Compare multiple travel insurance plans, please complete the form below and our friendly staff will get back to you as soon as possible. Thank you. 1. Travel Plan Choose your cover * ---Single TripAnnual Multi-Trip Travelling to * ---AsiaWorldwide Country ---AfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua & BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoMyanmar/BurmaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominican RepublicDominicaEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaGabonGambiaGeorgiaGermanyGhanaGreat BritainGreeceGrenadaGuadeloupeGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIsrael and the Occupied TerritoriesItalyIvory Coast (Cote d'Ivoire)JamaicaJapanJordanKazakhstanKenyaKosovoKuwaitKyrgyz Republic (Kyrgyzstan)LaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgRepublic of MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotteMexicoMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueNamibiaNepalNetherlandsNew ZealandNicaraguaNigerNigeriaKorea, Democratic Republic of (North Korea)NorwayOmanPacific IslandsPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent's & GrenadinesSamoaSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovak Republic (Slovakia)SloveniaSolomon IslandsSomaliaSouth AfricaKorea, Republic of (South Korea)South SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTajikistanTanzaniaThailandTimor LesteTogoTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsUgandaUkraineUnited Arab EmiratesUnited States of America (USA)UruguayUzbekistanVenezuelaVietnamVirgin Islands (UK)Virgin Islands (US)YemenZambiaZimbabwe Start Date * End Date * Adults 21-69 yrs Children 0-20 yrs Seniors 70+ yrs 2. Insured Information Traveller 1 Full Name Date of Birth Gender ---MaleFemale I am a * ---Singaporean/PRForeigner NRIC / FIN No. * Passport No. Traveller 2 Full Name Date of Birth Gender ---MaleFemale I am a ---Singaporean/PRForeigner NRIC / FIN No. Passport No. 3. Contact Information Name of contact person * Email * Tel (HP) * Tel (Home) Address * Postal Code * 4. Additional Information Promotional Code How Did You Hear of Us/Find Us? * ---Social mediaRecommended by friend/familySearch engineRadioBusiness associateInternet adLink from another pageFlyer/Banner/PosterRoad ShowBloggerEmailOther Remarks I/we hereby understand that I/we need to disclose our personal data in order for Assure (Singapore) Pte Ltd to generate a quotation for me/us. I/we have read the Privacy Policy and I/we consent to the collection and use of my/our personal data in accordance with its terms and conditions. I/we agree and understand that accuracy of quotation premium is solely reliant on information provided by me/we only. *indicates required field. By clicking Submit, you agree to our Privacy Policy.
