top of page

Travel insurance waiver form

​

 

The risks for declining coverage have been explained to me by my Travel Advisor, Daphne Best. I understand that declining travel insurance means I will lose all benefits of coverage and I fully accept that risk. 

 

​

 

I UNDERSTAND THAT I WILL NOT BE COVERED FOR: 

• Lost luggage 

• Missed connections or train delays 

• Emergency air lift assistance 

• Emergency medical and/or dental assistance

Emergencies at home affecting me and/or my immediate family (children,  grandchildren, aunts, uncles, brothers, sisters, nephews, nieces) 

• Death of myself and/or my immediate family (children, grandchildren, aunts,  uncles, brothers, sisters, nephews, nieces) 

• Supplier default and/or bankruptcy 

• Any other covered circumstances as outlined in the offered travel insurance  policy 

​

​

​

​

​

​

YOUR OWN DETAILS:

Thanks for submitting!

bottom of page