Travel Insurance Form

Wise travelers recognize the important need to protect their trip investment, health, and
personal belongings. Emergencies can happen when you least expect it, therefore, I highly
recommend that you protect your vacation with a travel insurance. Cruise lines, airlines, hotels,
and tour operators all have penalties for cancellation, ranging from the full deposit to no refund
at all. Travel Protection Insurance may offer protection in the following areas:


Trip Cancellation
Trip Delay
Trip Interruption
Missed Connection
Baggage Loss, Theft or Damage
Baggage Delay
Emergency Medical and Dental Expenses
Emergency Medical Transportation
24/7 Hotline Assistance
Many insurance suppliers do not provide the following coverage:
• Supplier Bankruptcy
• The ability to cancel your trip (for covered reasons) up to the time of departure. (CFAR)
• Trip interruption coverage once you have departed.
• Medical coverage.
• 24-hour hotline assistance for travel and medical emergencies.


Even pre-existing coverage may not apply to world events such as strikes, natural disasters,
terrorism, etc. While I am not a registered insurance agent and cannot legally provide specific
advice or information regarding insurance, I can certainly suggest a couple of them.

By submitting the form below, you agree that you have been advised of and understand the benefits of Travel Protection Insurance. You understand
that you do not have any coverage until 24 hours after the policy form is completed and active by
the insurance company. Should you decline this protection, you understand that you will assume all
financial responsibility for any expenses incurred because of being unable to travel, or travel
disrupted for any reason as well as any medical expenses. You also understand that you must purchase
Travel Protection Insurance immediately to obtain maximum coverage, in order to be covered for
any pre-existing conditions and it must cover full cost of all non-refundable trip arrangements.

Travel Insurance Form

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Thanks for submitting!