Consent Gjensidige Travel Assistance
In order to assist you with your injury/illness, Gjensidige Travel Assistance needs to collect and disclose your information, including health information. For us to do so, we must ask for your consent. Here you can see what you consent to, who we disclose your information to and where we collect information about you.
When I become injured or ill
Gjensidige Travel Assistance collects information to be able to assess whether I am entitled to compensation. In this connection Gjensidige Travel Assistance may disclose information that identifies me (such as my civil registration number) and relevant information about my insurance case and my health to the parties from which the company collects information. Gjensidige Travel Assistance will specify to the parties from which information is collected what information is relevant.
From whom can information be collected?
With this consent, Gjensidige Travel Assistance may for one year from the date of my signature collect relevant information from the following parties:
- My current and former general practitioner.
- Medical specialists, dentists, physiotherapists, chiropractors and psychologists in home country and abroad
- Public and private hospitals, clinics, centres and laboratories in home country and abroad
- Other insurance companies to which I have reported my case, including credit card companies.
With this consent, the specified parties may for one year from the date of my signature disclose the relevant information to Gjensidige Travel Assistance.
To whom may relevant case information be disclosed?
With this consent, Gjensidige Travel Assistance may disclose relevant case information to the following parties in connection with the consideration of my case:
- Physicians who are to examine or treat me or who have examined and treated me.
- Hospitals at which I have been attended or to which I have been admitted.
- Other insurance companies to which I have reported my case, including credit card companies.
- Gjensidige Travel Assistance may sign the form to the airline on your behalf via the travel agency (Medical Information Form).
- Contact doctors Gjensidige Travel Assistance uses to assess my case.
What types of information may be collected, used and disclosed?
The consent covers collection, use and disclosure of the following categories of information:
- Medical information, including information about illnesses, symptoms and contacts to the health services.
For what period of time may information be collected?
The consent covers information for a period of one year prior to the date of occurrence or the time of onset of the illness and until the time when Gjensidige Travel Assistance has considered my case.
If the information for that period so warrants, Gjensidige Travel Assistance may providing a specific reason, also collect information relating to the time before that period.
Withdrawal of consent
I can withdraw my consent at any time with effect for the future. The withdrawal may affect the ability of Gjensidige Travel Assistance to consider my case.
When my/our child becomes injured or ill
Gjensidige Travel Assistance collects information to be able to assess whether my/our child is entitled to compensation. In this connection Gjensidige Travel Assistance may disclose information that identifies my/our child (such as civil registration number) and relevant information about the insurance case and my/our child´s health to the parties from which the company collects information. Gjensidige Travel Assistance will specify to the parties from which information is collected what information is relevant.
From whom can information be collected?
With this consent, Gjensidige Travel Assistance may for one year from the date of my/our signature(s) collect relevant information from the following parties:
- My current and former general practitioner.
- Medical specialists, dentists, physiotherapists, chiropractors and psychologists in home country and abroad
- Public and private hospitals, clinics, centres and laboratories in home country and abroad
- Other insurance companies to which I have reported my case, including credit card companies.
With this consent, the specified parties may for one year from the date of my/our signature(s) disclose the relevant information to Gjensidige Travel Assistance.
To whom may relevant case information be disclosed?
With this consent, Gjensidige Travel Assistance may disclose relevant case information to the following parties in connection with the consideration of the case:
- Physicians who are to examine or treat my/our child or who have examined and treated my/our child.
- Hospitals at which my/our child has been attended or to which my/our child has been admitted.
- Other insurance companies to which I/we have reported the case, including credit card companies.
- Gjensidige Travel Assistance may sign the form to the airline on my/your child´s behalf via the travel agency (Medical Information Form).
- Contact doctors Gjensidige Travel Assistance uses to assess the case.
What types of information may be collected, used and disclosed?
The consent covers collection, use and disclosure of the following categories of information:
- Medical information, including information about illnesses, symptoms and contacts to the health services.
For what period of time may information be collected?
The consent covers information for a period of one year prior to the date of occurrence or the time of onset of the illness and until the time when Gjensidige Travel Assistance has considered my case.
If the information for that period so warrants, Gjensidige Travel Assistance may providing a specific reason, also collect information relating to the time before that period.
Withdrawal of consent
I/we can withdraw my/our consent at any time with effect for the future. The withdrawal may affect the ability of Gjensidige Travel Assistance to consider the case.