Life is Beautiful Offer

Offers are only saved for registered users.

Request An Offer "Life is Beautiful"

The policyholder & beneficiary

Lastname

Firstname

Birth Date

The insured one

Lastname

Firstname

Birth Date

Relationship between the policyholder and the insured

Request An Offer "Life is Beautiful"

€{{ product.price }}/year

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Request An Offer "Life is Beautiful"

Declaration of good health:

The insured one

Gender

Birth Place

I declare not to be diagnosed or under treatment of a serious illness.

declaration_of_good_health

The policyholder

Gender

Birth Place

I declare not to be diagnosed or under treatment of a serious illness.

declaration_of_good_health

Address of household:

Street

Number

Postal Code

City / Country

Contact

I have a broker

Agent Account at VdH - Vander Haeghen

Email where to send the contract

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Life is Beautiful Offer

The policyholder & beneficiary

The insured one

Declaration of good health:

Address of household:

Contact

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