Incident note

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Employer & Policy

Employer

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Policy information

   
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Contact person

   
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Bank account

   
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Company details

   
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Insured person

Personal data

   
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Personal details


   
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Employment data

   
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Working time

   
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Basic contractual wage

   
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Further social insurance

Does the insured person receive a daily allowance or a pension?

   
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Incapacity to work

Incapacity to work

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Comment

Comment for insurance

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Operator help

Do you have any questions about the insurance or policy?

Call 0800 822 022

Do you have any questions about the software?

Sunet-Helpdesk: 041 455 43 09

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Version: 22500