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Place Date:  
Subject: Cancellation of insurance with OOM
Policynumber: 
Dear madam, sir,
I hereby inform you that I wish to terminate the above insurance as of .
If the stated date is not correct, I request that you use the correct contract expiry date. This cancellation will then take effect on that date.
I request that you confirm this cancellation,
Yours sincerely,
Signature: 
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Account number for possible OOM premium refund: 

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NOTE: If you have not or not fully complied with your disclosure obligation, this may mean that your entitlement to benefits is limited or even expires. If you deliberately mislead us or if we would never have taken out the insurance if we had known the truth, we may terminate the insurance.

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About Insure to Study

Insure to Study is an innovative provider of student insurance in the market of mobility and exchange. Students can quickly and simply receive the best coverage against the lowest premium. Try us!

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Laan van Nieuw Oost-Indië 133L
2593 BM The Hague
P.O. Box 97640
2509 GA The Hague
The Netherlands

Opening hours:
Monday till Friday 09:00-17:00

T. +31 70-2051860
F. +31 70-3248419
E. [email protected]
Chamber of Commerce 61913723

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