Forms Services to Former Affiliates

 

Our forms are different depending on your plan type. In order to better meet your needs, we request that you use the correct forms.

You can ask your human resources department for information about your plan.

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Designation/change of beneficiary(ies) in the event of death
Group insurance (2nd pillar)

Please only use this document if you want to waive the standard order of your payment to designate or change beneficiaries:

  1. Fill in and sign the “Designation/change of beneficiary(ies) in the event of death” form
  2. Send it to the address on the form.

In the following situations:

  • You have an AG Insurance policy covering a departure prior to 2004.
  • You have an AG Insurance policy covering a departure after 2004.
  • You have a policy in the Hosting Structure with AG Insurance.
  • You have an AG Insurance policy in the IN Hosting Structure.
 
 
NL  FR  EN  DE
 

 
If you need more information about completing the form or if you want to see an example of a correctly completed form, you can go to the explanatory note. .

  

Waiver of the application of Article 110/1 LCAT (2nd pillar)  NL    FR

 

 

Individual Life Insurance (3rd pillar)

You can use the following form

 
 
NL  FR  EN  DE
 

Waiver of the application of Article 110/1 LCAT (3rd pillar)   NL    FR

 

 

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