A referral that is worth it

Calculation example: In the event of the successful referral of a family of four, you would receive CHF 50/person.

Upon conclusion of one of the following supplementary insurances:
DIVERSA NATURA Hospital Insurance

Refer us to your friends and simply sharing joy

My address

0% Complete
Your referral

0% Complete
Further referrals

0% Complete

Metadata

User Id

Form Uuid

Language

Webmail2Id

mailTo

Bcc

formType

resourceDownloadUrl

onServer

Title

Mrs./Ms.

Mr.

Surname

First name

Street, n°

Postcode

Town

Insurance number

Your message

Date of birth

Please contact me by

phone

e-mail

mail

Bitte vergessen Sie Ihre Kontaktangaben nicht, damit wir Ihre Anfrage bearbeiten können.

Phone

E-mail

I confirm that I have received permission from the recommended person to share their contact details for this purpose.

Title

Mr.

Mrs./Ms.

Family

Surname

First name

Street, n°

Postcode

Town

Date of birth

Phone

E-mail

Number of persons in the household

Please specify the other members of the household.

Your CONCORDIA agency

Further referrals?

Yes

If you refer a family, it is sufficient to specify one name.

I agree to inform the person accordingly.

Title

Mr.

Mrs./Ms.

Family

Surname

First name

Street, n°

Postcode

Town

Date of birth

Phone

E-mail

Number of persons in the household

Please specify the other members of the household.

Your CONCORDIA agency

No remuneration will be paid out in the following cases:

New customers that refer themselves
Persons referred by individuals not insured with CONCORDIA
New-born children
Referrals from persons living in the same household (e.g. spouse, children)

Clients recruit clients

Refer us to your friends and simply sharing joy

Metadata