DIVE MASTER TRAVEL INSURANCE is only available together with IDEC
 
You can only buy this Travel Insurance on it’s own, if you are a non-diving member of a dive group
or if you are travelling together with a family member or a partner
 
TRAVEL INSURANCE PROPOSAL FORM
 
First name Surname
House name / number Street
Post code Town / County
Country Telephone
E-mail Fax
Date of birth Nationality
Diving since Diver qualification
Certifying association BSAC number
 
Please choose the type of Travel Insurance you require:
 
Short Trip Travel Area of travel:
    Dates of travel:
    Dates of IDEC:
    Destination:
 
Annual Multi Trip Travel Start date:
 
Worldwide Diver Start date:
 
Short Trip Travel Premiums
Europe Trip
WorldWide
IDEC premiums
to add
 9 days
  € 32.80
  € 58.20
     9 days
   € 26.24
17 days
  € 39.35
  € 63.95
   17 days
   € 38.87
24 days
  € 45.95
  € 78.70
24 days
   € 57.15
31 days
  € 54.95
  € 82.00
31 days
   € 74.54
EAWeek
   € 11.50
  € 18.05
EAWeek
   € 22.39
Annual
 € 134.15
 
Annual Multi Trip Travel Premiums
The policy is divided into two sections, so that you can tailor the cover to suit your own needs.
This means that you only pay for the cover you require.
 To calculate the premium, firstly choose the appropriate travel rate:
Individual Travel rate 
    € 106.10
Couple Travel rate      € 162.45
Familiy Travel rate (up to 2 children)      € 205.00
Familiy Travel rate (3 children)         € 254.20
Familiy Travel rate (4 children)     € 303.40
Then add the number of divers in your family to get the premium for the Diving section of
the policy (minimum of 1 diver).
Rate per Diver (IDEC): € 84.40 
Then add the two figures together to give the total annual premium due.
Calculating Your Total Premium:
Appropriate Travel Rate: £.…………
No of Divers: …… x € 84.40 = € ..….……...
Total Premium € …………
 
World Wide Diver Premiums
     6 months € 281.88      10 months € 469.83
     7 months € 328.82      11 months € 516.78
     8 months € 375.85      12 months € 563.75
     9 months € 422.82
 
1 Have you previously suffered from any diving related illness and/or injury? Yes No
2 Are you suffering from any illness, injury or disease that would render you
medically unfit to engage in sport diving?		 Yes No
3 Are you currently taking any medication or receiving medical treatment? Yes No
If you have answered ‘No’ to all questions 1 to 3, then your application will be automatically accepted
on the requested start date.
If you have answered ‘Yes’ to any of the questions 1 to 3 then we are unable to automatically process
your application and we shall need more background details before we can consider giving cover.
Please give background details in the box below.

I have read and accepted the policy conditions and understand that certain situations are not covered.
I wish to proceed with the purchase of this insurance policy of certain Underwriters at Lloyd´s of London,
subject to their terms and conditions, issued through Dive Master Insurance Consultants Ltd.

Method of payment
Credit card type Debit card type
Credit card / Debit card
number		 Issue number
(if applicable)
Expiry date Valid from
Credit card owner Debit card owner

The validation card of your cover will be sent to you within 10 days from receipt of your application.
If you have not received the validation card within 10 days, please contact us.
No insurance cover is given if we fail to receive this proposal form.

Please print a copy of this form and / or the formmail that you will receive upon submitting this form.

Box for messages to Dive Master

 

© sunshine service