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Please complete your departure date, return date, destination and type of cover
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Plan L AUS RES Age 01 - 70 Years
Policy Excess $100.00
Day Month Year
Departing
Day Month Year
Returning
Cover Single Family
Destination Region 1

(for example: Middle East, North America (Including Hawaii), South America, Central America, Arctic and Antarctic Circles)


Region 2

(for example: Europe (UK/Ireland - Region 3) and African Continent (Middle East - Region 1))


Region 3

(for example: UK/Ireland, Asia, Japan, Indonesia (Bali only - Region 5) and Indian sub-continent )


Region 4

(for example: South Pacific Islands (New Zealand, Fiji, Norfolk Island - Region 5) and New Guinea)


Region 5

(for example: Bali, New Zealand, Fiji, Norfolk Island and cruising in Australian waters)