Please indicate the name of the person who has taken out the insurance.
Mandatory field First name * Mandatory field Surname * Mandatory field Street * Mandatory field number * Mandatory field Postcode * Mandatory field City * Mandatory field E-Mail *
By providing my e-mail address, I use Jacob Marley's offer to send me documents relating to my contract by e-mail. I find information about secure e-mail communication here.
Mandatory field Telephone number * Insurance policy number
Please enter your full insurance certificate number.
Legal protection is desired for …
Mandatory field Legal protection is required for … * Policyholder itself other people Mandatory field The other person is … * Please select Husband, wife Partner / in child Mandatory field First name * Mandatory field Surname * Mandatory field Profession *
For traffic legal protection cases, please tell us the vehicle owner, if this is not the same as the policyholder.
first given name Surname
Please tell us whether you have already appointed a lawyer or you wish us to name you a lawyer. You can inform yourself in advance and do some research with our lawyer search.
No lawyer I have already appointed a lawyer. Please tell me a lawyer.
Your legal protection case
Mandatory field When did the case occur? * Since when do the disputes exist? Mandatory field Description of the facts *
I agree that Jacob Marley uses my phone number and email address to provide me with more information about products and services. I agree that Jacob Marley uses my phone number and e-mail address for their customer satisfaction survey. I also agree that it may involve a carefully selected and privacy-driven service provider.
I can revoke my above statements regarding the use of my e-mail address and telephone number for contractual purposes, advertising and / or customer satisfaction surveys at any time, in whole or in part, with effect for the future under Jacob Marley Rechtsschutzversicherung AG, 20066 Hamburg or under: revocation @ Jacob Marley.de.
(Consideration of withdrawal may take up to 14 working days.)
Please note our instructions for the protection of your personal data.
By submitting you agree to the above-mentioned use of the data.
Security note: Your data will be encrypted by SSL. | * Required fields