Interim accident insurance registration

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Query about interim insurance*

New policy

Extension of existing interim insurance

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Personal information

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Title*

n/a

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Name

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First name

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Address

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Postcode

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Place

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E-mail

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Telephone

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Date of birth

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Working time

If your weekly working time is less than eight hours per week, it is not possible to take out interim insurance.

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Did you work at least eight hours a week at your last employer?*

Yes

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Most recent employer

To take out interim insurance with ÖKK, you must have already been insured against non-occupational accidents with ÖKK at your most recent employer.

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Name

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Address

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Post code

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Place

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Policy no.

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Extension

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Last day with salary entitlement

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The date may not be more than 31 days in the past (subsequent cover). If the subsequent cover is more than 31 days in the past, it is not possible to take out interim insurance.

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Cover from (1st day after subsequent cover)

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Required extension*

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The interim insurance costs CHF 40 per month. Please note that once interim insurance has been taken out, it cannot be terminated. In addition, premium reimbursements are not possible. We therefore recommend that you only take out the interim insurance for the period of time you definitely require. The minimum term is one month. If necessary, you can extend the insurance on a monthly basis, up to a maximum of six consecutive months – before expiry of the insurance term already concluded.

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Reason for concluding interim accident insurance*

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Comments

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HIN encryption

I would like to receive any documents via HIN-encrypted message.

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* Required field

The information provided will not be passed on to third parties. These data will only be stored and used to process the relevant matter.

By submitting the form, you confirm that you have acknowledged and accepted the Data protection notice.

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