Apply for Au pair insurance

With the application form below you can apply for the ISIS Au Pair Insurance.

The applicant has received explicit permission from all parties involved to use and share the entered data with JoHo Insurances and the other parties involved. In the context of the duty of care and the interest of the au pair, both the host family and the au pair agency will be informed about this application.

1. Who applies for this insurance?

Applicant insurance
Consent host family

2. Details au pair agency

Name au pair agency
Enter the name of the organization when not listed
Indicate here through which official referent (au pair agency) arranged the mediation.

3. Details policyholder (host family)

The policyholder is the 'owner' of the insurance. The policyholder is responsible for paying the premium, and only a policyholder may communicate changes and requests for termination.

All documents of this Isis Au pair insurance will be sent to the host family by email. These documents always come with an English-language instruction, which the host family can hand over to the au pair.

Gender

4. Details au pair

Gender

5. Travelling details au pair and coverage ISIS au pair insurance

The start date of the insurance must be the day of departure of the au pair from her/his own country. If the au pair already arrived in the Netherlands, please indicate this below.
Has the au pair already left the home country?
Additional questions if the au pair has already left the home country
Does this application concern a rematch?
Did your au pair already have an au pair insurance through the other host family?

6. Desired coverage ISIS au pair insurance

Coverage
Does your au pair already have a basic health insurance?
Would you like the All-in or Additional cover for the Au pair Insurance?
Only one file. 10 MB max. Allowed file types: jpg, jpeg, pdf.

7. SEPA mandate for a single collection

The premium for the insured period, entered above, will be paid in one single collection.

Creditor information
JoHo
Paviljoensgracht 18
2512BP the Hague, the Netherlands
Creditor ID: NL87ZZZ281004790000

8. Closing questions

Have you or another interested party been in contact with the police or the judiciary in the past 8 years?
Has an insurer ever refused or canceled an insurance policy for you or another interested party?
Have you or another interested party suffered or caused more than 3 damages in the past 5 years as a result of events that fall under the insurance that you have applied for?

9. Agree with the conditions and send by email

I would like to receive the information belonging to this insurance by email in the following language

Do not forget

Don't forget to arrange the basic health insurance within 4 months after the au pair has arrived in the Netherlands

The ISIS au pair insurance provides cover for Corona-related costs, provided basic health insurance has been arranged within the statutory term of 4 months. We will send you additional information about this when we send you the policy schedule of the requested ISIS Au pair insurance.