Grant Health Insurance

Conclusion

Homecountry

funnel::countries.

Promotion insitute

Date of birth

04/30/2024

Date of entry

04/30/2024

Planned return date

04/29/2029

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no additional insurance

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E-mail

Salutation

funnel::funnel.gender.values.

Name

Telephone

Nationality

funnel::countries.

Passport number

Address

Not specified

Bank Details

Not specified

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Booking comment

Right of Revocation

I have taken note of revocation as well as read and accepted the the general insurance conditions and customer information.

Exemption from Compulsory Health Insurance

I hereby apply - if necessary - for exemption from compulsory health insurance. I apply for a private comprehensive health insurance instead of a membership in a public health insurance. The exemption is valid for the entire period of my studies, also with respect to other health insurance companies. The exemption cannot be revoked.

DEGIS Membership

I agree that DR-WALTER will register me with DeGIS (German Society of International Students) free of charge.

Data Protection

I consent to the insurers and DR-WALTER GmbH as far as it serves the duly accomplishment of my insurance matters to record general contract data, contribution data and insurance cases in data pools. I have noted of the data protection information.

Product Information Mail

We would like to contact you by email from time to time for product recommendations and reviews. With your check mark you agree to this. You can object to this consent in writing at any time. Please contact for this info@dr-walter.com.

Signature of Contract

Grant Health Insurance

Conclusion

Duration of the insurance

Additional insurances

Insured person