Purchase a Plan

Travel Agent Location
Agent Information
Location Number (if applicable)
This number can be found on the back
of your brochure (e.g.: 33-7777)
Agent Code
Invoice Number
Travel Agent
Are you a travel agent?
Please Select One*

   
Plan Options
 
Flight Insure Plus - Single Trip
Underwritten by Stonebridge Casualty Insurance Company
 
Period of Coverage
 


 
Select Package Type 
 


 
Select Flight Accident Level 
 


Trip Information
Departure Date*
RadDatePicker
Open the calendar popup.

(mm/dd/yyyy)
Return Date*
RadDatePicker
Open the calendar popup.

(mm/dd/yyyy)
Final Destination*
select
 
Primary Traveler Information
 
First Name*  
Last Name*  

Are you a United States Citizen?*
Address*
 
 
 
City*
 
State*
Zip*
  
Country*
select

Phone*
     
Fax 
     
Email
 
Beneficiary
(max 256 chars)
 
Additional Traveler Information
Traveler #2
 
First Name*
Last Name*

Traveler #3
 
First Name*
Last Name*

Add Travelers
Maximum limit of 10 immediate family members per policy.
Policy Document Delivery Options
 
Delivery Method
 


 
Recipient #1
(Optional) Recipient #2

* Required Field
Plan Details
Flight Insure Plus
- Single Trip
Benefit
Coverage

Flight Accident AD&D
Choose:
$300,000,
$500,000,
$1 Million
Baggage / Baggage Delay
$2,000 / $500
Medical Expense Benefits
$2,500 Sickness
$2,500 Accident
Medical Evacuation / Repatriation of Remains
$25,000
24 Hour AD&D
$10,000
Travel Assistance
Included
Policy Details
Top
For Assistance Please Call (800) 228-9792
The above information contains a brief description of benefits. Refer to the applicable Certificate of Insurance or Evidence of Coverage (the "Policy") for full policy details. Certain conditions, exclusions, and limitations apply as set out in the Policy. Products may not be available to residents of all states. If there is any conflict between the contents of this website and the Policy, the Policy will govern in all cases. *Assistance Services provided by Travelex's designated provider.