Wij verzoeken u bijgesloten formuli

Wij verzoeken u bijgesloten formulier zo volledig mogelijk in te vullen. Indien u zelf (mede-)schuldig bent, kunt u dit vermelden. Dit heeft geen invloed op de vergoedingen. Volgens de verzekeringsvoorwaarden mag zonder onze toestemming geen regeling met derden worden aangegaan, omdat zo’n regeling de zorgverzekeraar in haar rechten kan schaden.

結果 (英語) 1:

Please attached form be completed as far as possible. If you have (co-) are guilty, you can mention this. This does not affect the fees. According to the insurance terms and conditions may be entered into any arrangement with third parties without our permission, because such an arrangement can impair the health care provider in its rights.

結果 (英語) 2:

We ask you to fill in the attached form as fully as possible. If you (co-) are guilty, you can mention this. This does not affect the benefits. According to the conditions of insurance may be entered into any arrangement with a third party without our consent, because such a procedure might adversely affect the health insurer's rights.

結果 (英語) 3:

we call on the enclosed form as completely as possible to fill in. if you owe yourself (co), you can mention. this does not affect the fees. according to the insurance without our consent can not be entered into arrangements with third parties, because such a system could harm the health insurer in her rights.