Globi

Quote Globi Insurance

You act as

Individual student or staff member of an educational institution, college or university
Educational institution, college or university

Home country

Home country of the student or staff member to cover

Your insurance needs

Staying temporarily in the country indicated below
Receiving temporarily a guest from the country indicated below

Main travel destination

Travel purpose

Travel period

from

until

Insurance version

Basic Comprehensive

Coverage type

Full Cover Travel Plus Top Up
(Top Up is only selectable when home country AND destination country are one of AT, BE, CH, CZ, DE, EE, FR, LI, LU, NL)

I declare to have social security in:

Options

Sport (part of comprehensive version)

Travel cancellation

Insurance start date

00h00

Insurance end date

00h00

(days)

Premium

(costs and taxes included)

Please read the

General conditions IPID documentation Privacy statement (GDPR)

Customer

Company name

First name

Company Id

Last name

Nationality

Gender

Male Female X

Birthdate

Address

Postal code

City

Country

Contact person

First name

Last name

E-mail

Repeat e-mail

Phone

Gender

Male Female X

ID/Passport number

ID/Passport valid until

Profession

Employer

Marital status

Partner name

Insured persons

Are customer and insured person the same ?

Yes No

First name

Last name

Birthdate

Gender

Male Female X

Nationality

E-mail

Repeat e-mail

Phone

Holding social security in

Payment Method

Select payment method

Credit Card
Bank Transfer
Direct Debit

I’m aware of the fact that this is a student insurance and can only be used to cover study periods abroad. Leisure activities are therefore not covered, unless the entire study period abroad is also insured. I’m also aware that medical conditions pre-existing to the conclusion of this policy will NOT be covered, unless otherwise agreed (contact the office info@expatinsurance.eu).

I confirm to have read the general conditions and the IPID-information document, and confirm that this policy meets my wishes and needs.

I explicitly confirm to have read the privacy policy and consent to have processed my personal data accordingly.

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