EmailMeForm
TRAVEL INSURANCE ACCEPTANCE/WAIVER
AGENCY ROLE
Miller Travel Company (“Agency”) is NOT an insurance agent or provider. We offer travelers the opportunity to purchase travel insurance through third parties. We take all reasonable measures to advise travelers of: (1) cancellation fees, change fees, and other potential fees relating to travel services provided by third-party suppliers, some of which may be non-refundable; and (2) the inherent risks in travel.
TRAVELER ROLE
You are responsible for: (1) understanding the potential costs and risks of travel; and (2) accepting or declining travel insurance, either at the time of purchase or, if permitted by travel insurance providers, prior to the final due date of travel payments. You are responsible for reading and understanding: (1) all details and terms regarding your travel itineraries; (2) all components of travel insurance coverage under the policies you may choose; and (3) all matters related to this Travel Insurance Acceptance / Waiver. You warrant that you are 18 years of age or older and have authority to sign and accept this Travel Insurance Acceptance / Waiver on behalf of all minor and adult travelers on the same booking who reside in your household. If you have any questions or if you have not received a quote for travel insurance, please contact us.
INSURANCE AGENT OR PROVIDER ROLE
Insurance agents and providers make available travel insurance to travelers in exchange for fees. Travel insurance and coverage of claims differ based on the type of travel and terms of each insurance policy.
TRAVEL INSURANCE OPTIONS
You must choose ONE option below:
Name on the booking
*
First
Last
Who is your Travel Advisor?
Roxi Miller
Angie Miller
Chris Parsons
Phone
*
###
-
###
-
####
Email
*
Booking Confirmation
*
I have read, understand, and accept the travel insurance quote(s), policy, and coverage offered to me. I authorize Agency to charge the quoted amount to my credit or debit card. The travel insurance policy I choose may exclude coverage relating to certain matters, including without limitation: (1) pre-existing medical conditions; (2) trip interruptions relating to any pandemic or epidemic; and (3) risk locations and activities. My decisions regarding travel insurance apply to me and all minor and adult travelers on the same booking who reside in my household.
YES, I AGREE TO PURCHASE TRAVEL INSURANCE (VIA CREDIT OR DEBIT CARD).
If you have a policy option choice, please specify to your advisor which option you are purchasing prior to confirming your booking
I understand the travel insurance quote(s) offered to me, but I choose to DECLINE travel insurance. By DECLINING travel insurance, I understand and agree to the following: I waive all insurance protection and assistance from Agency relating to my travel, including without limitation: (1) travel changes, interruptions, or cancellations; (2) baggage delays or loss; (3) travel supplier defaults; (4) medical costs; (5) accidents and emergencies; and (6) any other loss, cost, injury, or death that may arise; and I may lose up to 100% of the cost of my travel bookings, plus any cancellation or related fees charged by Agency and third-party travel suppliers; and I accept all risk of loss, cost, injury, and death relating to my travel; and I release from all liability and waive any claim against Agency, its owners, directors, employees, contractors, advisors, and successors and assigns regarding any loss, cost, injury, or death relating to my travel and my election to decline travel insurance; and My decisions regarding travel insurance apply to me and all minor and adult travelers on the same booking who reside in my household.
NO, I CHOOSE TO DECLINE TRAVEL INSURANCE.
