Travel Insurance Form

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Trinity College Dublin
Travel Insurance Programme
Background
Trinity College Dublin organise a Business Travel Insurance Scheme with AIG.
Policy No
HGC66736
Persons Insured
Any person (excluding students other than Postgraduates) over the age of 17 authorised by the College
to travel on official business of the College (including incidental holiday travel if in the same country as
business destination). Excluding persons on long term secondment.
Maximum duration of any one trip
6 months
Journeys Covered
Any journey undertaken by an insured person on official business of Trinity College Dublin which
commences during the period of insurance and involves travel that begins and ends in Ireland.
NB: Travel to the following countries will not be covered unless they are declared to insurers
in advance of the commencement of the journey and accepted in writing by insurers prior to
departure.
A request for such cover must be submitted to the Estates and Facilities Department (insurance@tcd.ie)
and the College Safety Officer accompanied by a detailed risk assessment along with a detailed itinerary,
signed by the Head of School or Head of Administrative Area and the individuals travelling, no less than
ten days in advance of proposed trip. A letter from the Head of School/Administrative Area setting out
why this trip is essential to the business of the College must accompany the above documentation. If
successful in obtaining cover an additional premium will apply which will be payable by the Department.
1.
2.
3.
4.
5.
Afghanistan
Iraq
North Korea
Somalia
Chechnya
Notwithstanding the above exclusions, please be advised that you are required to seek travel advice
from the Department of Foreign Affairs website www.dfa.ie prior to travel to any country. A full
departmental risk assessment must be carried out where the Security Status advice given on the DFA
website is anything above "exercise caution". This risk assessment must be signed by each traveller and
the Head of School or Head of Administrative Area that is authorising and approving this travel on behalf
of the University. The risk assessment should be sent to the College Safety Office in advance of travel
commencing.
Cover
Medical Expenses
EUR Unlimited
Personal Baggage
EUR 15,000
Personal Liability
EUR 7,500,000
Cancellation / Curtailment (subject to policy conditions) EUR 15,000
Money
EUR 7,500
Hijack
EUR 37,500
Kidnap
EUR 250,000 (Aggregate Limit)
Maximum claim from
injury
relating to aircraft
regardless
EUR 25,000,000 - Multi engined aircraft
of number of persons
involved:
Deductible:
EUR 100 - Each and every claim
Cover Requirement
Cover is only operative provided the journey is authorised by your Head of School/Administrative Area
and a travel insurance form has been completed and returned to the Estates and Facilities Department,
West Chapel, prior to the commencement of the journey. This may be done on-line below or a hard copy
may be printed out and returned to the Estates and Facilities Department, West Chapel, College. This is
subject also to the adherence of the protocol advised under the Areas of Unrest heading above.
Field Trips
Field Trips require a completed Travel Insurance Form and a Risk Assessment to be forwarded to the
Safety Office in the Estates and Facilities Department regardless of destination/location.
Claims
A claim under the policy should be notified immediately to Ms Patricia Gray at insurance@tcd.ie or to the
Estates and Facilities Department, West Chapel, College. In the event of property loss, the local police
should be notified and a statement obtained from them that the matter is noted and will be investigated.
Luggage loss, in the custody of an airline, must be reported to the airline and a report obtained from
them. All reports, medical certificates, receipts and proof of travel must be retained to support any
claim.
Lifeline Plus Assist Emergency Medical Assistance
Tel: +44 124 362 1053
Operates 24 hours a day 365 days year. As well as medical assistance the Lifeline Plus Assist Helpline will provide the
following assistance:
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Advice on replacement of lost or stolen tickets, passport or travel documents
Assistance in liaison with carrier on location of lost luggage items
Emergency message relay to family or business associate where normal channels fail
Referral to Embassy or Consulate where legal consultation is needed
Multi lingual assistance co-ordinators speaking more than 15 languages
A network of doctors and nurses throughout the world.
N.B. The services of the Lifeline Plus Assist Helpline are to provide advice and assistance only
- there is no insurance cover in connection with these services.
Travel Insurance Form 2015-16
Trinity College Dublin Business Travel Insurance Scheme for persons (excluding students other than Postgraduates)
travelling on College business. Please fill in your details and click Submit. If you are undertaking more than one
journey each individual journey must be submitted on a separate form.
First Name:
Surname:
Staff No:
Postgraduate Student No:
Department:
Has this trip been
authorised by your
Head of School/Administrative Area?:
Yes
No
Name of Head of School/Administrative Area:
Age
(Between 17 and 75 inclusive):
Yes
No ( If "No" then trip must be declared in
writing to Patricia Gray 10 days in advance of trip)
Date of Departure:
Date of Return:
Length of trip:
UK
Europe ( Excluding the UK )
Asia
Destination:
Africa
Australasia
North America
South America
When you click on SUBMIT DETAILS, please wait for the
Confirmation Page to generate, and take note of the Reference
Number as confirmation that your application for travel
insurance has been received.
The data collected on this form are being obtained by the Estates and Facilities Department for the
purpose of dealing with your application. These data may be accessed by our staff and will be held until
your application has been responded to. Your data will only be used for these purposes and will not be
released to other parties without your permission, except as permitted by law. You have the right to
access your own personal data which you supply here and the right to rectify those data.
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