InsureMyTrip - Policy Cancellation Request Form

All of this information is required to process your request policy cancellation (refund) request. If all of the information is not included, then it may delay your request. Someone from our Customer Care team may reach out to gather the missing information.

If you have any questions about this form, or unable to complete it as requested, please contact us at customercare@insuremytrip.com.

1. Policy Number

2. Primary Traveler's Name

3. Primary Traveler's Phone Number

4. Email Used to Purchase the Plan *This question is required. This question requires a valid email address.

6. If your request is outside the "Review Period", we must have documented proof from your travel suppliers (cruise, tour operator, travel agent) that you were provided a refund for your trip. Please add the files here.

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You can attach up to 10 files. Each file must be under 2MB. If you have files that are larger than these requirements, you can send them to customercare@insuremytrip.com or fax it to (401) 921-4530.

7. Confirmation of No Claims
By adding your digital signature below, you are acknowledging that you have not submitted a claim under this policy and do not plan to file a claim against the currently insured trip in the future.

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Signature of