Online conclusion in 2 steps:

1. Carefully complete the application form.

2. On page two double-check your indications and confirm the application.

You will immediately receive your cover note. Shortly after, we will send an e-mail confirmation to the address indicated by you.

Details about the applicant:
First name 
Family name 
Street and house number 
Postal code 
Data of the person to be insured:
First name 
Family name 
Date of birth  . .  
Home country 
Duration of cover:
Date of arrival  . .  
Start of insurance  . .  
End of insurance  . .  
The insurance should be taken out before leaving the home country. However, it can also be taken out ten days after entry.
Premium and scope of coverage:
up to 64 years
Persons aged
65 years or older
Minimum premium: 20,00 €
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.
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.
The total amount will be debited in the form of a single payment from the given account.
Account holder 
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?
If you have any questions, please feel free to contact us:

Phone: +49 2247 9194 -982

Mon-Fri: 8 am to 6 pm