Please complete the form below to receive your health insurance services
declar pe propria raspundere ca am luat la cunostinta continutul Notei de Informare, astfel cum se regaseste pe www.signal-iduna.ro (sectiunea politica de protectie a datelor),
aplicatia mobila Signal Care Assistant (sectiunea termeni si conditii), ghidul asiguratului sau Notei de Informare pusa la dispozitie prin intermediul Contractantului si ma oblig sa o transmit tuturor persoanelor pentru care solicit asigurarea, in vederea informarii corecte a acestora,
I declare on my own responsibility that I have taken note of the content of the Information Note, as found on www.signal-iduna.ro (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,
inteleg ca datele mele cu caracter personal si cele privind starea de sanatate / medicale si / sau ale persoanelor pentru care solicit asigurarea sunt absolut necesare SIGNAL IDUNA ASIGURARE REASIGURARE S.A. si ca refuzul de a le furniza poate limita accesul la serviciile medicale oferite prin intermediul contractului de asigurare,
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.