Customers recruit customers

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 share a reward

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

You will find your insurance number on the back of your health insurance card or on your insurance policy. Your insurance number has at least 10 and maximum 11 digits.

Your message

Date of birth

Please contact me by

phone

e-mail

mail

Please don't forget to enter your contact details, so that we may process your request.

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.

Preferred CONCORDIA agency

Would you like to refer other people?

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.

Preferred CONCORDIA agency

No reward 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, life partner, children)