Your forms

​​​​Income protection

Reporting an occupational incapacity

• Claim form

NL - FR - EN - DE

• Medical certificate
  You only need to fill out this form if explicitly directed to do so by our medical department.

NL - FR - EN- DE


Continuation of group income protection coverage on an individual basis

NL - FR - EN - DE


Fact sheets (IPID)

IPID stands for Insurance Product Information Document. This document gives you useful, simple and concise information about your insurance. It is drawn up in accordance with the legal provisions of Assuralia, the professional association of insurance companies in Belgium.

• Group income protection plan

NL - FR - EN

• Group waiver of premiums plan

NL - FR - EN