Serving the public since 1975 

Travel Insurance


About you

Title
Sex
Forename(s)
Surname
Postcode Great Britain, Isle of Man and Channel Isles only  
Home tel. number
Mobile tel. number
Email

Travel details

To which country are you travelling?
How long are you going for? (in days)
How many children aged under 2?
How many children aged 2 to 18?
How many adults aged 19 to 65?
Is this trip for holiday purposes?
Do you require the winter sports option?
Would you like a quote for an annual travel policy

Declaration

For you or anyone travelling with you

As far as I know the following apply:

a) Nobody is waiting for an operation, hospital consulation (other than a regular check ups), or other hospital treatment or investigation.

b) Nobody has received treatment, other than regular medication, in the last 12 months for;

  • any blood disorder;
  • any form of cancer, leukaemia or tumour;
  • a transplant;
  • any psyciatric illness;
  • dialysis treatment; or
  • dementia

c) Nobody has any breathing or heart problems which has needed hospital treatment more than once in the last 12 months.

d) Nobody has seen by a specialist in the last threee months (other than regular check ups) or been admitted to a hospital overnight.

e) Nobody has been diagnosed by a registered doctor as having a terminal condition.

f) I do not know of any reason (other than medical) why the trip is likely to be cancelled or cut short.

For a close relative or business associate who is not travelling and whose health may affect the trip.

If, at the time of taking this insurance (or booking the trip if this was later) your close relative or business associate had a medical condition for which he or she:

  • was receiving treatment at hospital;
  • was waiting for a hospital consultation or treatment;
  • had been given a terminal prognosis, or been told that their condition is likely to get worse in the next 12 months;

we will not pay for any problem which has anyhting to do with that medical condition

I agree

 


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