WORLDWIDE TRAVEL INSURANCE
Veterinary Adventures Single Trip Travel Insurance 2007/2008
Comprehensive Travel Insurance • Covers full duration of travel, both whilst working and leisure time • Premium up to 17 days cover: £81.50 up to age 50; £95.50 age 50 to 65
Summary of Cover
Cancellation & Curtailment £5,000 Medical & Emergency Expenses £10M Hospital Inconvenience Benefit £1,000 Personal Accident £50,000 Travel Delay (Abandonment) £250 (£5,000) Missed Departure £2,000 Personal Effects and Baggage £3,000 Max. per item, pair or set (Total limit for all Valuables) £350 (£450) Money/Travellers Cheques £1,000 Passport Indemnity £500 Catastrophe Cover £1000 Personal Liability £2M Legal Expenses £50,000 Business Personnel Replacement £5,000 Homecare Assistance £250 Transport Disruption £500 Financial Failure Protection £2,000 Excesses NONE Limits apply within some sections – for details please ask for a copy of our keyfacts. Restrictions applying to Veterinary work: 1. Section 4, Personal Accident - excluded entirely whilst working. 2. Section 2, Medical & other expenses - Excess increased to £100 each and every claim resulting directly or indirectly from veterinary work. 3. Section 10, Personal Liability - You are not covered for any liability for bodily injury, loss or damage that you may cause to someone else, including other players/participants, or their property whilst working. You are not covered unless you adhere to the rules set by any Governing Body (or equivalent authority), observe all normal safety precautions and use all recommended protective equipment and clothing.
Application Form
Title, First Name & Surname: Address: Date of Birth: Email: Fax No: Telephone No: Departure date: Premium £
Medical Conditions
Please answer these questions in relation to yourself and your travelling companions and contact Worldwide if necessary. Have any of you ever suffered from or been investigated or treated for or diagnosed with: i. any cancer or malignant condition ii. any lung- or heart- related condition (including angina) There is NO cover for claims related directly or indirectly to these conditions. However, cover may be available by contacting Worldwide on 0870 112 8100. An additional charge may apply to cover your medical conditions. ► If cover is offered, this will be confirmed in writing on your Insurance Certificate. Non travelling relatives Serious medical conditions suffered by people who are not insured on this policy but on whom your travel plans depend should be declared to us as Material Facts: Material Facts You MUST tell us all material facts. A material fact is one that is likely to influence us in accepting your Insurance. This could be the state of your health or that of a close relative or any planned hazardous activities. If you are in any doubt as to whether a fact is ‘material’, you should tell us. If you do not tell us this may result in your claim being invalid. Please note: You are not covered for any related claims if • you are planning to travel against the advice of your doctor or with a view to obtaining medical treatment. • you or, as far as you are aware, a travelling companion or non-travelling relative, have been given a terminal prognosis. • are pregnant with an anticipated delivery date of less than 14 weeks after you plan to return home.
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Do any of you suffer from any other pre-existing medical condition as defined: Pre-existing medical condition means any condition that has been suffered or for which you have either received or been put on a waiting list for medical advice (including routine check-ups), investigation, treatment or medication within the 24 months prior to the date that this insurance is arranged or the date that you subsequently made arrangements for a trip or you extended the original period of your insurance.
I have read the above and confirm that all information I have previously given remains unchanged & I have no material facts to declare, OR I have attached details of my medical condition(s). I am aware that there may be an additional charge but understand that I will be contacted BEFORE my payment is processed if this applies:
Signed
Date
19/02/2008