Customer account In order to start your subscription, please answer the following question so that we can direct you. Ouest Assurances customer I am a new customer I am an existing customer souscription_cust_type souscription_cust_type_particulier souscription_cust_type_entreprise Complete the following form and click on the Next button to create a Ouest Assurances customer account and finalize your subscription. In order to continue your subscription, you will have to login to your Ouest Assurances customer account. Click on the Continue button to log into your account. Customer Title Association auto entrepreneur Works council Ent. Individuelle EURL High school Madam Sirs Mister Dear Madam, dear Sir SA SARL SAS SASU SCI SCP SNC Société Company Name Firstname Customer souscription_cust_cie_civil_lbl Association auto entrepreneur Works council Ent. Individuelle EURL High school Madam Sirs Mister Dear Madam, dear Sir SA SARL SAS SASU SCI SCP SNC Société Company souscription_cust_cie_name_lbl souscription_cust_contact_title Address Address (next part) Postal code City Country South Africa Albania Algeria Germany Andorra Andorra Angola Antigua and Barbuda Netherlands Antilles Saudi Arabia Saudi Arabia Argentina Armenia Australia Austria Bahamas Bahreïn Barbados Belgium Belize Benin Bermudes Belorussia Birmanie Bolivia Bosnie Herzegovine Brazil Brunei Bulgaria Cambodia Canada Cape Verde Chili China Cyprus Colombia South Korea Corse Costa Rica Ivory coast Croatia Cuba Denmark Dominica Egypt United Arab Emirates Equator Spain Spain except Canaria islands Estonia United States Ethiopia Finland France Gabon Ghana Gibraltar Greece Grenada Guadeloupe Guatemala French Guiana Hong Kong Hungary Mauritius Island Iles Feroe British Virgin Islands India Indonesia Ireland Island Israël Italy Japan Jordania Kazakhstan Koweït Reunion island Reunion island The Netherlands Latvia Lebanon Liechtenstein Lithuania Luxembourg Macao Madagascar Malaysia Malawi Maldives Malta Morocco Martinique Mexico Moldavia Monaco Montenegro Namibia Norway Nouvelle-Caledonie New-Zealand Oman Pakistan Panama Paraguay Netherlands Peru Philippines Poland French Polynesia Portugal Portugal except Açores islands Qatar Dominican Republic Czech Republic République yougoslave de Macédoine Romania United Kingdom Russia Saint-Barth San Marino Saint-Marteen Saint-Vincent and Grenadines islands Saint Lucia Senegal Serbie Seychelles Singapour Slovakia Slovenia Sweden Switzerland Thailand Tunisia Turkey Ukraine Uruguay Vatican Venezuela Viêt Nam Yougoslavia Main phone Secondary phone Email souscription_cust_add_info_title Date of Birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050 2051 2052 2053 2054 2055 2056 2057 2058 2059 2060 2061 2062 2063 2064 2065 2066 2067 2068 2069 2070 2071 2072 2073 2074 2075 2076 2077 2078 2079 2080 2081 2082 2083 2084 2085 2086 2087 2088 2089 2090 2091 2092 2093 2094 2095 2096 2097 2098 2099 2100 Country of birth South Africa Albania Algeria Germany Andorra Andorra Angola Antigua and Barbuda Netherlands Antilles Saudi Arabia Saudi Arabia Argentina Armenia Australia Austria Bahamas Bahreïn Barbados Belgium Belize Benin Bermudes Belorussia Birmanie Bolivia Bosnie Herzegovine Brazil Brunei Bulgaria Cambodia Canada Cape Verde Chili China Cyprus Colombia South Korea Corse Costa Rica Ivory coast Croatia Cuba Denmark Dominica Egypt United Arab Emirates Equator Spain Spain except Canaria islands Estonia United States Ethiopia Finland France Gabon Ghana Gibraltar Greece Grenada Guadeloupe Guatemala French Guiana Hong Kong Hungary Mauritius Island Iles Feroe British Virgin Islands India Indonesia Ireland Island Israël Italy Japan Jordania Kazakhstan Koweït Reunion island Reunion island The Netherlands Latvia Lebanon Liechtenstein Lithuania Luxembourg Macao Madagascar Malaysia Malawi Maldives Malta Morocco Martinique Mexico Moldavia Monaco Montenegro Namibia Norway Nouvelle-Caledonie New-Zealand Oman Pakistan Panama Paraguay Netherlands Peru Philippines Poland French Polynesia Portugal Portugal except Açores islands Qatar Dominican Republic Czech Republic République yougoslave de Macédoine Romania United Kingdom Russia Saint-Barth San Marino Saint-Marteen Saint-Vincent and Grenadines islands Saint Lucia Senegal Serbie Seychelles Singapour Slovakia Slovenia Sweden Switzerland Thailand Tunisia Turkey Ukraine Uruguay Vatican Venezuela Viêt Nam Yougoslavia Department of birth Ain Aisne Allier Alpes-de-Haute-Provence Hautes-Alpes Alpes-Maritimes Ardèche Ardennes Ariège Aube Aude Aveyron Bouches-du-Rhône Calvados Cantal Charente Charente-Maritime Cher Corrèze Côte-d'Or Côtes-d'Armor Creuse Dordogne Doubs Drôme Eure Eure-et-Loir Finistère Corse-du-Sud Haute-Corse Gard Haute-Garonne Gers Gironde Hérault Ille-et-Vilaine Indre Indre-et-Loire Isère Jura Landes Loir-et-Cher Loire Haute-Loire Loire-Atlantique Loiret Lot Lot-et-Garonne Lozère Maine-et-Loire Manche Marne Haute-Marne Mayenne Meurthe-et-Moselle Meuse Morbihan Moselle Nièvre Nord Oise Orne Pas-de-Calais Puy-de-Dôme Pyrénées-Atlantiques Hautes-Pyrénées Pyrénées-Orientales Bas-Rhin Haut-Rhin Rhône Haute-Saône Saône-et-Loire Sarthe Savoie Haute-Savoie Paris Seine-Maritime Seine-et-Marne Yvelines Deux-Sèvres Somme Tarn Tarn-et-Garonne Var Vaucluse Vendée Vienne Haute-Vienne Vosges Yonne Territoire de Belfort Essonne Hauts-de-Seine Seine-Saint-Denis Val-de-Marne Val-d'Oise City of birth City of birth postal code souscription_cust_benef_title Name Firstname Date of Birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050 2051 2052 2053 2054 2055 2056 2057 2058 2059 2060 2061 2062 2063 2064 2065 2066 2067 2068 2069 2070 2071 2072 2073 2074 2075 2076 2077 2078 2079 2080 2081 2082 2083 2084 2085 2086 2087 2088 2089 2090 2091 2092 2093 2094 2095 2096 2097 2098 2099 2100 Country of birth South Africa Albania Algeria Germany Andorra Andorra Angola Antigua and Barbuda Netherlands Antilles Saudi Arabia Saudi Arabia Argentina Armenia Australia Austria Bahamas Bahreïn Barbados Belgium Belize Benin Bermudes Belorussia Birmanie Bolivia Bosnie Herzegovine Brazil Brunei Bulgaria Cambodia Canada Cape Verde Chili China Cyprus Colombia South Korea Corse Costa Rica Ivory coast Croatia Cuba Denmark Dominica Egypt United Arab Emirates Equator Spain Spain except Canaria islands Estonia United States Ethiopia Finland France Gabon Ghana Gibraltar Greece Grenada Guadeloupe Guatemala French Guiana Hong Kong Hungary Mauritius Island Iles Feroe British Virgin Islands India Indonesia Ireland Island Israël Italy Japan Jordania Kazakhstan Koweït Reunion island Reunion island The Netherlands Latvia Lebanon Liechtenstein Lithuania Luxembourg Macao Madagascar Malaysia Malawi Maldives Malta Morocco Martinique Mexico Moldavia Monaco Montenegro Namibia Norway Nouvelle-Caledonie New-Zealand Oman Pakistan Panama Paraguay Netherlands Peru Philippines Poland French Polynesia Portugal Portugal except Açores islands Qatar Dominican Republic Czech Republic République yougoslave de Macédoine Romania United Kingdom Russia Saint-Barth San Marino Saint-Marteen Saint-Vincent and Grenadines islands Saint Lucia Senegal Serbie Seychelles Singapour Slovakia Slovenia Sweden Switzerland Thailand Tunisia Turkey Ukraine Uruguay Vatican Venezuela Viêt Nam Yougoslavia Department of birth Ain Aisne Allier Alpes-de-Haute-Provence Hautes-Alpes Alpes-Maritimes Ardèche Ardennes Ariège Aube Aude Aveyron Bouches-du-Rhône Calvados Cantal Charente Charente-Maritime Cher Corrèze Côte-d'Or Côtes-d'Armor Creuse Dordogne Doubs Drôme Eure Eure-et-Loir Finistère Corse-du-Sud Haute-Corse Gard Haute-Garonne Gers Gironde Hérault Ille-et-Vilaine Indre Indre-et-Loire Isère Jura Landes Loir-et-Cher Loire Haute-Loire Loire-Atlantique Loiret Lot Lot-et-Garonne Lozère Maine-et-Loire Manche Marne Haute-Marne Mayenne Meurthe-et-Moselle Meuse Morbihan Moselle Nièvre Nord Oise Orne Pas-de-Calais Puy-de-Dôme Pyrénées-Atlantiques Hautes-Pyrénées Pyrénées-Orientales Bas-Rhin Haut-Rhin Rhône Haute-Saône Saône-et-Loire Sarthe Savoie Haute-Savoie Paris Seine-Maritime Seine-et-Marne Yvelines Deux-Sèvres Somme Tarn Tarn-et-Garonne Var Vaucluse Vendée Vienne Haute-Vienne Vosges Yonne Territoire de Belfort Essonne Hauts-de-Seine Seine-Saint-Denis Val-de-Marne Val-d'Oise City of birth City of birth postal code Create your customer account (optional) Votre compte client vous permet d'accéder au portail client de Ouest Assurances. Vous pourrez ainsi accéder à vos différents dossiers, déclarer un sinitre en ligne ainsi que d'accélérer vos prochaines souscriptions.Si vous ne désirez pas créer de compte client, simplement ne pas remplir la section qui suit. User code Password The password must be at least 8 characters long and contain at least one letter and one number. Password confirmation Login User code Password