Take out PI media freelancers insurance

Capacity

Self-employed without a company / private

Company

Annual turnover

<= €250.000

> €250.000

What amount of capital (professional liability) do you wish to insure ?

€250.000

€500.000

First name

Name

Company name

CBE number

Email address

Telephone number

Address

Street, number, postcode, town/city

Language of the contract

Dutch

French

Desired start date of the contract

The policyholder declares:

that he/she has taken note:
- the legal provisions at >https://www.vandessel.be/en/legal-information
- the privacy statement at >https://www.vandessel.be/en/privacy-policy
- the minimum legal information at the bottom of this webpage, including the General Conditions of Insurance Third Party Liability and Professional Liability Self-employed Persons 07.2020, the Insurance Product Information Document (IPID) "Business Liability" and the Insurance Product Information Document (IPID) "Professional Liability Insurance".
that he/she knows that by signing this web form, an application for insurance is made. The insurance contract will only come into force after the insurer has obtained confirmation that neither the insured nor its activities are in breach of any applicable law, have violated any regulations relating to trade and economic sanctions or have been the subject of any judicial, administrative or other proceedings or investigations relating to fraud, taxation, theft or other offences that may affect the insurer's assessment of the risk. Once this confirmation has been obtained, cover is retroactive to the date of acceptance of the offer by the insured.
that the insured must ensure the accuracy of the information provided and immediately inform the insurance intermediary or the insurer of any change in these declarations that may occur before or after the date on which the insurance policy comes into force.

The policyholder agrees with the above statements

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