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Step {{ currentStep }} of 6

1 Travel information

2 Available plans

3 Eligibility requirements

4 Personal information

5 Summary

Travel information

Use the following fields to target your needs. The plans proposed in the next step will be linked to the information provided in this step.

*Required fields

What type of traveler are you?*

What is the reason for the trip?*

Are you covered by a provincial health insurance plan (e.g. RAMQ)?*

Do you have any pre-existing health conditions?*

Native country*

Place of residence during the trip?* Information “Place of residence during your trip" means the Canadian province where you plan to settle during your stay or the destination country for your stay outside Canada.

Travel dates*

Arrival dates in Canada*

List of travelers*

Traveler {{ index + 1 }}

If you have a partner code, enter it here Information A "Partner Code" is a code held by some of our partners, including Collaborating Brokers, Immigration Advisors and, but not limited to, Licensed Advisors. This partner code is intended for their clients to ensure a link to the partner account when making a quote.

Available plans

Find out which insurance plans meet the criteria you entered in step 1. You can compare coverages and select the one that's right for you.

Deductible Information "Deductible" refers to the predetermined amount that the insured must pay before the remaining eligible expenses are covered by the insurer. In other words, the deductible is the amount that remains at the insured's expense in the event of a claim.

Maximum coverage amount Information "Maximum coverage amount", or sum insured, refers to the maximum sum an insurer will cover during the term of the contract. A good assessment of emergency needs is necessary, taking into account the actual costs of health services in the region, province or country visited.

Pre-existing conditions Information "Pre-existing conditions" means any pathological or physical condition, disorder or related ailment, symptom or Disease for which Treatment has been sought, or for which an ordinarily prudent person would have sought Treatment, which existed prior to or on the Effective Date or the date of your departure.

Medical care

Accidental Death & Dismemberment

Maternity Benefit

Hospital care

Ambulance

Medications

Vision care

Physical Examination

Professional Services

Psychological or psychiatric care

Dental Accident

Dental Emergencies

Secondary travel outside destination country

Emergency air treatment and/or Return home for treatment

Transportation of Family or Friend

Return of Deceased

Subsistence Allowance

Included services and benefits

Options

Eligibility requirements

Documentation

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Deductible

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Maximum coverage amount

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Medical care

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Accidental Death & Dismemberment

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Maternity Benefit

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Hospital care

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Ambulance

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Medications

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Vision care

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Physical Examination

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Professional Services

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Psychological or psychiatric care

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Dental Accident

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Dental Emergencies

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Secondary travel outside destination country

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Emergency air treatment and/or Return home for treatment

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Transportation of Family or Friend

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Return of Deceased

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Subsistence Allowance

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Included services and benefits

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Options

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Eligibility requirements

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Documentation

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Eligibility requirements

Please read the following carefully

To be eligible for the insurance plan you have chosen, you must meet all eligibility criteria. Please read the following carefully.

If you have any questions or uncertainties, please contact our team at 1 800-607-1920 or info@assurancevisiteurs.ca.

Personal information

Please enter personal information for each traveler.

Plan chosen

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Total

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Deductible

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Maximum coverage amount

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Pre-existing conditions

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Traveler information {{ index + 1 }}

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Summary

Be sure to check that all the following information is correct, as it is required to provide you with travel insurance services and to issue a policy. If this is not the case, click on "modify" to make the changes. The premium amount may change according to the new information provided.

Plan chosen

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Total

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Deductible

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Maximum coverage amount

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Pre-existing conditions

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Travel information

Type of trip

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Reason for travel

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Pre-existing conditions

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Native country

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Place of residence during the trip

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Provincial health insurance plan

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Travel dates

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Date of birth of travelers

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Date of arrival in Canada

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Partner code

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Eligibility requirements

Information from the traveler(s)

Traveler {{ index + 1 }}

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Gender

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Contact information

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Address in Canada*

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Pre-existing conditions

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I confirm (on behalf of all travellers listed in this contract) that I accept the terms and conditions of the insurance coverage, and that I understand what is not covered. I am aware of the premium costs associated with this application and I agree to pay the associated fees. I confirm that the information provided is accurate, and I acknowledge that any false declaration will result in the cancellation of the insurance. In case of doubt, I have contacted Assurance Visiteurs.

I confirm that by providing the personal information of all insureds in the submission, I have obtained the consent of all insureds to provide the personal information to Assurance Visiteurs and the insurer. I confirm that I am the parent or guardian of any minor insured or that I have obtained consent directly from the parent or guardian of such minor to share his or her personal information.

I confirm that by purchasing this travel insurance, I agree and consent to Visitor Insurance and its agents collecting, processing, distributing and retaining the personal information collected for the purpose of providing and administering travel insurance and conducting internal research and analysis in accordance with the stated Privacy Policy. I understand that this information will be retained for a minimum period of 5 years as required by Assurance Visiteurs’ regulatory obligations.

I confirm that by purchasing this travel insurance, I authorize Assurance Visiteurs and its agents to share my personal information for the duration of the insurance coverage with insurers, service providers and partners. This personal information may be shared with agents, brokers and credit card processors to facilitate the provision of travel insurance services. This information may be shared outside Quebec (if a resident of Quebec) or Canada for the purposes of insurance application, assistance services, claims processing and dispute resolution.

I understand that my medical history will be reviewed in the event of a claim. In order to make a proper assessment the Insurer may, with my written consent, obtain all available medical information from any health care organization concerning my medical history. I understand that if I refuse to sign the written authorization, the insurer will deny the claim.

I consent to Assurance Visiteurs, its agents and suppliers communicating with me, during the term of my coverage, the information required to maintain and renew my policy. Without limitation, such communications may be for informational purposes or in connection with a request for service in the event of a claim. Consent may be withdrawn at any time.

If you are applying for a policyholder other than yourself, please complete this section.

If this request concerns a person other than yourself (e.g. spouse, parent, sibling, friend, client, etc.) or more than one person to be insured, that person must consent to the transmission of his or her personal information. Under Quebec’s Bill 25, each person must consent to the collection and transmission of his or her personal information. The person to be insured must read this consent form, sign it and return it by e-mail to info@assurancevisiteurs.ca within the next 24 business hours. In the case of minors, this authorization must be signed by a parent or guardian. After this time, the policy will not be activated.

The premium amount is based on the information provided in Step 1. Please refer to the policy wording for complete terms and conditions of coverage, including eligibility criteria, limitations and exclusions. Travel insurance does not cover everything. Certain limitations may apply depending on destination, age, health or conditions not mentioned in Step 1, and the premium may be reassessed. We would like to inform you that we have agreements with a number of partners and insurers, including Allianz Global Assistance. A fee may be payable to the distributor of this insurance.

Assurance Visiteurs, Groupe Conseil Amar, Gouin inc., registration number: 607065
Firm in the insurance of persons
2001 Boul. Robert-Bourassa, Montréal (QC), H3A 2A6, suite 1700

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Information

Leave us your contact details and we will contact you to answer your questions.

Depending on the information provided, your situation may require further analysis by our team. Leave us your contact details and we'll contact you to find the best insurance solution for you.

Depending on the information provided, your situation may require further analysis by our team. Leave us your contact details and we'll contact you to find the best insurance solution for you.

By clicking “Submit” I agree and consent to Assurance Visiteurs and its agents collecting, processing, distributing and retaining the personal information collected for internal research and analysis in accordance with the stated Privacy Policy.

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