Travel Details

Personal Details

Main policy holder Title First name Last name Date of birth
The policy end date should be the same as your Uni-Care Travel Start Date

If your application is accepted the following conditions will apply to your policy for the first 90 days:

  1. The policy must be taken for a minimum period of 90 days.
  2. Each and every claim will be subject to an excess of $200.00 NZD.
  3. There is nil refund available upon cancellation of this policy.
  4. The policy must start immediately
  5. Section 2: (Luggage, Personal Effects, Travel Documents, Money and Credit Cards) is excluded from the policy.

After 90 days the policy will revert back to the standard policy conditions for the remainder of the policy period

Contact Details

PRE-EXISTING CONDITIONS

Pre-Existing conditions are not automatically covered under your policy. A pre-existing condition is any medical, dental, mental or physical condition or circumstance which you are aware of or ought to be aware of prior to the start date of your policy. Pre-existing conditions that you do not tell us about, or do not seek cover for, will be excluded under your policy.

The application must be completed within 7 days of purchasing your policy. After completing the purchase of your Uni-care Travel Insurance Policy you will recieve an email with a link to complete the Pre-Existing Condition application form. You only need to complete this form if you want cover for your Pre-existing condition.

Please note that your application will be referred to our underwriting team for review and we may request further information from you regarding your pre-existing condition. If cover is offered for your pre-existing condition, an additional fee will be payable.

You will not have cover for any claims related to your Pre-existing Condition(s) until they have been declared to us, the additional fee has been paid and we have agreed in writing to provide cover.

Specified Items

The policy limit for any one item, set or pair of items is $2,500 unless the item, set or pair of items is specified and additional premium is paid. Additional premium will be charged at a rate of 2% of the full value of the item. Lesser valued items of luggage are covered under the general luggage allowance.

A full description of the item(s) to be specified needs to be made in the Item Name field. This needs to include the make, model & serial number of laptops and other electronic equipment.

Item name Item value

Declaration

Please read the following Declaration carefully. You must accept this Declaration to complete the Uni-Care application.

  • I/We have not been refused travel insurance by any other company nor are I/we insuring with the intention of receiving medical treatment or to claim for events which have already occurred.
  • I/We are not aware of any circumstances likely to lead to cancellation or curtailment of the trip. The underwriter is aware of all facts likely to affect the acceptance or conditions of this insurance.
  • I/We will notify the underwriter of changes in circumstances or health occurring prior to the commencement date.
  • I/We confirm the details have been correctly declared in this application form including medical information that will be submitted for approval by the underwriter.
  • I/We agree, in the event of illness or injury giving rise to claims under the medical section of the policy, to be medically evacuated to Australia, New Zealand or our country of origin, at the underwriter's discretion.
  • I/We agree to a waiver of privacy in that I consent to any requested medical information being released by your doctor, specialist, or other health provider to the Underwriter or its agent and to the release of any further information necessary for the purposes of this insurance.
  • I/We authorise any claim to be paid to any named institution which has submitted claim details and requested payment to be made to them on our behalf.
  • I/We accept that failure to supply correct application and medical certificate details may affect the validity of the policy.
  • I/We understand that I/we have certain rights of access to and correction of this information. View Uni-Care's Privacy Policy.
  • I/We understand that this policy does not cover any event that happens to us, unless I/we are aged 65 years or under at the date of the event.
  • I/We understand and agree that the act of completing and submitting this application to Uni-Care will have the legal force of a signature.

Trip Summary
Plan Summary

Total Cost $0.00

Includes
Specified Item Premium
$0.00
Levies
$0.00
Documentation Fee
$0.00
Trip Summary
Plan Summary

Total Cost $0.00

Includes
Specified Item Premium
$0.00
Levies
$0.00
Documentation Fee
$0.00