Information on the insured persons

    First name*

    Surname*

    Street*

    Place*

    Date of birth*

    E-mail address*

    Insured persons*

    Your professional situation*

    Product options Special legal protection insurance for cross-border commuters

    Labor law*
    YesNo

    Inheritance and family law*
    YesNo

    Owner-occupied property (apartment or house)*
    YesNo

    Residential unit to be insured*

    Rented property (apartment or house)*

    Motor legal protection for*

    Do you accept restrictions?

    Deductible*
    YesNo

    Other notes

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    I have read the privacy policy. I agree that my details will be stored permanently for the purpose of contacting me and for queries.