Fill in a health declaration form

Here you can fill in the health declaration form for Corporate Health Care Insurance taken out by your employer or, if you are an entrepreneur, by yourself. If the insurance is a private insurance (not a business insurance), please turn to our customer service for private customers, tel. +358 (0)10 19 19 19.

The health declaration forms are TSL encrypted.

Instructions:

  1. Select the correct health declaration form in the desired language.

    Usually, the first health declaration form on the list is filled in, e.g. when applying for a medical expenses insurance.

    If your application concerns accident cover only, please fill in the second form.

    If your application concerns death cover only, please fill in the last form.
  2. Log in to the health declaration form using your bank identifiers.
  3. Please fill in the health declaration carefully. If you apply for insurance cover for death and you want to name beneficiaries, please name them at Additional information.
  4. When you have filled in the health declaration, preview and check the content.
  5. If you want, you can print out or save the health declaration form also for yourself.
  6. Send the form to If via Internet. You will receive verification that the form has been sent successfully.
  7. Send possible copies of relevant case history notes and/or medical statements to If. You can send the documents free of charge when using the business reply mail address provided.

If you do not manage to proceed to bank identification, pop-up windows have with great likelihood been blocked on your computer. When you allow pop-ups the forms should open correctly. Mac&Safari users can find the pop-up window settings in Safari-Preferences-Security. You can alternatively try another browser.

The applied insurance coverage will enter into force at the earliest as of the day on which we received the health declaration you sent through our website.

If you have any questions concerning the health declaration, please contact us, tel. +358 (0)10 514 2242. We are at your service on weekdays from 8 a.m. - 4.30 p.m.

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Health declaration

Health declaration, illness and accident
    
Health declaration, only accident insurance   
Health declaration, only insurance covers for death

Terveysselvitys

Terveysselvitys, sairaus ja tapaturma
   
Terveysselvitys, vain tapaturmavakuutusta haettaessa   
Terveysselvitys, vain kuolemantapausturvaa haettaessa

Hälsodeklaration

Hälsodeklaration, sjukdom och olycksfall
    
Hälsodeklaration, enbart olycksfallsförsäkringen    
Hälsodeklaration, enbart dödsfallsskyddet