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Application Form For Tall Ships Volunteer CrewTravel Policy

Note: coverage under this section is for volunteer crew only it is not available for general voyage crews

Please fill in the form below. Payment can be made online through our secure payment system.
* Required fields
* First Name
* Surname
* Date of Birth (DD/MM/YYYY)
* Home Address
* Postcode
* Telephone
* Email address
Residential Information
* Are you habitually resident in United Kingdom (do you have a permanent place of residence in the UK)
Medical Background
* Do you have any existing or historical medical conditions? (If yes, please provide full details in declaration box below)
Cover Information
* What date do you require the cover to commence:
(please note that cancellation sections of the policy only come into effect from the date of commencement of the insurance)
Pick date (dd/mm/yyyy)
Note: Tall Ships Volunteer Crew allows for up to 35 days away from the UK at any one time. If longer duration is required please contact us
Please detail any other people to insure or any material facts that underwriters should be made aware. (A material fact is one likely to influence acceptance or assessment of this Application by Insurers. If you are in any doubt as to whether a fact is material or not, you must declare it.)

Travel insurance arranged for GH Insurance Services Limited by Acumus Insurance Solutions Limited with UK Underwriting Limited on behalf of AXA Insurance UK plc. AXA Insurance UK plc. Registered Office: 5 Old Broad Street, London EC2N 1AD, Registered in England No. 78950. GH Insurance Services Limited, Acumus Insurance Solutions Limited, UK Underwriting Limited and AXA Insurance UK plc are authorised and regulated by the Financial Services Authority. This can be checked on the FSA.s register by visiting the FSA.s website at www.fsa.gov.uk/register or by contacting them on 0845 606 1234

Acumus Insurance Solutions Limited and UK Underwriting Limited are both part of the Primary Group of companies.

Pre-Existing Medical Conditions

  1. Have you or anyone travelling with you been referred to a hospital or specialist consultant for a health condition that has:
    1. Been diagnosed within the last twelve months; or
    2. Been in existence in the last twelve months; or
    3. Resulted in treatment being given in the last 12 months?
  2. Have you or anyone travelling with you ever received treatment for:
    1. A heart related or circulatory condition (such as a heart condition, hypertension, blood vessel disease or a stroke); and/or
    2. A breathing condition (other than well-controlled asthma when suffered in isolation); and/or
    3. A cancerous condition?

If you have answered .Yes. to either of the above questions, you must detail this within the above form Please note that the insurance helpline cannot offer cover in the following circumstances: if you, anyone travelling with you or any person upon whose health the trip depends;

  1. are travelling against the advice of a medical practitioner; or
  2. are travelling for the purpose of obtaining medical treatment; or
  3. are on a hospital waiting list, or awaiting results of medical tests or investigations; or
  4. are suffering from anxiety, stress or depression; or
  5. have received a terminal prognosis by a registered doctor prior to taking out this policy; or
  6. will be more than 26 weeks pregnant at the time you return from the trip.

Should we require any additional premium and you accept our offer, this should be paid to GH Insurance Services either by credit card or cheque within 14 days. Should you decide not to pay the additional premium, any claims arising directly or indirectly from the declared health condition and related conditions will not be covered. Any additional health conditions not declared to us will not be covered.
Cooling Off period, if within 14 days of accepting this insurance, you discover that it is unsuitable, your unused premium will be refunded to you at short-term rates, provided that you have not made a claim.

The submission of this application form and payment of premium does not constitute acceptance of the risk by underwriters. Cover will only be effected when the application has been received and assessed by GH Insurance Services Limited and valid from the date the insurance certificate is issued.

In submitting this application you are making the following declaration:

I declare that I have read and understood the conditions and that I have not
withheld any material facts from insurers.

(N.B. A material fact is one likely to influence acceptance or assessment of this Application by Insurers.  If you are in any doubt as to whether a fact is material or not, you must declare it.  Non-disclosure or misrepresentation of a material fact may entitle  Underwriters to void the Insurance.)