Claim form for continued payment of reduced earning capacity benefits and/or waiver of premium

Complete the claim form for continued payment of reduced earning capacity benefits and/or waiver of premium electronically and sign with NemID. You must have an email address to complete the claim form.

About the claim form

You fill out the claim form via a secure connection on our partner Visma Addo's platform. Visma Addo has the same obligations as we have regarding the processing of sensitive personal data.

Read more about security at Visma Addo here.

Claim form for continued payment of reduced earning capacity benefits and/or waiver of premium