• Claim Form

  • ✅ The Rewire users registered in those countries can submit a claim :

    Belgium, Germany, Estonia, Spain, Finland, France, Greece, Ireland, Italy, Lithuania, Luxembourg, Latvia, Malta, Netherlands, Poland, Portugal, Slovenia, Slovakia

    ❌ The Rewire users registered in United-Kingdom, Cyprus or Austria are not eligible to the insurance program and therefore are not allowed to submit a claim

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  • Personal information of the insured

    The insured is the ReWire customer whose interest is protected by the insurance
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    Pick a Date
  • Personal information of the claimant

    The claimant is the person who is acting on behalf of the insured
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  • Accident information

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  • Address of the accident

  • Medical information

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  • Death location

    Please provide the place where the insured deceased
  • Occupational information

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  • Evidences and attachments

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  • Upload Files
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  • Upload Files
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  • Upload Files
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  • Upload Files
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  • Declaration

  • Personal data

  • Your personal data (hereinafter the ‘data’) will be collected and processed by AIG Europe, Netherlands, located at the address above (hereinafter ‘AIG’) in accordance with the Code of Conduct for the processing of personal data by financial institutions (‘Code of Conduct’). AIG is the controller responsible for the processing of the personal data you are required to share to benefit from the AIG insurance product. The data will be processed only for the purpose of the use of the services provided by AIG, including risk assessment, insurance contract management, claims handling and crime prevention (such as fraud) as well as to allow AIG to fulfill its legal obligations. In connection with AIG’s activities and for the purpose of good service, AIG may transfer these data to other companies of the group of companies it belongs to, to subcontractors, insurance intermediaries such as Qover and Rewire or to partners. These companies, subcontractors or partners may be located in countries outside the European Economic Area that do not necessarily offer the same level of protection as The Netherlands. With regard to these transfers, AIG will take precautionary measures to ensure the protection of data in these countries as well as possible. You allow Rewire, AIG and its processor Qover to share and process your personal data including your ReWire IBAN number among each other for the above purposes. According to the Code of Conduct, you are entitled to access, amend or oppose (for a reasonable cause) to the processing of data related to you. To exercise these rights, you can contact AIG at any time in writing at functionarisvoordatabescherming.nl@aig.com. For further information on the mechanisms for processing your data by AIG, you will find AIG’s complete Global Privacy policy on http://www.aig.com/nl-privacybeleid

  • CIS Foundation

  • In order to ensure a responsible acceptance, risk and fraud policy we may check your (personal) data and have it recorded in the CIS Foundation, Bordewijklaan 2, 2591 XR The Hague, PO Box 124, 3700 AC Zeist. The purpose of processing personal data in CIS is to detect the abuse of financial products and services of insurers, preventing, combating and controlling risks to the fullest extent. For more information, see www.stichtingcis.nl.

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