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  • Visitors to Canada

Travel Date

  • Arrival Date(YYYY-MM-DD) *

  • Effective Date(YYYY-MM-DD)*

  • Expiry Date(YYYY-MM-DD)*

  • Days*

Coverage details

  • Coverage*

  • Deductible Amout*

  • Family Plan

  • Select Pre-existing condition coverage

  • 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 61. All other members should be below age 21.

Insured member

  • Date of Birth 1*

  • Age1

  • Add one more person
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Insured Member

  • First Name*

  • Last Name*

  • Date of Birth 1*

  • Gender*

Beneficiary

  • Beneficiary*

Address

  • Address1*

  • Address2

  • City*

  • Province*

  • Postal Code*

  • Country of Permanent Residence

Contact Information

  • Email Address*

  • Phone/Mobile

  • Wechat

  • Special Notes/Instructions

  • 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.



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