Fillable Grenzversicherung Europa Pkw-camper En

Fill Online, Printable, Fillable, Blank Grenzversicherung Europa Pkw-camper En Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Grenzversicherung Europa Pkw-camper En

On average this form takes 10 minutes to complete

The Grenzversicherung Europa Pkw-camper En form is 4 pages long and contains:

  • 0 signatures
  • 1 check-box
  • 39 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
For insurance coverage in Europe for cars, caravans and trailers, you can choose one of the following:
Coverage 1:
• Liability insurance with a limit of € 2.500.000 / € 1.000.000 / € 50.000 for each claim for bodily injury /
property damage / nancial loss.
Coverage 2:
• Liability insurance incl. full comprehensive and partial comprehensive cover with a deductible
of € 2.500 for each claim.
• Vehicle must be under 8 years old.
• No reimbursement for theft in countries of the former Eastern Bloc.
Please complete the attached application form, sign it and send it back to us.
For all insurance premiums incl. taxes, please see the price list following below.
MOTOR INSURANCE FOR EUROPE 
CARS, CARAVANS, TRAILERS
– foreign plate numbers and custom plates incl. German license plate in Russia –
INFORMATION
• Please transfer the insurance premium to the following account at HypoVereinsbank:
IBAN: DE28 2003 0000 0000 4291 34, SWIFT/BIC: HYVEDEMM300
• For payment by Master Card or by Visa Card, please ll in the following credit card authorisation form
and send it back to us by fax or by post only (not by e-mail).
• Complementary travel insurances can also be provided by us. If required, please ask for more information.
OUR PARTNERS
▲
Applicant
Name First Name
Address
Zip, City Country
Phone E-Mail
Date of Birth
Description of the vehicle
Make Year
Type Plate Number Country of Registration
Vehicle ID No. Actual Value in €
Declared value incl. supplementary equipment (in €) if applicable. This value will be the basis for your claim.
Desired Coverage
Yes No
Third Party Liability
Bodily Injury € 2.500.000
per person, in case of death or injury of 3 or more persons a total of € 7,5 mio.,
limited to a total of € 2,5 mio. per injured person.
Property Damage € 1.000.000
Financial Damage € 50.000
(each claim)
Comprehensive incl. re and theft
Deductible € 2.500 each claim
Period from to for months
Date Signature
The conditions „Allgemeine Kraftfahrt Versicherungsbedingungen“(AKB) of the AXA Versicherung AG as amended from time to time shall apply.
AXA Versicherung AG/TourInsure GmbH, Herrengraben 5, 20459 Hamburg, Tel.: +49 (0)40 / 25172150, Fax: +49 (0)40 / 25172121
E-Mail: Service@Tourinsure.de, Internet: www.TourInsure.de
APPLICATION FOR MOTOR INSURANCE  EUROPE
CARS, CARAVANS, TRAILERS
OUR PARTNERS
▲
PREMIUMS FOR MOTOR INSURANCE  EUROPE
valid for customs and foreign registrations – cars, caravans & trailers
(all premiums in € including tax)
Third-party liability insurance
month
Period 1 2 3 4 5 6 7 8 9 10 11+12
Premium 229 327 425 523 621 719 817 915 1.013 1.111 1.307
Trailer 80 80 80 124 124 124 144 144 144 171 171
Total coverage € 2.500.000
Comprehensive and collision including third-par ty liability insurance (not for motorcycles)
12.500 907 1.348 1.612 1.886 2.149 2.413 2.602 2.866 3.129 3.806 4.130
25.000 1.208 1.876 2.139 2.639 2.902 3.166 3.434 3.691 3.948 5.071 5.426
37.500 1.509 2.403 2.666 3.391 3.534 3.791 4.338 4.595 4.852 6.300 6.655
50.000 1.810 2.930 3.082 4.000 4.256 4.513 5.241 5.498 5.755 7.060 7.402
75.000 2.262 3.584 3.841 5.662 5.919 6.176 7.319 7.578 7.835 8.783 9.125
insurance against theft including third-party liability insurance (not for motorcycles)
12.500 681 1.008 1.216 1.431 1.640 1.848 2.007 2.215 2.424 2.907 3.188
25.000 882 1.359 1.568 1.933 2.142 2.350 2.562 2.766 2.970 3.751 4.053
37.500 1.082 1.711 1.919 2.435 2.563 2.767 3.164 3.368 3.572 4.570 4.872
50.000 1.283 2.062 2.197 2.841 3.045 3.248 3.766 3.970 4.174 5.077 5.370
75.000 1.584 2.499 2.703 3.949 4.153 4.357 5.152 5.357 5.560 6.225 6.518
surcharge for drivers at the age of 21-24 and for sportscars is 25%.
no indemnity for theft-claims in countries belonging to the former eastern block.
Deductible € 2.500 for each comprehensive and collision and theft claim.
Current value in €
Current value in €
OUR PARTNERS
▲
CREDIT CARD AUTHORIZATION FORM
Please do not send by e-mail!
Please complete this form and return it by post or by fax to:
TourInsure Agentur für
Touristenversicherungen GmbH
Herrengraben 5
D-20459 Hamburg Fax: +49 (0)40 / 251 721 21
Cardholder details (Please print)
Name First Name
Address
ZIP, City Country
Phone E-Mail
Total amount in €
Credit Card (please tick where applicable)
Master Visa
Credit Card number exp. date (4 digit)
/
Security code (3 or 4 digits, above signature)
I authorize TourInsure Agentur für Touristenversicherungen GmbH to charge my credit card with the a. m. amount.
Date Signature
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Grenzversicherung Europa Pkw-camper En

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 August 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document