Travel Insurance



Submit your request for Travel Insurance Quotes


Applicant's Name


Applicant 1:  



Applicant 2:



Province of Residence


Country of Primary Destination

  (Where you are going to travel)

   Individual Coverage                     Couple


Emergency Medical Insurance

  Single-Trip Medical Plan                   Annual Multi-Trip Medical Plan 


  Total number of days  per trip*             

*For Single-Trip plans and and Top-ups : Total trip length including departure and return dates

  For Multi-Trip plans: Max number of days per trip

  For Top-up coverage:  number of days covered by the existing  policy   


Non-medical Insurance

Please choose  insurance you want to apply for:

  Single-Trip                              Annual Multi-Trip

  Trip Cancellation & Interruption    Trip Cost (sum insured per person)  $

  Baggage Loss          Baggage Cost  (sum insured per person)   $


Date of Booking Your Trip              (ddmmmyyyy) 

 All -Inclusive plan

All Inclusive plan may include Emergency medical, Trip cancellation & Interruption,

Baggage loss , Flight accident insurance.

  Single-Trip                              Annual Multi-Trip

 All-Inclusive   plan          Trip Cost  (sum insured per person)  $


Coverage for  Pre-existing Medical Conditions


     Phone       (if you want an insurance broker call you)


Additional Information

(If you have pre-existing conditions, you can provide the details here)

Please confirm your E-mail   




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Revised: October 19, 2017