in the field c/o.
If the group to be insured is a family with a maximum of 2 adults until their 65st birthday and children until their 21st birthday, please click on the family rate box above.
Please enter German or Austrian current accounts only, because we can only do direct debit in those countries. In case of the SEPA direct debit method, the premiums due will be collected shortly before the period of coverage to which the premiums due relate. A few days before we will send you a pre-notification. If you choose for payment at once, the entire insurance premium will be collected at the beginning of the period of coverage.
So that we can collect the SEPA direct debit from the indicated account, we need the name and surname of the account holder and a SEPA direct debit mandate. The mandate will be deposited with us as a PDF document to your payment details. You will receive the mandate as a PDF, sent to the e-mail address you provided. Please enter below the data of the account holder:
As part of the SEPA migration enacted by the EU, you must state your BIC instead of your bank code and your IBAN instead of the account number. These can be found, depending on the bank, on your debit card or on your bank statement. If the BIC and IBAN cannot be found out, you can contact us for your support by dialing +49 228 97735-44, +49 228 97735-11 or +49 228 97735-33.So that we can collect the SEPA direct debit from the indicated account, we need a SEPA direct debit mandate. The mandate will be deposited with us as a PDF document to your payment details. You will receive the mandate as a PDF, sent to the e-mail address you provided.
Die Versicherungsprämie kann erst nach der Auswahl des Versicherungsbeginns angezeigt werden.
Tipp for qq-user:To be sure that you receive all documents, please fill in another (not qq-)e-mail in the field for the second e-mail
The fields marked with an * asterisc are not compulsory for conclusion of the policy, but it makes easier to approach you. You won’t get unrequested advertising by e-mail.
By clicking on the adjoining field you are confirming that you have read, understand and agreed the following conditions. At the same time you are confirming that you have printed and / or downloaded the following conditions:
