Explicit statement:
  1. Waiver of confidentiality
    I am aware that, when assessing its duty to pay benefits, the insurer also checks information that I give as grounds for any claim or derived from documents I submit (e.g. medical or other certificates) or reports I have instigated from a hospital or member of a medical profession.
    For this purpose, I hereby release these members of a medical profession or medical institutions named in the documents submitted, or that were involved in the treatment, from their duty of confidentiality.
    I also waive confidentiality for the purposes of examining claims in the event of my death. This waiver of confidentiality also extends to members of other accident, health or life insurers who may be asked about any insurance policies existing with them. Die betroffene Person kann jederzeit verlangen, dass eine Erhebung von Daten nur erfolgt, wenn jeweils in die einzelne Erhebung eingewilligt worden ist.

  2. Empfangsberechtigung der Versicherungsleistungen
    Der Versicherungsnehmer ermächtigt den Versicherer, die Leistungen aus diesem Vertrag gegebenenfalls auch mit der versicherten Person oder Behandlern etc. direkt abzurechnen.

  3. Consent under the German Data Protection Act (Bundesdatenschutzgesetz)
    I hereby consent to the insurer passing on data derived from the application documents or related to the fulfilment of contract (premiums, insured events, changes in risk/policy) to reinsurers for the insurers and/or to the “HUK Verband” (Verband der Haftpflichtversicherer, Unfallversicherer, Kfz-Versicherer und Rechtsschutzversicherer e. V.) and to the Verband der privaten Krankenversicherung e. V. for passing on of such data to other insurers.
    Irrespective of how the policy came about, this consent also applies to appropriate checks in the case of (insurance) contracts applied for elsewhere and future applications.
    I also consent to the companies of the HanseMerkur Versicherungsgruppe maintaining my general application, policy and benefits data in joint collections of data and passing them on to intermediaries responsible for me insofar as this serves orderly handling of my insurance matters.
    Medical data may only be passed on to personal insurers and reinsurers; they may only be passed on to intermediaries to the extent this is necessary for the policy to be drawn up.
    Without prejudice to the policy, I also consent to such intermediaries using my general application, policy and benefits data for consulting purposes for other financial services (please let us know in written form by e-mail, fax or post, if not wanted).
    I may revoke such consent at any time. Such consent applies only when I had reasonable opportunity to become familiar with the content of the information on data processing.
    You will find this information down below. I may reject further advertising measures in writing or by telephone. This wish will be respected following a period necessary for technical/organizational implementation.

Note: Only the German wording of this text is legally effective.

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