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Individual Trip Insurance Quote Form

To receive a price quote from us for Allianz for an individual trip you've already booked, please submit the form below.

If you'd like a quote for an Allianz annual plan, to cover all your trips throughout the year for all members of your household (starting at $435 per year), please submit this form instead. If you'd like a quote for both, please submit both forms.

Have questions? Visit my travel insurance for cruisers FAQ page.

What is your name (first and last)?

Phone Number

What is your state of residence?

What is your estimated total trip cost? (nonrefundable travel expenses you'll incur prior to departure date, including plane tickets, hotel, cruise fare, excursions, etc.)?

What is your initial deposit date? (this is the date your paid for your trip or put money toward it)

What is your trip departure date?

What is your trip return date?

What are the dates of birth of the primary traveler and all individuals going on this trip? (this is required by Allianz)

What are the suppliers for this trip (name of the cruise line, resort, hotel, airline, etc. that you've booked)?

Form submission[]

By submitting this form, you're agreeing to receive emails from Professor Melissa. Don't worry, your info is safe with me. We'll never share or sell it. You can also unsubscribe at any time. I am an Independent Travel Agent with Cornerstone.

Disclaimer: I am an Independent Travel Agent with Cornerstone, but I am not a licensed insurance agent and do not provide insurance advice. The travel insurance options provided are offered through Allianz. For detailed policy information, coverage options, and exclusions, please contact the insurance provider directly.

Individual Trip Insurance Quote Form

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