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travel type Annual Multi-Trip destination travel dates travelling party




Does any person travelling on the trip and named in the schedule have, or have had, any Medical Condition (that includes any disease, illness or injury) for which they are taking prescribed medication or are waiting to receive treatment, or have received treatment (including surgery, tests or investigations) at any time in the past ?

If you have ticked yes to the above was the treatment (including surgery, tests or investigations) within the last 5 years or are you waiting to receive the treatment?

Does any person travelling on the trip and named in the schedule have 2 or more of the following conditions listed below or any other condition not listed here?

  • Achilles tendon injury
  • Acne
  • ADHD
  • Anal fissure/fistula
  • Benign Prostatic
  • Enlargement
  • Blindness
  • Broken bone (not head or spine)
  • Carpal tunnel syndrome
  • Cataracts
  • Chicken pox
  • Colitis (no hospital admissions in the last 12 months)
  • Common cold/influenza
  • Corneal graft
  • Cosmetic surgery
  • Cuts and abrasions (non self-inflicted)
  • Cyst - testicular
  • Cyst- breast
  • Cystitis
  • Deafness
  • Diarrhoea and/or vomiting
  • Dislocated hip (not replacement hip)
  • Eczema
  • Epididymitis
  • Essential tremor
  • Fungal nail infection
  • Gastric reflux
  • Glandular fever (not within 3 months of the planned trip)
  • Glaucoma
  • Gout
  • Haemorrhoids
  • Hayfever
  • Hernia (not hiatus)
  • Hip replacement
  • HRT
  • Hyperthyroidism (overactive thyroid)
  • Hypothyroidism (underactive thyroid)
  • Impetigo
  • Macular degeneration
  • Menorrhagia
  • Migraine (confirmed diagnosis, no ongoing investigations)
  • Myalgic
  • Encephalomyelitis (if only symptom is fatigue)
  • Nasal polyps
  • Neuralgia, Neuritis
  • Nut allergy
  • Osteochondritis
  • Pelvic inflammatory disease
  • PMT
  • Pregnancy (no complications)
  • Reflux oesophagitis
  • Retinal detachment
  • Rheumatism
  • Rhinitis
  • RSI
  • Shingles
  • Shoulder injury
  • Sinusitis
  • Sleep Apnoea
  • Tendon injury
  • Tinnitus
  • Uticaria
  • Varicose veins – legs only (if GP has confirmed that client is fit to travel)
Please confirm that all residents are permanently resident in the UK and are registered with a medical practitioner in the UK and all trips need to begin and end in the UK
The Destination of your Travel.

For Single Trip Travel, please select from one of UK, Europe, Worldwide Excluding USA or Worldwide Including USA

For Annual Multi-Trip Travel, please select from one of Europe, Worldwide Excluding USA or Worldwide Including USA

United Kingdom is defined as England, Scotland, Wales, Northern Ireland, Isle of Man, Channel Islands

Europe is defined as Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia Herzegovina, Bulgaria, Canary Isles, Corsica, Croatia, Cyprus, Czech Republic, Denmark, Eire, Estonia, Faroe Islands, Finland, France, Georgia, Germany, Gibraltar, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania , Luxembourg, Macedonia, Madeira, Malta, Moldova, Monaco, Netherlands, Norway, Poland, Portugal, Romania, Russia (west of Urals), San Marino, Slovakian Republic, Slovenia, Spain, Spitzbergen, Sweden, Switzerland, The Balearic Isles, Turkey, Ukraine, Vatican City State, Yugoslavia, England, Scotland, Northern Ireland, Wales, Channel Islands, Isle of Man

Worldwide Excluding USA is defined as Any country in the world except USA, Alaska, Hawaii, Canada, Caribbean Islands, Cuba, Bahamas, Bermuda, Mexico

Worldwide Including USA is defined as USA, Alaska, Hawaii, Canada, Caribbean Islands, Cuba, Bahamas, Bermuda, Mexico
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For Single Trip Travel, the Start and End Dates of your trip

For Annual Mult -Trip Travel, the Start Date is the Inception Date

Dates must be of the format DD/MM/YYYY
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'You' being the primary holder of the Travel Policy. This can not be de-selected and your details will be requested at time of Purchase

'Couple' is defined as You and eitther Your spouse, partner, civil partner or Close Relative who lives with You in a domestic relationship at the same address as You

'Close Relative' is defined as mother, father, sister, brother, wife, husband, civil partner, daughter, son, grandparent, grandchild, parent-in-law, son-in-law, daughter-in-law, sister-in-law, brother-in-law, step parent, step child, step sister, step brother, foster child, legal guardian, partner or fiancé/fiancée

Family Cover is defined as up to two adults and any number of their children, step children or foster children aged under 18 or 23 if in full time education, accompanying the parents or legal guardian insured on the same policy travelling on any Trip to the same destination. Under annual multi trip cover either adult is also insured to travel on their own

Single Parent Cover is defined as one adult and any number of his/her children, step children or foster children aged under 18 or 23 if in full time education, accompanying the parent insured on the same policy travelling on any Trip to the same destination. Under annual multi trip cover the adult is also insured to travel on their own

Please note that our system will apply either 'Individual Cover', 'Cover for a Couple', 'Family Cover' or 'Single Parent Cover' based on your selections
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