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Globality Health Form 2015-2023
Application for health insurance
Page 1
Application for health insurance (individual insurance)
Please note: We will not be able to process your application if any columns are left incomplete.
For uncertainty, please refer to General Conditions of Insurance.
I hereby apply for a health insurance contract for the Globality YouGenio® World plan for the persons to be insured as listed below.
A. Policyholders personal details
I act as the policyholder only
I act as both policyholder and insured...
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