Online Application for International Health Insurance


Thank you for choosing one of HealthCare International's Medical Insurance plans

On the following pages, we will be asking you to complete all of the fields as accurately as possible, and where you have any doubt, we have left room in section K at the very end for any information you feel we should know or you would like taken into account.

The whole process, from start to finish, should only take approximately 10 minutes to complete, depending on the connection between your computer and our server.

I would also like to remind you that the information you supply via the web, is through our secure server at all times, any personal and financial information is encrypted for your security.

During the course of completing the application form, should you make a mistake or wish to change any answers, you can always go back and amend the answer without loosing the information already completed.

Once you have answered all of the questions, you will then be given several options in the way that you can proceed.

You will have several payment options.

(Please remember that which ever payment option you make, we will require the original signed application form before any claims can be made).

 
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