• Business Travel Insurance Application Form

  • Will any trips involve manual work, hazardous activities or visits to areas in a state of civil unrest, civil war or war, as certain territories are excluded from cover unless declared?*

  • Claims Record

  • Have there been any claims under a similar insurance in the last 3 years?*

  • Estimated Business Travel Over the Next 12 Months

  • Before completing the boxes below, please note:

    • When providing this information please ensure that it is the total number of trips e.g. 3 persons travelling on the same trip should be counted as 3 trips.
    • Trips within the United Kingdom must involve either air travel and/or an overnight stay and will not cover medical expenses.
    • All trips with a duration of longer than 30 days must be detailed separately in the space provided below.
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  • * Means all European countries including Russia west of the Ural Mountains, the Azores, Madeira, the Canary Islands, Mediterranean islands and Turkey.

     

    ** North America means the United States of America and Canada

     

    *** Only complete information if cover is required for UK trips, see note above in respect of UK trips.

  • Are there any trips with a duration of 30 days or more that you wish to cover?*

  • Insured Persons

  • Who is to be insured:*

  • Optional - Holiday Travel Extension

    Cover can be extended to include holiday travel for specified directors and/or employees. The cover provided under this extension is based on the same terms and conditions as business travel, except for the following:

    • The maximum duration of any one trip shall be 30 days.
    • Cover shall automatically include the partner/spouse and dependent children while accompanying them.
    • Cover shall automatically include winter sports holidays (subject to certain excluded activities). Please refer to the Main Exclusions detailed in the Policy Summary.

    Should the holiday travel extension be required, please provide the name(s) of the directors or employees you wish to be covered by this extension.

     

  • Do you wish to extend cover to include holiday travel?*
  • Which directors and/or employees wish to extend cover to include holiday travel :*
  • How would you like to provide the list of directors and/or employees who require holiday extension cover?*
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  • Optional - Holiday Travel Extension

    Cover can be extended to include holiday travel for specified directors and/or employees. The cover provided under this extension is based on the same terms and conditions as business travel, except for the following:

    • The maximum duration of any one trip shall be 30 days.
    • Cover shall automatically include the partner/spouse and dependent children while accompanying them.
    • Cover shall automatically include winter sports holidays (subject to certain excluded activities). Please refer to the Main Exclusions detailed in the Policy Summary.

     

    Should the holiday travel extension be required, please tick the checkbox next to the name(s) of the directors or employees you wish to be covered by this extension.

    If you choose to upload a file listing all directors and/or employees to be insured, please ensure the file includes a separate column clearly indicating which individuals are to be covered by the holiday travel extension.

     

  • How would you like to provide the list of directors and/or employees to be insured?*
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