Quotation Guaranteed Income

Activities of the person to be insured
Start date independent activity
DD slash MM slash YYYY
The person to be insured performs the independent activity
- Main occupation
- Side occupation
The person to be insured is
- Start-up self-employed (self-employed status less than 3 years)
- Established self-employed person (self-employed status more than 3 years or equivalent work experience as employee)
Exact description of professional activity
In case of a self-employed person in a secondary occupation: description of the main occupation
Please divide your time to spend in the 5 parts below

Total is 100%
Administration and management (%)
Please enter a number less than or equal to 100.
Manual labor (%)
Please enter a number less than or equal to 100.
Transport (%)
Please enter a number less than or equal to 100.
Working at heights (%)
Please enter a number less than or equal to 100.
Other (description + %)
Are you staying abroad regularly?
Do you practice a sport that requires cover?
Specify the sport(s)

Coverage of your income
Your annual net taxable income from your work
What amount of your net taxable income do you want to insure?
Max. 80% of your net taxable income
Against which form(s) of unfitness do you wish to insure yourself?
- Both economic disability and disability
- Only economic disability
Invalidity: reduction of physical integrity. (eg amputation finger => regardless of whether this has an influence on the exercise of your profession)
Economic unfitness: the reduction of the work capacity due to the disability. (eg amputation finger influences pianist when exercising profession).
Illness and accidents
- Of all kinds
- Private life

Policyholder