Home
PRIVATE
For GF Bank clients

For GF Bank clients

Useful documents

Claim Form for Group Credit Borrowers' Life and Health Insurance Benefits (to be completed electronically).

Claim form for group credit borrowers' life and health insurance benefits

You can fill out the application for a group life and health insurance payout on your computer, except for the fields for the applicant's first name, last name, and signature.

When submitting the application for consideration regarding the insurance payout, it is necessary to print it, indicate the applicant's first name and last name, and sign it.

Choose the most convenient way to purchase insurance

Buy
online

Buy

One number
for all questions

Call 19111

Send an inquiry and
we will contact you

Write Us Write Us

Customer
Service Centers

Visit Us

Write to us!

Fill in an application form below and we will contact you as soon as possible

Name

Surname

Email address

Phone number

Theme

Message

Please contact me By email address By phone number

I have read the Privacy policy regarding the processing of personal data

Send

The service is available only to SEESAM health insurance clients who have chosen the health insurance program "OUTPATIENT TREATMENT"
If you register for a remote family doctor consultation after 5 p.m., the consultation will be provided the next day, in the time slot you selected in the registration form (if it is not a weekend day).
IMPORTANT! Consultations are not provided on weekends and festive days.

Услуга доступна только клиентам медицинского страхования SEESAM, которые выбрали программу медицинского страхования «Амбулаторное лечение»
Если осуществляется регистрация на дистанционную консультацию у семейного врача с 17:00 час., консультация будет предоставлена на следующий день, во временной отрезок, который вы выбрали в форме регистрации (если это – не выходной день).
ВАЖНО! Консультации не предоставляются в выходные и праздничные дни.

Phone number

Policyholder/Employer

Consultation date

Consultation time

Please be informed that for the purpose of registering a doctor's visit, Compensa Vienna Insurance Group, ADB will transfer the personal data you have provided in the registration form to Telesante, UAB (https://telesante.lt/en/), a provider of remote doctor consultation, health care licence No 4774. For more information on the processing of personal data, please refer to the Privacy Policy approved by Compensa Vienna Insurance Group, ADB.

Информируем, что в целях регистрации визита к врачу акционерное страховое общество «Compensa Vienna Insurance Group» передаст указанные Вами в форме регистрации персональные данные (за исключением информации о страхователе) ЗАО «Telesante» (https://telesante.lt/) (номер лицензии на уход за здоровьем: 4774). Больше информации по обработке персональных данных Вы можете найти в Политике конфиденциальности акционерного страхового общества «Compensa Vienna Insurance Group».

I confirm that I am aware that Compensa Vienna Insurance Group, ADB (company code 304080146, address Ukmergės g. 280, Vilnius) processes my personal data for the purpose of claim management. I am informed that I have the right to request access to my personal data, to request rectification or erasure or restriction of processing, to object to processing and to withdraw my consent to processing, as well as the right to data portability. I am also informed that I can find more information about the exercise of my rights and the processing of my personal data by the insurer in the Privacy Policy https://www.compensa.lt/privacy-policy-2/ or at the insurer's registered office at Ukmergės g. 280, Vilnius. In the event of a personal data breach, I have the right to contact the Data protection officer via e-mail dpo@compensa.lt as well as to complain to the State Data Protection Inspectorate or to a court.

I confirm

SEND