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  . .  
(Maximum age 69 years)
Home country 
Duration of cover:
Date of arrival  . .  
Start of insurance  . .  
End of insurance  . .  
The maximum duration of insurance is one year. If the policy is purchased within one month after entry, the contract can be concluded for a maximum period of two years.
Premium and scope of coverage:
Monthly premiums Individuals up to 29 years Individuals up to 69 years
Purchase of insurance before or within one month after entering the country of destination (1st to 12th month) 38,50 € 64,00 €
Purchase of insurance within one year after entering the country of destination (up to 12 months) 54,00 € 85,00 €
Purchase of insurance before or within one month after entering the country of destination (13th to 24th month) 58,50 € 111,00 €
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 monthly or in one sum 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.
Please choose between one lump sum payment or monthly payment.
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 -981

Mon-Fri: 8 am to 6 pm