Insurance Application MOVILIDAD ESTUDIANTES
Remember to attach a copy of your enrollment or certificate issued by a Spanish University, and make sure the start and end dates of the insurance match the time period of your course.
If you have been in Spain for more than 2 years already (regardless of whether you have taken out this insurance before or not), in order to use this insurance, you have to prove that you travel to your country every year. Otherwise, you are considered a permanent resident in Spain, and you should take out a Health Insurance Coverage.
Information about the Insured
Name:
Last Name:
Birth Date:
Gender:
NIF / CIF / NIE / Passport:
Email:
Telephone:
Other Details
Are you a student, researcher or professor?:
Study Program / Master:
Country of Origin:
Country of Destination:
Coverage Details
Start Date:
Check the required option:
Option Insured Amount Annual Total Price Premium + Administration Expenses
hasta 183 días (6 meses)30.000 €171,54 €(170,00 + 1,54 €)
hasta 183 días (6 meses)50.000 €214,93 €(213,00 + 1,93 €)
hasta 183 días (6 meses)100.000 €249,24 €(247,00 + 2,24 €)
hasta 12 meses30.000 €223,01 €(221,00 + 2,01 €)
hasta 12 meses50.000 €259,33 €(257,00 + 2,33 €)
hasta 12 meses100.000 €301,72 €(299,00 + 2,72 €)
Check the required option:
hasta 183 días (6 meses)
Insured Amount: 30.000 €
Annual Total Price: 171,54 €
Premium + Administration Expenses: (170,00 + 1,54 €)
hasta 183 días (6 meses)
Insured Amount: 50.000 €
Annual Total Price: 214,93 €
Premium + Administration Expenses: (213,00 + 1,93 €)
hasta 183 días (6 meses)
Insured Amount: 100.000 €
Annual Total Price: 249,24 €
Premium + Administration Expenses: (247,00 + 2,24 €)
hasta 12 meses
Insured Amount: 30.000 €
Annual Total Price: 223,01 €
Premium + Administration Expenses: (221,00 + 2,01 €
hasta 12 meses
Insured Amount: 50.000 €
Annual Total Price: 259,33 €
Premium + Administration Expenses: (257,00 + 2,33 €)
hasta 12 meses
Insured Amount: 100.000 €
Annual Total Price: 301,72 €
Premium + Administration Expenses: (299,00 + 2,72 €)
PERSONS EXCLUDED FROM TAKING OUT THIS INSURANCE: Persons that are paralytic, alcoholic and/or drug addicted, epileptic, mentally deranged or diabetic cannot be insured. If one of these circumstances occurs during the validity of the insurance, the Policy Holder or Insured, must communicate it to the Insurance Company as soon as possible.
Remarks
Documents
Please send a copy of your enrollment or certificate issued by a Spanish University.
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