ASESORÍA INDEPENDIENTE EN SEGUROS
Ciudad de México · 55 7012 4124
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2
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Número de Asegurados
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Asegurado Titular
Nombre
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Email
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Whatsapp
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Código Postal
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Asegurado 2
Nombre
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- Parentesco -
Conyuge
Hijo(a)
Padre/Madre
Abuelo(a)
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Otro
- Parentesco -
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Field is required!
[{"field":"{quantity}","logic":"greater_than","value":"1","and_method":"","field_and":"","logic_and":"","value_and":""}]
Asegurado 3
Nombre
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- Edad -
Field is required!
Field is required!
- Parentesco -
Conyuge
Hijo(a)
Padre/Madre
Abuelo(a)
Nieto(a)
Otro
- Parentesco -
Field is required!
Field is required!
[{"field":"{quantity}","logic":"equal","value":"3","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"4"},{"field":"{quantity}","logic":"equal","value":"5","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"6"},{"field":"{quantity}","logic":"equal","value":"7","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"8"}]
Asegurado 4
[{"field":"quantity","logic":"equal","value":"3","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"4"},{"field":"quantity","logic":"equal","value":"5","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"6"},{"field":"quantity","logic":"equal","value":"7","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"8"}]
Nombre
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Field is required!
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- Edad -
Field is required!
Field is required!
- Parentesco -
Conyuge
Hijo(a)
Padre/Madre
Abuelo(a)
Nieto(a)
Otro
- Parentesco -
Field is required!
Field is required!
[{"field":"{quantity}","logic":"equal","value":"4","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"5"},{"field":"{quantity}","logic":"equal","value":"6","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"7"},{"field":"{quantity}","logic":"equal","value":"8","and_method":"","field_and":"","logic_and":"","value_and":""}]
Asegurado 5
[{"field":"quantity","logic":"equal","value":"3","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"4"},{"field":"quantity","logic":"equal","value":"5","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"6"},{"field":"quantity","logic":"equal","value":"7","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"8"}]
Nombre
Field is required!
Field is required!
- Edad -
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- Edad -
Field is required!
Field is required!
- Parentesco -
Conyuge
Hijo(a)
Padre/Madre
Abuelo(a)
Nieto(a)
Otro
- Parentesco -
Field is required!
Field is required!
[{"field":"{quantity}","logic":"equal","value":"5","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"6"},{"field":"{quantity}","logic":"equal","value":"7","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"8"}]
Asegurado 6
[{"field":"quantity","logic":"equal","value":"3","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"4"},{"field":"quantity","logic":"equal","value":"5","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"6"},{"field":"quantity","logic":"equal","value":"7","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"8"}]
Nombre
Field is required!
Field is required!
- Edad -
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- Edad -
Field is required!
Field is required!
- Parentesco -
Conyuge
Hijo(a)
Padre/Madre
Abuelo(a)
Nieto(a)
Otro
- Parentesco -
Field is required!
Field is required!
[{"field":"{quantity}","logic":"equal","value":"6","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"7"},{"field":"{quantity}","logic":"equal","value":"8","and_method":"","field_and":"","logic_and":"","value_and":""}]
Asegurado 7
[{"field":"quantity","logic":"equal","value":"3","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"4"},{"field":"quantity","logic":"equal","value":"5","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"6"},{"field":"quantity","logic":"equal","value":"7","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"8"}]
Nombre
Field is required!
Field is required!
- Edad -
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- Edad -
Field is required!
Field is required!
- Parentesco -
Conyuge
Hijo(a)
Padre/Madre
Abuelo(a)
Nieto(a)
Otro
- Parentesco -
Field is required!
Field is required!
[{"field":"{quantity}","logic":"equal","value":"7","and_method":"or","field_and":"{quantity}","logic_and":"equal","value_and":"8"}]
Asegurado 8
[{"field":"quantity","logic":"equal","value":"3","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"4"},{"field":"quantity","logic":"equal","value":"5","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"6"},{"field":"quantity","logic":"equal","value":"7","and_method":"or","field_and":"quantity","logic_and":"equal","value_and":"8"}]
Nombre
Field is required!
Field is required!
- Edad -
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- Edad -
Field is required!
Field is required!
- Parentesco -
Conyuge
Hijo(a)
Padre/Madre
Abuelo(a)
Nieto(a)
Otro
- Parentesco -
Field is required!
Field is required!
[{"field":"{quantity}","logic":"equal","value":"8","and_method":"","field_and":"","logic_and":"","value_and":""}]
Tu Seguro
Suma Asegurada
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Deducible
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Field is required!
- Gama Hospitalaria -
Alta
Media
Basica
- Gama Hospitalaria -
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Field is required!
- Atención en el Extranjero -
No
Solo emergencias
Si
- Atención en el Extranjero -
Field is required!
Field is required!
- Forma de Pago -
Anual
Semestral
Trimestral
Mensual
- Forma de Pago -
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Field is required!
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