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To enable us to transfer your credit balance, please provide us with your postal or bank details. Please note that claims arising from insurance policies are subject to the statute of limitations pursuant to Article 46 of the Insurance Contract Act.

What type of credit balance is involved?

Please select the preferred settlement

If you prefer a payment, please specify your account details
If you wish to have the amount applied to another active policy, please specify this on the next page
If you wish to apply the amount to the same policy, you can simply cancel completion of this form. The amount will be automatically offset with the next invoice

What is the policy number?

Policyholder

Contact details

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