Anesthesia risk insurance

By signing, the applicant declares that the answers provided are correct and complete. The undersigned also declares that they wish to take out insurance as specified above with Equipe Horse Insurance and agrees to the application of the applicable terms and conditions to the requested insurance.

You are obligated to answer the questions in this application form as completely as possible. This also applies to facts and circumstances relating to a third party whose interests are co-insured. Furthermore, your answers are not solely based on your own knowledge, but also on that of the other stakeholders in this insurance policy. You must nevertheless answer questions to which you assume the company already has the answers as completely as possible. Failure to comply with your disclosure obligation, or incomplete compliance, may result in the right to payment being limited or even lost, or the insurance being terminated.

When applying for insurance, personal data is requested. Equipe Horse Insurance processes this data solely for the purpose of entering into and executing agreements, preventing and combating fraud against financial institutions, for statistical analysis, and to comply with legal obligations.

Complaints about the performance of the insurance contract must first be submitted to Equipe Horse Insurance. If the company's assessment is not satisfactory, you can contact the Financial Services Complaints Institute, which will attempt to resolve the complaint through mediation. If you are not satisfied with the handling of the complaint by the Complaints Institute, please refer to the Complaints Procedure in the Equipe policy conditions.

Dutch law applies to this insurance.

This insurance is taken out with Convex Europe SA. Convex Europe SA is a limited liability company registered in the Grand Duchy of Luxembourg with registration number B253295. Its registered address is Convex Europe SA, 37 Boulevard Joseph II, 2nd floor, L-1840 Luxembourg, Grand Duchy of Luxembourg. Convex Europe SA is authorized and supervised by the Commissariat aux Assurances (CAA reference 894500S0IQYVDCWFAR23). All insurance professionals in Luxembourg are required to maintain the confidentiality of information entrusted to them in the exercise of their mandate or as part of their professional duties. Convex Europe SA outsources certain services, activities, or tasks to service providers. This means that conversations, documents, personal data, and confidential information shared by you, your beneficiaries, or any other person acting on your side of the insurance relationship may be shared with these service providers throughout the entire term of the insurance contract. These service providers are bound by professional secrecy or a confidentiality agreement. Further details can be found on the Convex Europe SA website: https://convexin.com/location/luxembourg/. By signing an application form, entering into an insurance contract, or otherwise discussing the purchase of insurance with Convex Europe SA, you authorize Convex Europe SA to outsource services, activities, and tasks to service providers.

If our application is accepted by the insurance company, you will have entered into two agreements: an insurance agreement with the insurance company and a contract of assignment with Equipe Horse Insurance. We will carry out this assignment to the best of our ability. However, we will do so under the Equipe Horse Mediation Terms and Conditions. By giving us permission to apply for the insurance(s) in response to this email, you also agree to these Equipe Horse Mediation Terms and Conditions. Therefore, please read these terms and conditions carefully. You can find them via the link in the attachment.

Download and view our mediation conditions here

By completing and digitally returning this application form, you declare that the answers provided are complete and correct. You also agree to accept the policy and pay the applicable premium and fees.