Travel Insurance

• Application Date(YYYY-MM-DD)*
  申請日期

• Departure Date(YYYY-MM-DD)*
  出發日期

• Effective Date(YYYY-MM-DD)*
  生效日期

• Expiry Date(YYYY-MM-DD)*
  失效日期

• Days*
  總天數

The days of coverage must not exceed 365

• Destination*
  目的地

• Which state/country?
  目的州/國家

• Coverage*
  保額

• Deductible Amout*
  免保金額

• Family Plan
  是否家庭計劃

• For family plan, enter the oldest member first. Total members must be 3 or more. At least 1 member but no more than 2 members’ age must between 21 to 59. All other members should be below age 21.
  如選擇家庭計劃，請先填寫最年長的家庭成員信息。總人數必須為3人或以上。其中1至2人的年齡必須在21歲到59歲之間，其餘成員的年齡不得超過21歲。

• Date of Birth 1*
  出生日期

• Age1
  年齡

• Add one more person
• Delete one person

• First Name*
  名

• Last Name*
  姓

• Date of Birth 1*
  出生日期

• Gender*
  性別

  Male Female

• Beneficiary*
  受益人

• Address1*
  地址欄1

• Address2
  地址欄2

• City*
  城市

• Province*
  省

  AB BC ON

• Postal Code*
  郵編

• Country of Permanent Residence
  國籍

• *Product is available in BC, Alberta and Ontario only.
  本保險僅限BC、Alberta以及Ontario居民購買

• Email Address*
  電郵地址

• Phone/Mobile
  電話/手機號碼

• Wechat
  微信號

• Special Notes/Instructions
  備註/特殊要求

• All Persons insured are subject to the terms and conditions below.

  The contract, which contains your policy number, effective date, expiry date, and payment information will be confirmed to you via email.

  The applicant has been advised to read and understand the policy for full details of coverage and exclusions. You must agree to the terms of the contract.

  以下條件條款適用於所有受保成員：

  此保險合同，包括您的保險單號、生效日期、失效日期以及付款信息，將通過電子郵件的方式向您確認。

  建議申請人閱讀並理解本保險政策中關於受保範圍以及例外的全部細節。您必須同意該保險合同的條款以進行購買。

  After successful payment, please wait until you are automatically redirected to the Invoice page.

  付款完成後，請務必等待窗口自動跳轉至賬單頁面。

• For All Members

• I Agree  

• Payment*
  付款方式