I am an existing business partner
I am a policyholder
I am an authorised signatory for my company:
Yes, I am the only authorised signatory
Yes, but my company is bound to joint signature
Please fill in your details.
Mobile phone number:
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I have read and I understand the information on the
electronic signature process
adopted by Lombard International Assurance S.A.
I have read and I understand Lombard International Assurance S.A.’s
By ticking this box, I consent to the use of my email address and mobile telephone number by Lombard International Assurance S.A. for the setup of my Connect account. I understand that the data collected are necessary to set up my digital signature and to correspond with me via electronic means on matters related to my insurance policy. I acknowledge that I have had the opportunity to review the information given and ask any questions I might have had.