Travel Retailer Training Completion Certificate

Managers/ officers or owners who are responsible for the travel insurance program, as well as any Employees who will disseminate battleface travel insurance plans must complete the training and attestation.

This form includes:

Training Certificate: certifying completion of mandatory training.
18 U.S.C. § 1033 Attestationfor any producer engaged in the business of insurance.

18 U.S.C. § 1033 CERTIFICATION AND ATTESTATION

As an employee of a registered Travel Retailer permitted to offer travel insurance products, you must be in compliance with 18 U.S.C. § 1033.

18 U.S. Code § 1033 – Crimes by or Affecting Persons Engaged in the Business of Insurance

It is a criminal offense for an individual who has been convicted of a felony involving dishonesty, breach of trust, or any violation of 18 U.S.C. § 1033 to engage or participate in the business of insurance without written consent from a regulator.
It is a criminal offense for any person to employ or permit a “Prohibited Person” to participate in the business of insurance without written consent.
A Prohibited Person may be an officer, director, employee, agent, solicitor, broker, consultant, third-party administrator, managing general agent, or subcontractor representing an insurance agency or insurance company.

Business Name(Required)

First Name(Required)

Last Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Select Your Role(Required)

Manager Certification (Owner, Partner, Officer, or Designated Responsible Manager)

Employee Certification

Title(Required)

Email Address(Required)

Business FEIN(Required)

Phone Number(Required)

* If you are unable to attest please contact [email protected] for instructions.

Date(Required)

Signature(Required)

Benefits	Sum Insured	Excess
Cancellation and Curtailment	€5,000
Medical and Emergency Expenses	€10,000,000	€250
Hospital Benefit	€25 per day Maximum €100
Personal Accident	€50,000
Baggage	€2,000	€250
Personal Money and Passport	€500	€250
Personal Liability	€500,000
Travel Delay	€50 per 12 hr period Maximum €500
Optional Upgrades	Sum Insured	Excess
Business Cover	€1,000	€100
Winter Cover	€750	€50 per person (€100 per family)
* Plans not available for residents of France, Spain, Portugal, Italy, Croatia, Hungary and Poland. * These are only brief description(s) of the coverage(s). The policy will contain reductions, limitations, exclusion, and termination provisions. Full details of each coverage are contained in the policy document. Please read the policy carefully to fully understand the coverages, terms conditions, limits, and exclusions. If there are any conflicts or discrepancies between the descriptions above and the policy or any point is not covered above, the terms and conditions of the policy shall govern. Please contact battleface for more information.

Benefit	Limit	Deductible
Trip Cancellation Package (Required for VA and WA residents)
Trip Cancellation	100% of trip cost (up to a maximum of $20,000 per order)
Single Occupancy	Up to trip cost
Cancel for Any Reason (Not available to NY residents)	Up to 75% of trip cost Up to 50% of trip costs in FL (Available for trip cost up to $10,000 per traveling party.)
Trip Interruption	Up 150% of trip cost
Delay Package
Trip Delay Package	Up to $200 per day and $2,500 per trip
Missed Connection	Up to $1,000 per covered trip
Baggage Package – Excess
Baggage and Personal Effects	Up to $2,500	$100 deductible applies
Baggage Delay	Up to $100 per day and $500 per trip
Travel Medical Package – Excess (Required for IN residents) AK, CO, ID, ND, NH – Primary
Travel Medical Expense – Adventure sports included	Up to $100,000 ($50,000 for NH residents)	$50 deductible applies
Emergency Dental	Up to $750
Emergency Evacuation and Repatriation of Remains	Up to $500,000 ($1,000,000 for NH residents)
Accidental Death & Dismemberment	Select $100,000, $250,000, or $500,000 ($50,000 maximum for NH residents)
Pet Medical Package (Not availble for FL residents)
Pet Medical Expense	Up to $2,000	$100 deductible applies
Pet Return	Up to $500
Rental Vehicle Damage – Primary (Not available to FL residents)	Up to $35,000 per rented vehicle	Primary $250 deductible for loss greater than $2,000
Vacation Rental Damage	Select $1,500, $3,000 or $5,000 per vacation rental reservation
These are only brief description(s) of the coverage(s). The policy will contain reductions, limitations, exclusion, and termination provisions. Full details of each coverage are contained in the policy document. Please read the policy carefully to fully understand the coverages, terms conditions, limits, and exclusions. If there are any conflicts or discrepancies between the descriptions above and the policy or any point is not covered above, the terms and conditions of the policy shall govern. Not all plans or coverages are available in every state. Please contact battleface for more information.

Benefit	Limit	Deductible
Trip Cancellation	Up to $30,000
Trip Interruption	Up to 150% of trip cost, to a maximum of $30,000
Single Occupancy	Up to trip cancellation maximum
Trip Delay	$250 per day to a maximum of $2,500
Missed Connection	$750
Security Evacuation	$50,000
Baggage and Personal Effects	$1,500 per-item restrictions apply Sporting Equipment Coverage Included	$0 Deductible
Baggage Delay	$250 Sporting Equipment Delay Included
Travel Medical Expense	$50,000	$0 Deductible
Hospital Room and Board	$200 per day
Emergency Dental	$750	$0 Deductible
Emergency Evacuation and Repatriation of Remains	$500,000
Optional Coverage: The following will be included if elected and appropriate costs have been paid. Cancel For Any Reason, reimburses up to 75% of trip cost (50% within the state of FL). Not available to NY residents. You must purchase prior to final trip payment, insure your full trip cost, and cancel before 48 hours of scheduled departure. Other benefits include: · Available coverage for Pre-Existing Medical Conditions. The Pre-Existing Medical Condition exclusion is waived if the full cost of all nonrefundable payments are insured and the plan is purchased prior to final trip payment. · No exclusion for mental, nervous or psychological disorders.

Standard Benefits	Limit	Excess
Trip Interruption	US $2,000
Emergency Medical Expenses and Repatriation	US $10,000,000	US $250
Hospital Benefit	US $25 per day Maximum US $100
Personal Accident	Up to US $50,000
Baggage Loss or Delay	Up to US $2,000	US $250 or US $50
Personal Money and Passport	US $500 Limited to US $250 in respect of cash	US $250
Personal Liability	UUS $500,000

Optional Benefits	Limit	Excess
Business Extension	Up to US $1,000	US $100
Winter Sports (Ski Equipment)	Up to US $750	US $50 or US $100
Increased Personal Accident	Up to US $250,000
Increased Baggage	Up to US $10,000	US $50
Please see the full underwriting disclosures here. *These are only brief description(s) of the coverage(s). The policy will contain reductions, limitations, exclusion, and termination provisions. Full details of each coverage are contained in the policy document. Please read the policy carefully to fully understand the coverages, terms conditions, limits, and exclusions. If there are any conflicts or discrepancies between the descriptions above and the policy or any point is not covered above, the terms and conditions of the policy shall govern. Please contact battleface for more information.

Benefits	Sum Insured	Excess
Cancellation and Curtailment	£5,000
Medical and Emergency Expenses	£10,000,000	£250
Hospital Benefit	£25 per day Maximum £100
Personal Accident	£50,000
Baggage	£2,000	£250
Personal Money and Passport	£500	£250
Personal Liability	£500,000
Travel Delay	£50 per 12 hr period Maximum £500
Optional Upgrades	Sum Insured	Excess
Business Cover	£1,000	£100
Winter Cover	£750	£50 per person (£100 per family)
*These are only brief description(s) of the coverage(s). The policy will contain reductions, limitations, exclusion, and termination provisions. Full details of each coverage are contained in the policy document. Please read the policy carefully to fully understand the coverages, terms conditions, limits, and exclusions. If there are any conflicts or discrepancies between the descriptions above and the policy or any point is not covered above, the terms and conditions of the policy shall govern. Please contact battleface for more information.

Standard Benefits	Sum Insured	Excess
Emergency Medical	Unlimited	Yes
Funeral Expense Abroad	AUD 20,000	No
Hospital Benefit and Confinement	AUD 50 per day Up to AUD 1,000	No
Airfare Reimbursement	Up to AUD 2,500	Yes

Optional Benefits	Sum Insured	Excess
Trip Cancellation	Up to AUD 40,000	Yes
Trip Interruption	Up to AUD 40,000	Yes
Travel Delay	AUD 50 per 6 hours Up to AUD 2,000	No
Personal Accident	AUD 25,000	No
Personal Liability	Up to AUD 2,500,000	No

Luggage and personal effects	Up to AUD 10,000	Yes
*Note that not all benefits apply and will depend on whether you have selected them (and are reflected on your Certificate of Insurance). Terms, conditions, exclusions, limits and sub-limits apply. Please read the Product Disclosure Statement (PDS) and Target Market Determination (TMD) for further details.