Clear Compare | GBI Quote

Policy Type

Single Trip

Trip destination

,

Traveler Type

Individual

Departure date (dd/mm/yyyy)

Return date (dd/mm/yyyy)

Telephone number

Email Address

Date of Birth (yyyy/mm/dd): 1969/12/31

Are you travelling contrary to medical advice or travelling to get medical treatment or medical advice abroad?

Are you awaiting investigative testing or treatment of an unresolved condition

Do you require kidney dialysis?

In the past 12 months, have you used or been prescribed home oxygen for a lung condition?

Do you have a terminal illness for which a physician has estimated you have less than 6 months to live?

Please confirm that every traveler's can perform ALL the regular functions of daily living?

Have you ever had, or are you awaiting a stem cell, bone marrow, or organ transplant (except corneal transplant)?

Do you have metastatic cancer

Have you had a medical check-up in the last 18 months?

Have you used a tobacco product of any nature in the last two years?

Medical conditions disclosed

CONDITION	QUESTIONS	CUSTOMER RESPONSE
No Medical History