In case you want to book an insurance for more than 364 days, we would like to inform you that the total period of coverage has to be split into two parts. The first period will cover 364 days and has to be paid with a first invoice. After those 364 days, the second period starts for which you will receive a separate invoice towards the end of the first period. Please note that the rates for the second period are subject to change in case of a price increase!

  • Date Format: DD slash MM slash YYYY
  • Date Format: DD slash MM slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Hidden fields for SF API

  • Module Leads in SF NEW Fields in Lead DB: Salutation__c First_Name__c Last_Name__c Middle_Name__c Organization_Name__c Old fields hidden: LastName company
  • for values see here:
  • This field is for validation purposes and should be left unchanged.

You will receive your invoice via email shortly. After we receive the full payment, we will issue all insurance documents to you via email.