Company Details:

Company Name *:

Address 1:

Address 2:

Suburb:

State:

Postcode:

Main Contact *:

Office Number *:

Mobile Number:

Email *:

Staff Details:

Number of employees that travel *:

What regions do your staff travel to (ie Worldwide, Europe, Asia, Pacific or Interstate). If this varies between the staff then please detail below *:

What is the maximum number of staff that would be traveling together at one time *:

How many trips do you estimate your staff making over 12 months *:

What would you estimate the average duration of each trip to be *:

Does your company have any corporate travel insurance claims history?:

* denotes a required field

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Travel Insurance

1Cover Australia

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Underwritten by Allianz

1Cover travel insurance is managed by ETI Australia Pty Ltd, a company of the Mondial Assistance Group; AFSL 245631, ABN 52 097 227 177, and underwritten by Allianz Australia Insurance Limited; AFSL 234708, ABN 15 000 122 850 (Allianz)

Because we don't know your financial needs, we can't advise if this insurance will suit you. You should consider your needs and read the PDS before making a decision to buy insurance, to download a copy of the FSG and PDS click here.

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