Apply for INF Visitor Insurance

Insurance is offered to persons traveling on a limited duration trip (364 days or less) to the US, Canada or Mexico.

Please note that INF Premier and Elite plans require minimum 90 days enrollment; and Standard and Safe Traveler USA require minimum 30 days enrollment.

Select Plan

Pre-existing Cover

Policy Maximum:

Policy Deductible:

PreEx Deductible/ Max:

Visitor Information

Accidental Death and Dismemberment Beneficiary (ADDB)

ADDB Name (?)

ADDB Relation

How did you hear about us?

Dependent Details

Spouse Details

First Name

Last Name

Date of Birth

Passport

Children Details

(Child 1)

First Name

Last Name

Date of Birth

Passport

Children Details

(Child 2)

First Name

Last Name

Date of Birth

Passport

Payment Details

Total Premium :

Disclosures

I understand and agree that refund of plan cost less the enrollment fee and membership fee will be considered only if written cancellation form with $25 payment authorization is received by the INF office before the trip start date. After that trip start date, the plan cost is considered fully earned and non-refundable. I understand that once cancelled, the plan is considered null and void and there will be no benefits or services available.

I have read and agree to the Terms of USE and Consent for Electronic Delivery

I hereby confirm that all information entered in the application is accurate. Any changes to policy may incur additional premiums and WILL INCUR CHANGE FEE OF $25 before effective date if needed. I have read the Terms, and hereby authorize INFPlans.Com to charge the Amount on the card below.

Credit Card Details

Card Holder

Card Number

Expiry

CVC

Home Address

Street Address

City

State

Zipcode/PinCode