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BVBA E. Laureys
Home
Menu
Our Team
Our vision
Insurance
Insurance
Private individuals
Self-employed & SMEs
Associations
Offer
Private individuals
Self-employed & SMEs
Calculate your price
Extra
Useful links
Digital
Available Apps
Stappenplannen
Damage
Information
Documents
Report damage
Contact
News
Language
Nederlands
English
Français
Quotation IP Manager
Step
1
of
5
20%
Policyholder
Company name
*
Legal form
LTD
PLC
LLP
CCLL
Limited partnership
Other
Address
Street Address
City
ZIP / Postal Code
Company number
(If in formation: type IF)
Start date company
DD slash MM slash YYYY
Beneficiary (manager)
Name
First
Last
Address
Street Address
City
ZIP / Postal Code
Email
*
Date of birth
DD slash MM slash YYYY
Place of birth
Sex
M
F
X
Marital status
Married
Legally cohabiting
Practically living together
Single
Smoker
No
Yes
Employment (%)
Please enter a number less than or equal to
100
.
eg. 100%
You are employed in the company since (date)
DD slash MM slash YYYY
How much time do you spent on administration / management
(relative to your total hours that you make for the company)
When do you plan to retire
Age of 65
Age of 60
Detailed description profession
Sports activities
None or harmless sport
Scuba diving
Martial arts
Climbing sports
Parachuting
Sports with airplane
Bungee jumping
Automobile or motorcycle racing
Water racing
Sailing trips on long distance
Stuntman
Career
Started to work
DD slash MM slash YYYY
Till
DD slash MM slash YYYY
Statute
Employee
Indépendant
From
DD slash MM slash YYYY
Till
DD slash MM slash YYYY
Statute
Employee
Indépendant
From
DD slash MM slash YYYY
Till
DD slash MM slash YYYY
Statute
Employee
Indépendant
From
DD slash MM slash YYYY
Till
DD slash MM slash YYYY
Statute
Employee
Indépendant
Preferred guarantee
Pension build-up
Do you wish to build up a pension?
Yes
No
Tax maximum
or
Fixed amount
Guaranteed Income (Sickness & Accident)
Do you want to insure for Guaranteed Income?
Yes
No
Until when do you want to insure for this?
Age of 65
Age of 60
Own risk period
1 month
2 months
3 months
6 months
12 months
Period that you may/wish to bridge yourself in the event of incapacity for work, without the intervention of this insurance. (Of course: premium-setting)
Passing away
Do you wish to subscribe for a Life Insurance?
Yes
No
Desired capital
Eg: Single: 25.000 € / Family: 200.000 €
Double capital Life Insurance if you die due to a sudden accident?
Yes
No
Premium exemption
Do you wish to insure the guarantee 'premium exemption'?
Yes
No
If you are unfit for work: the company will pay your premiums for pension formation + death for you, as you may then have less income.
Payments
Distribution
Monthly
Quarterly
Half-yearly
Yearly
Comments
This field is for validation purposes and should be left unchanged.
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