Sigedis form

Contact our services

Do you have questions about your contract or the succession of your file? Please fill out this form. We ensure that you will receive a personal response as quickly as possible.

Your demand

Briefly describe your question *

Do you want to add attachments (benefit statements, hospital bills)?

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Your details

Name*

First Name*

Salutation*

Birthdate*

Street

Postal Code

Number

Location

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Email Address

Phone Number

Contract number

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By clicking "Next", I agree to allow AG Insurance to use my personal data to contact me regarding my request. My personal data won't be communicated to third parties. My data will be processed in accordance with the applicable data protection and privacy laws as well as with AG Insurance's Privacy Notice and Cookie Policy.

I hereby acknowledge that I have read AG Insurance's Privacy Notice and Cookie Policy.