Request concerning subsidies

Note

This form is for your requests concerning subsidies. Here you will find the answers to the questions most frequently asked by our policyholders.

Title

Name *

First name *

Date of birth *

Client No.

Address *

Postcode and town *

Telephone number *

Email address *

Message *

Cancel

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Your Customer Area

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Legissana+

Protect your rights in the event of a medical dispute

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