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Allianz Worldwide Care

Personalised online application form for registered agencies

Please use the service below to generate a link to an online application form for your clients.

You will need your agency number to complete the process, this is the number that would have been issued to you when you registered with us.

A special link will be made available to you at the end of this quick three step process. Please forward it to your client by email or via your website.
Your use of this service is subject to the condition that only your client may complete the required information in the online application form.

Regardless of how this link is distributed (email, website etc.), your agency will be credited with commission for any policies sold as a result*.

STEP 1 OF 3 - BEGIN WITH A QUOTE?

If you select 'Yes', the link that will be generated in step 3 will bring the user to our individual quotation engine first. Once a quote is issued and the user elects to apply online, your personalised form will be displayed to the user. If you select 'No', the link will bring the user directly to part 1 of your personalised online application form instead.



* PLEASE NOTE: This link must be used in its entirety to function correctly. It is therefore your responsibility to check this link and ensure that your agency name and number are displayed correctly on part 1 of the resulting online application form. To test your link, 'copy and paste' it into your web browser’s location bar. Generate a quote (if you've elected to begin with a quote) and proceed to part 1 of your online application form.

Once used, the user will no longer be able to apply directly via the Allianz Worldwide Care website (your form will always appear instead of our standard form). However, this process relies on the user’s browser 'cookie' technology - it must be enabled and the cookie preserved for the duration of the application to function correctly. (Most browsers support this technology).

 


If you are unsure of your agency number or your personalised form is not generated, please contact our sales support team by email and they will help to resolve any issues. Please provide your name and your agencies name for verification. Please allow 48 hours for our Sales Support Team to respond to your request.