Data Protection Consent Form for policyholders for special categories of personal data (LBS0047B)

The consent form must be signed and returned by the data subject to be able to process the special categories of personal data (health, genetic personal data about either the policyholder or third parties such as insured persons under a group policy) in connection with the insurance cover, including complaint management and claims management.

Prior to given consent, the Data Subject shall be informed as follows:

The data subject shall have the right to withdraw his or her consent at any time. The withdrawal of consent shall not affect the lawfulness of processing based on consent before its withdrawal.