Expat Infinity

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Please fill out the following questionnaire to receive a quotation for a personal EXPAT INFINITY international health insurance plan. We will process your information and get in contact with you as quickly as possible.

Details of person to be insured

Full name

Nationality/Nationalities

Message

How may we get in contact with you?

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Email address

Phone number

In order to provide you with a quote we would need the following information

Favoured insurance category

Your age group

Which countries shall be included in your insurance coverage?

What should be the deductible amount?

Details of jointly insured relatives

Should relatives be jointly insured?

noyes

Age group of relative	Favoured deductible amount

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Abchasien
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua/Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
Brazil
Brunei Dar-es-S
Bulgaria
Burkina-Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauretania
Mauritius
Mexico
Micronesia
Moldavia
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Niue Islands
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Ruanda
Russian Fed.
S.Tome,Principe
Saint Barthelemy
Saint Martin
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
Sri Lanka
St Kitts & Nevis
St. Lucia
St. Vincent
St.Pier,Miquel.
Sudan
Südossetien
Südsudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikstan
Tanzania
Thailand
Togo
Tonga
Trinidad,Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emir.
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis,Futuna
West Sahara
Western Samoa
Yemen
Zambia
Zimbabwe