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Policy #
Company Name
Please select from the drop down menu the company or business unit that your travel is on behalf of
Reference #
Please select your dates of travel.

The first date should be when the travellers intend to leave their place of residence and the second date should be when the travellers intend to return to their place of residence.
Please check http://www.safetravel.govt.nz/ for current travel warnings for your destination country(s)
Travel Period is
RadDatePicker
RadDatePicker
Open the calendar popup.
to
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RadDatePicker
Open the calendar popup.
*
Days:
1
Travel Type
Travel Destination
*
Please select the main destination that you will be spending most of your time

Traveller Details

Number of Travellers
*
Please list all travellers’ details and note the number of ‘Leisure Days’ that their travel will include for each person that are NOT for business related purposes.
Must be authorised and eligible for business travel.
Title First Name Surname Date of Birth Approved Business
Travel
Leisure Days
Primary Traveller
*

Specified Items

Please list each item that is valued more than $5000.00 and it’s current value.
If you require cover for any personal baggage item/s over the policy item limit of $5,000 please provide details here (maximum total limit is $20,000.) If the item is required for business purposes please contact your broker to discuss cover for this item.

Tick here if Specified item cover is required:

Contact Details

Address
*
Suburb
City
*
Phone
*
Email
*
Confirm Email
*

This insurance is issued and managed by AWP Services New Zealand Limited trading as Allianz Global Assistance and underwritten by Allianz Australia Insurance Limited ABN 15 000 122 850 (Incorporated in Australia) trading as Allianz New Zealand. You should consider the Policy Wording before making any decisions about this travel insurance policy.

For further information on Allianz Australia Insurance Limited's financial strength rating, please refer to the following Financial Strength Rating and Overseas Policy Holder Preference Disclosure Notice.

Allianz Australia Insurance Limited has an AA- insurer financial strength rating given by Standard & Poor's (Australia) Pty Limited.

The rating scale* in summary form is:

AAA Extremely Strong, BBB Good, CCC Very Weak
AA Very Strong, BB Marginal, CC Extremely Weak
A Strong, B Weak, R Regulatory Action
Plus (+) or minus (-): Ratings from "AA" to "CCC" may be modified by the addition of a plus (+) or minus (-) sign to show relative standings within the major rating categories.
*A full description of the rating scale is available via www.allianz.co.nz/insurer-rating.

An overseas policyholder preference applies. Under Australian law, if Allianz Australia Insurance Limited is wound up, its assets in Australia must be applied to its Australian liabilities before they can be applied to overseas liabilities. To this extent, New Zealand policyholders may not be able to rely on Allianz Australia Insurance Limited's Australian assets to satisfy New Zealand liabilities.