TRAVEL DETAILS
Please use the date of birth that appears in your travel documents, for e.g passport. A request to correct date of birth after the policy is purchased may result in changes to policy premium and benefits.
Child coverage is not applicable for this plan
PLAN DETAILS
This quote is for from - - - inclusive of start and end dates.
Primary Traveller (Age -)
-
Spouse Traveller (Age -)
-
Child Traveller (Age -)
-
TRAVELER DETAILS
All fields are required fields unless stated as optional
Insured Person Information
Primary traveller
Enter First, Last Names as shown in the passport or a government issued ID
-
Spouse traveller
Enter First, Last Names as shown in the passport or a government issued ID
-
Mailing Address Information
Please enter Any Residential or business address
Enter First, Last Names as shown in the passport or a government issued ID
Beneficiary
Name the person who will receive the benefits in the event of insured person's accidental Death. Usually this name should be other than the travelers themselves. For example if you are buying this policy for your parents, you can put your name as beneficiary.