Your reliable
     health insurance partner abroad
Care Economy
Health insurance abroad for foreign visitors
Service
Care Concept AG
- Vertragsabteilung -

Postfach 33 01 51

53203 Bonn

Fax-no.: +49 (0)228 - 977 35 911 | e-mail: 
25.05.2013

 
Policy number
  Termination of the Policy - Kündigung Care Economy

Policyholder
Salutation First name Last name
Insured person
Salutation First name Last name born on:
Contact information
Street , no c/o Postal code City Country

Dear Sir or Madam,

I hereby give notice of termination of the above-mentioned insurance policy, because of on the
  effective as of .... or at the earliest possible date. Please send written
  confirmation of termination of the policy to the above-mentioned address.


An appropriate certification (e.g., travel documents) is enclosed  
Documentation cannot yet be provided, because

Faithfully yours,

 ________________________________

Date, signature of the insured person(bei minderjährigen Personen Unterschrift des gesetzlichen Vertreters)

Auslandskrankenversicherung - Ecke Links untenAuslandsversicherung - Ecke Links UntenAuslandsversicherung - Bogen Links UntenAuslandsversicherung - Bogen rechts UntenAuslandsversicherung - Ecke rechts Unten
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