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Liaison Travel Choice Insurance Application

Please note that :

  • Not Available for Addresses from the Following US States: 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).
  • Not available for Citizens of: Kosovo (XKX).
  • Not Available for the following Destination Countries: Antarctica (ATA), Iran (IRN), Kosovo (XKX) & Syria (SYR).
All fields are required fields unless stated as optional
Sorry, we don't have an online application for your country at this time. Please contact support@visitorscoverage.com for more infomation.

(Begins at 12:00 AM EST)

(Ends at 11:59 PM EST)

(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.
Where can we email your policy details?
LCH

Administrative Company

Seven Corners

Carrier / Underwriter

Lloyd's of London and Tramont Insurance Company

Eligibility

  • For international travelers traveling outside their home country.
  • Coverage for minimum 5 days to maximum up to 364 days in a policy period.

Comprehensive Coverage Plan


The comprehensive plan provides percentage of eligible expenses, up to the policy maximum. After the deductible,

in the USA

:

within the PPO Network,

Liaison Travel Choice plan pays 90% of first $5,000; then 100% up to chosen medical maximum.

Outside the PPO Network

:the plan pays 80% for the first $5,000 and then 100% up to the policy maximum

Outside the USA

: After the deductible is met, the plan pays 100% up to the policy maximum. Review Policy document(Description of Coverage) ,for complete policy details including benefits and exclusions.

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