Chima Travel Insurance Opt-out Form
I am refusing travel insurance for my trip.
The risks for declining coverage have been explained to me by my Travel Advisor. I understand that declining travel insurance means I will lose all benefits of coverage and I fully accept that risk.
I am aware that my own medical insurance may not cover me on this trip.
I UNDERSTAND THAT I WILL NOT BE COVERED FOR:
Missed connections or train delays
Emergency air lift assistance
Emergency medical and/or dental assistance
Emergencies at home affecting me and/or my immediate family (children, grandchildren, aunts, uncles, brothers, sisters, nephews, nieces)
Death of myself and/or my immediate family (children, grandchildren, aunts, uncles, brothers, sisters, nephews, nieces)
Supplier default and/or bankruptcy
Any other covered circumstances as outlined in the offered travel insurance policy
I understand that I may lose up to 100% of the cost of my cruise / vacation package and travel arrangements, plus any cancellation fees from Chima Travel and / or other suppliers, if my trip is cancelled or delayed.
I hereby release Chima Travel, its administration, personnel, and my Travel Advisor from responsibility for any consequences, both known and unknown, resulting from my refusal of trip cancellation insurance.
I understand that Chima Travel has advised me of the importance of such insurance and I will not hold them responsible for any risks or lost funds. By filling out this form below I agree to all of these stated matters.