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Insure Your Luxury Travel

Attention Agents: 

The below form is required for each of your clients that have booked a trip (whether or not they express interest in purchasing the insurance at this time). This form is crucial to making sure that the commission is appointed to the correct agent. If you need to add a Top up/ Add on to the policy please continue to scroll down for the appropriate form.

All Tully agents are legally obligated to send a form to InsureYourLuxuryTravel.com whether or not your clients purchase or express interest to purchase insurance. 

Lynette Rempel or Dusty Boswell will notify you when the client purchases. If you have any questions feel free to email orders@insureyourluxurytravel.com.

  • Please select your name below.
  • Please select your name below.
  • Please note if your client is not looking to purchase the insurance immediately. We will notate that information in our database and follow up when they are ready.
  • MM slash DD slash YYYY
  • NOTE: If the travelers have different residence addresses, please fill out a separate quote form for each as they will need to purchase separate policies.
  • MM slash DD slash YYYY
  • NOTE: If the travelers have different residence addresses, please fill out a separate quote form for each as they will need to purchase separate policies.
  • MM slash DD slash YYYY
  • NOTE: If the travelers have different residence addresses, please fill out a separate quote form for each as they will need to purchase separate policies.
  • MM slash DD slash YYYY
  • NOTE: If the travelers have different residence addresses, please fill out a separate quote form for each as they will need to purchase separate policies.
  • MM slash DD slash YYYY
  • NOTE: If the travelers have different residence addresses, please fill out a separate quote form for each as they will need to purchase separate policies.
  • If you have more than 6 travelers please enter additional traveler information at the end of the form.
    MM slash DD slash YYYY
  • Please let us know if these travlers are family members, married couple, or traveling companions. This helps us know how to address the clients in communications. Thank you.
  • If YES, please list the known condition in the comments section at the bottom of the form for all travelers.
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Date that the first deposit was put down
    MM slash DD slash YYYY
  • Even if your client has not paid in full, please give us the total amount to be paid for the entire trip.
  • MM slash DD slash YYYY
  • Does the client have a future cruise credit to use with this trip? Please answer.
  • Please let us know what travel supplier/tour operator/cruise line they are traveling with.
  • Please upload a copy of your client's full itinerary.
    Max. file size: 64 MB.
  • Max. file size: 64 MB.
  • Max. file size: 64 MB.
  • Please enter additional travelers full names and date of births above.
  • After filling out the form you will see a Confirmation page that says, "Your Form has Been Submitted!" If you do not see this confirmation notification the form did not go through. Thank you!
  • This field is for validation purposes and should be left unchanged.

 

ADD – ON / Top Up Form: 

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
    Please list the new departure date if it has changed from the original policy. If the departure date has not changed you may leave blank.
  • MM slash DD slash YYYY
    Please list the new return date if it has changed from the original policy. If the departure date has not changed you may leave blank.
  • Max. file size: 64 MB.
  • Max. file size: 64 MB.
  • Max. file size: 64 MB.
  • Please add any notes for Craig Robinson and his team regarding the Top-Up/Add-on

Lynette Rempel for
Craig Robinson
Insurance Consultants Int’l
Phone: 719-428-4502

email: lynette@insureyourluxurytravel.com
websites: www.insureyourluxurytravel.com

 

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We are here to help you find the plan that best suites your needs and  here to answer any questions about the policy and coverage. 

Lynette Rempel 

Director of Luxury Travel

719-428-4502

lynette@insureyourluxurytravel.com

 

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Check out our Informational Travel Insurance Posts!

  • Is Your Travel Investment Protected?
  • Our Insurance vs Cruise Line Insurance
  • Importance of Insuring Your Deposit
  • If Jim Cantore shows up at your hotel, it’s too late for travel insurance!
  • His Heart Caused His Cruise to DOUBLE in Price!

InsureYourLuxuryTravel.com

A division of
Insurance Consultants International

719-428-4502

orders@insureyourluxurytravel.com 

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