Insurance Plans
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Traveler Details
Name*
Address*
Date of Birth*
Date Format: DD slash MM slash YYYY
Nationality*
Passport Number*
Please choose an Insurance plan in order to proceed your payment
Number of additional travelers*
Additional traveler 1
Date Format: DD slash MM slash YYYY
Additional traveler 2
Date Format: DD slash MM slash YYYY
Additional traveler 3
Date Format: DD slash MM slash YYYY
Additional traveler 4
Date Format: DD slash MM slash YYYY
Additional traveler 5
Date Format: DD slash MM slash YYYY
Additional traveler 6
Date Format: DD slash MM slash YYYY
Additional traveler 7
Date Format: DD slash MM slash YYYY
Additional traveler 8
Date Format: DD slash MM slash YYYY
Additional traveler 9
Date Format: DD slash MM slash YYYY
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Ce champ permet d'afficher les informations ci-dessous. Il met fin à la section qui affiche ou non les additional travelers
0,00 €
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0,00 €
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Your Summary
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Address |
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Date of Birth |
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Nationality |
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Passport Number |
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Phone |
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Email |
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Country of Departure |
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Country of Arrival |
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Date of departure |
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Return date |
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I accept that Insurte and its partners use my personal data to send me, especially by email, information on their products and services.
You have declared that you have read, prior to any agreement, the
pre-contractual information notice, the insurance product information document
(IPID) and the Terms & Conditions. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You have recognized that the guarantees, as described in the Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data.
You have declared that you have read, prior to any agreement, the
pre-contractual information notice, the insurance product information document
(IPID) and the Terms & Conditions. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You have recognized that the guarantees, as described in the Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data.
You have declared that you have read, prior to any agreement, the
pre-contractual information notice, the insurance product information document
(IPID) and the Terms & Conditions. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You have recognized that the guarantees, as described in the Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data.
You have declared that you have read, prior to any agreement, the
pre-contractual information notice, the insurance product information document
(IPID) and the Terms & Conditions. You agree that the entire purchasing process is online, including your consent and that you will not receive a paper version. You have recognized that the guarantees, as described in the Terms & Conditions, constitute a solution adapted to your needs and requirements. You have thus agreed to take out the Visa travel Insurance Contract and to authorize the processing of your personal data.
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For Visa, MasterCard and Discover (left), the 3 digits on the back of your card.
For American Express (right), the 4 digits on the front of your card.

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