Apply to cover pre-existing medical conditions

Select your credit card provider and card type

Credit card provider* Card type*
If your credit card provider is not shown here you will need to phone the number shown in your credit card insurance booklet to complete a medical assessment.

Please complete the following declarations before proceeding

1. I have obtained and read the relevant information booklet to confirm my eligibility for this insurance and accept the terms and conditions.*
2. I am aware an administration fee must be paid before cover is valid for any approved conditions.*
3. I authorise the medical information declared in this assessment to be sent to the email or mailing address provided.*
4. I have read and understood the important information section below.*
5. I declare that the information I provide in this application is true and accurate and I have received and understand my duty of disclosure.*
6. I understand that for Overseas Travel Insurance, my cover may be subject to an age restriction of 80 yrs of age and I confirm I am eligible for this insurance.*

All fields marked by * are mandatory

Important information

The complimentary travel insurance benefits are only available to cardholders of eligible credit card accounts. Please ensure you have obtained and read the relevant credit card insurance booklet to confirm your eligibility for this insurance. This can be obtained from your credit card provider or by visiting zurich.com.au.

You will need to apply separately for each journey you undertake before leaving Australia.

If you do not pay the administration fee you will not be covered for any claim arising from any approved pre-existing medical conditions. The administration fee is not refundable under any circumstances. An administration fee is payable for each new assessment where we are able to approve any of your pre-existing medical conditions.

The pre-existing medical conditions of your relatives (other than an insured spouse or dependent child travelling with you), travel companion or any other persons that may give cause for you to claim cannot be covered.

If you complete this assessment on behalf of an eligible card holder it is your responsibility to ensure the information supplied is an accurate and true reflection of their health as an inaccurate response could invalidate a future claim.

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