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Inbound USA Basic Insurance Application

Please note that :

Not Available for Addresses from the Following U.S. States/Territories: Colorado (CO), Maryland (MD), New York (NY), South Dakota (SD) & Washington (WA).
Not available if Home Country/Country of Residences are: Cuba (CUB), Gambia (GMB), Ghana (GHA), Iran (IRN), Kosovo (XKX), Nigeria (NGA), Sierra Leone (SLE), Syria (SYR) & United States (USA).
Not available for Citizens of: United States (USA).

All fields are required fields unless stated as optional

Citizenship

Residence / Home Country

Where are you traveling to?

Sorry, we don't have an online application for your country at this time. Please contact support@visitorscoverage.com for more infomation.

Date of Arrival in the US

Coverage Start Date
(Begins at 12:00 AM EST)

Coverage End Date
(Ends at 11:59 PM EST)

Coverage Area

Please use the date of birth that appears in your travel documents, for e.g passport. A request to correct date of birth after the policy is purchased may result in changes to policy premium and benefits.

Applicant Date of Birth

Spouse Coverage Needed

Spouse Date of Birth

Child Coverage Needed
(18 years and under)

Dependent Child: Children 18 years and under of the primary insured on this policy. Grandchildren, nieces, nephews etc. are not considered as dependent children. Please fill a separate application in such cases or for older children.

+ Add Child

Where can we email your policy details?

Email Address

Will be used for communicating policy related notifications.

IUB

Inbound USA Basic

Administrative Company

Seven Corners

Carrier / Underwriter

Lloyd's of London

Payment Options

Credit cards accepted:
Debit cards are accepted.

Eligibility

For Non US citizens and Non US residents traveling to the USA.
Coverage for minimum 5 days to maximum up to 364 days.

Limited Coverage Plan

Plan provide basic and fixed pre defined dollar amount for covered services, as defined in the policy.

Review Policy document (Description of Coverage) for complete policy details including benefits and exclusions.

Review & Download

Plan Brochure Description of Coverage

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