Holiday Travel Insurance Registration Form

Step 1. Enter Application Details

Fields marked with an asterisk * are required.

Member Details

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Note: Age Limit - up to 75 years, at the time of registration.
Please contact Windsor Management Insurance Brokers for assistance if you do not meet this criteria.
Contact details below.
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Additional Contact Details

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I dont have an Email Address

At least one phone number is required *

Home Address

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Postal Address same as above

Postal Address

Accompanying Spouse & Dependant Children

Add Spouse
Spouse - Husband, Wife, De-Facto, or Life Partner who you have continuously lived with for at least 6 months or more.
Add Dependant Child
Dependant Children - Under 19 years, or under 25 while full time students, and in either case legally dependant on you for maintenance or support

Travel Details

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0 Must be more than 0 Days
Yes No

Please Select: *
New Zealand
Indonesia, Bali, South Pacific Islands, Norfolk Island, Papua New Guinea and South Pacific Cruises
UK and Ireland
China, Hong Kong, Japan, Singapore, Philippines, Thailand, India, Malaysia, Vietnam, Korea and other Asia
Europe, Middle East
Africa, Canada
USA, South and Central America, Antarctica
Yes No

Important Notes

Please note, this policy will only cover you for 90 days of travel within Australia and overseas. Additional cover will need to be purchased for any extra days, a representative will contact you with a quote to extend your cover which must be paid prior to your departure if possible. For more information, call Windsor Management Insurance Brokers on (03) 9663 2411.

Please allow 3 business days for your union to confirm financial membership, once confirmed you will receive a confirmation email with policy documents attached. If you have no email address we will post the documents to you, please allow an extra business day.

Confirmation of Cover

If your registration is approved, Windsor Management Insurance Brokers will provide you with a Policy Schedule, Wording/PDS and other documentation as required to confirm your cover under the Group Policy within two working days. Cover is subject to the policy definitions, terms, conditions, limits and exclusions, please ensure you read and understand the cover provided in the policy.

About this Insurance

This insurance is arranged by Windsor Management Insurance Brokers (AFS Licence Number 230747). This insurance is provided under a Group Policy issued to BERT Pty Ltd ABN 82 010 917 281, which is underwritten by QBE Insurance (Australia) Limited ABN 78 003 191 035, AFS License Number 239545 of 82 Pitt Street Sydney NSW 2000.

For any advice or enquiries please contact Windsor Management Insurance Brokers on (03) 9663 2411 or email qldtravel@wmib.com.au. Both QBE and Windsor Management Insurance Brokers are committed to safeguarding your privacy and the confidentiality of your personal information. Information about how we manage the privacy of personal information is provided on our websites at www.qbe.com.au or www.wmib.com.au or in the policy wording.

Policy Statement

For information purposes only, you can download a copy of the BERT Travel Policy for your perusal while your application is being approved BERT Travel Policy.

If your registration is approved, Windsor Management Insurance Brokers will provide you with a Policy Schedule to confirm your eligibility under the Group Policy.

Please call (03) 9663 2411 or email qldtravel@wmib.com.au if you have any further enquiries.