AIDWORKER - Private
Extension of Existing Contracts

Your two steps to purchase insurance online:

1. Fill in the application.

2. Check your entries on page 2 and confirm your application.

You will immediately receive your insurance certificate. In addition, we will send you an email with the certificate to the email address you entered.

Details about the applicant:
Address 
Title 
First name 
Family name 
Company 
Street and house number 
Postal code 
City 
Country 
Email 
Telephone 
Data of the person to be insured:
Address 
First name 
Family name 
Date of birth  . .  
Home country 
Term of the insurance and previous insurance:
This insurance can only be concluded as a connecting insurance and needs to commence immediately after the previously existing insurance. Please enter the entire period of the stay abroad:
Start of insurance and travel start date within the existing insurance policy  . .  
Start of AIDWORKER-insurance  . .  
End of insurance  . .  
Destination 
Sending organization / Previous insurance
(Through which organization was the insured person sent to the developing country?)
Premium and scope of coverage:
Premium/day AIDWORKER
1,88 € AW24 - Foreign Travel Health Insurance, AW-H1 - Personal and public liability Insurance, AW-U4 - Accident Insurance including infections and tropical diseases
Method of payment:
In the following methods of payment the total sum will be debited.
After insurance conclusion you will be redirected to SIX Payment Services (Europe) S.A.
 
Six/Saferpay 
 
Alternatively you can pay by using the SEPA direct debit scheme.
 
Payment by SEPA direct debit 
I hereby authorize DR-WALTER GmbH to collect payments from my / our account by direct debit mandate. I further instruct my bank to pay the direct debits drawn on my / our account by DR-WALTER GmbH.
Payment 
The total amount will be debited in the form of a single payment from the given account.
Account holder 
IBAN 
BIC 
Name and domicile of financial institution 
 
DR-WALTER GmbH, Eisenerzstr. 34, 53819 Neunkirchen-Seelscheid, Germany / Creditor Identifier: DE76ZZZ00000887121 / Mandate Reference: your insurance policy number
Space for special notes:
 
Do you require advice?
Your contacts:
Gruppenvertrag
Our Corporate Clients team
will be happy to assist

T +49 2247 9194 -994
F +49 2247 9194 -40
E info-remove this text- (at) aidworker.de