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French Loan Insurance

French Loan Insurance - Free Quotation Form


Please fill out the loan insurance quotation form below.

The form below must be filled in COMPLETELY for a quote to be formulated.


1. PERSON(S) TO INSURE
Insured 1:


(dd/mm/yy)

Occupation:
 
Insured 2:
Last name:


Date of birth: (dd/mm/yy)

 First name:


Occupation:
 
Address:


Post Code:


Fax no.:

 Town:


Telephone no.:


Mobile no.:

2. CHARACTERISTICS OF LOAN(S)
Nature of loan (depreciating, fixed rate or variable): Duration of
Credit (years)		 Interest rate
of loan		 Initial amount of loan in € Quota
(% to insure)		 Sum to be insured in € (amount of the loan x quota)
1.
2.
3.
Total sum to be insured:
Name of loan organisation:


Address:


Fax no.:

3. COVER REQUIRED
  Death/Permanent & Total Incapacity Sick Leave / Illness
(over 90 days)
Insured 1: YES Yes   No
Insured 2: YES Yes   No

Receive relevant information from third parties?
Yes   No

Note: This form is not an insurance application. It is solely for the purpose of calculating an estimate at a standard rate for your information.

 

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