Signal Iduna

Form data processing agreement


Please complete the form below to receive your health insurance services

I declare on my own responsibility that I have taken note of the content of the Information Note, as found on (Data Protection Policy section), the Signal Care Assistant mobile application (Terms & Conditions section), the guide of the Insured or the Information Note made available through the Contractor and compel me to forward it to all the persons for whom I request the insurance, in order to inform them correctly,

I understand that my personal and health / medical data and / or people for whom I request insurance are absolutely necessary SIGNAL IDUNA ASSURANCE REASIGURATION S.A. and that refusal to provide them may limit access to medical services provided through the insurance contract,

I AGREE that SIGNAL IDUNA REASIGURANCE INSURANCE SA, either directly or through an associate (eg insurance brokers / healthcare providers) , collects, processes, transmits and store health / medical status data for the purpose of performing the contract / insurance contracts, according to the Information Note.

I AGREE with the same provisions for my minor addict / addict (if appropriate).

I agree to the use of personal data for commercial and marketing purposes and to receive any marketing information through any communication channel, without limitation to email, SMS, telephone, post and any other present and / or future means of communication. The marketing agreement does not limit access to medical services.