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Travel Insurance – Assessment of Demands and Needs
Insurance Brokers, Companies and Intermediaries
Other Insurance Brokers, Insurance Companies or Insurance Intermediaries that you have approached for quotations to date
Are you an existing MIB Customer?
*
Yes
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Please specify your Customer Number
Policy Holder Details
Name and Surname
*
Date of Birth
*
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ID Number
*
Email
*
Enter Email
Confirm Email
Address
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Contact Number
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Business/Occupation
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Travel Details
Commencement Date of Travel from Malta
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Return Date to Malta from Travel
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Destination
*
Reason for travelling
*
Business - excluding manual work
Pleasure
Type of cover required
*
Low Cover
Intermediate Cover
Highest Cover
Sports Activities
*
Will you be engaging in any Sporting Activities? If Yes, give details
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Sporting Activity Details
Additional Travellers
Name and Surname
ID Card
Date of Birth
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Travellers.
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Maximum number of travellers reached.
Health Details
Give details of any Health issues that any of the Insured Persons listed has experience in the past 12 months (insurance cover may be restricted or even declines by insurers depending on the condition/s reported and declared by you)
Would you like the policy to be extended for Covid?
*
Yes
No
Would you like your policy excess to be waived in case of a claim at an additional premium?
*
Not all insurers provide this extension
Yes
No
Would you like to include the Cancellation of Service cover for cancellations due to adverse weather conditions?
*
Terms and Conditions apply
Yes
No
Additional Details
Additional Comments
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Terms Accept
*
I have read and accept MIB's
Client Terms of Business & Privacy Policy
.
*
I understand that by completing this form the data will be processed by MIB in line with GDPR and hereby consent that this data (including if needed sensitive data as defined in article 9 of GDPR) are used for the purposes of providing your insurance services.
I also understand that it is my responsibility to secure and hold the necessary consent from any employees, beneficiaries or other third parties direct or indirectly involved in the insurance proposal/arrangements and whose data will be processed by MIB and the providers of insurance and ancillary services.
Insurance
Health Insurance
Home Insurance
Travel Insurance
Motor Insurance
Boat Insurance
Personal Accident Insurance
Life Insurance
Sports Medical Insurance
Get a Quote
Make a Claim
Insurance
Transit Insurance
Liability Insurance
Marine Insurance
Aviation Insurance
Property Insurance
Financial Risks Insurance
Professional Indemnity Insurance
Cyber Insurance and iGaming Exposures
Engineering Insurance
Employee Benefits
Construction Insurance
Motor Fleets & Tool of Trade
Risk Consultancy
Get a Quote
Make a Claim
Name and Surname
*
ID Card
*
Date of Birth
*
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