Group Programs

RoundTrip Travel Protection Group Quote Request

Seven Corners, Inc. requires a minimum of 10 primary insureds and $2,000 minimum premium in order to qualify for RoundTrip group coverage. Group programs may be modified to suit the group's needs. If you are in need of benefits and/or provisions that are not specifically addressed on this form, contact Seven Corners for assistance in obtaining those benefits and/or provisions. You may also attach any additional requests to this form.

Step 1 of 3:   Administrative Information
Group Name:  
Street Address:  
City: State:
Zip: -  
Country
Contact: Title
Phone:* Fax
Email:*  
Nature of Group:
Reason for Travel:
 
Seven Corners Agent Number:*     
If applicable
 
File Upload 1:
If applicable 		Clear  
File Upload 2:
If applicable 		Clear  
File Upload 3:
If applicable 		Clear  
Note: For a binding quote and proposal, please attach a complete and accurate census including Dates of Birth, Gender, Locations, and Nationalities of all group members and eligible dependents.
* In order to respond to your request for a quote a phone number, email address, or Seven Corners Agent Number is required.
 

 

 
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Seven Corners, Inc.   •   303 Congressional Boulevard   •   Carmel, IN 46032 USA   •   800-335-0611
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