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Travel Insurance: (For Trips which last less than 1 year)
Whether you travel for business or pleasure, international travel involves risk. You may arrive at your destination to find that your luggage with personal items has disappeared. A personal emergency may necessitate you/family return early to your Home Country. A medical emergency may require hospitalization or even air evacuation. In most cases, your existing insurance will not provide adequate protection for these and other risks. MultiNational Underwriters, Inc (Lloyd's of London is the Underwriter) has designed The Atlas Series to take the risks out of international travel, so you can have an enjoyable and productive trip. You may review coverage & get a free custom quote by filling in your information on the white lines below & click submit on the very bottom (scroll down) OR the quickest option is click here to review coverage, get a free instant price quote & order via a secure/safe internet connection  (have a printer turned on & attached to your computer in order to print your insurance cards immediately) you 
may elect to do so now click here              

Seguro de Viaje: (Para Viajes de menos de 1 Ano de duracion)
Ya sea que viaje por negocios o placer, viajar internacionalmente involucra riesgos. Podria arrivar a su destino y encontrarse que su equipaje con articulos personales ha desaparecido. Una emergencia personal pudiera necesitar regreso intempestivo a su Pais de origen. Una  emergencia medica pudiera requerir hospitalizacion o hasta evacuacion aerea. En la mayoria de los casos, su Seguro actual no le proveera adecuada proteccion para estos y otros riesgos. Multinational Underwriters, Inc. ha disenado los planes The Atlas Series para tomar los riesgos de Viajeros internacionales, asi usted puede disfrutar de un viaje Feliz y Productivo. Para revisar la cobertura y obtener una Cotizacion de precios de Primas, tenga una impresora conectada a su
 computadora y presione aqui   o permitale a Patty darle a usted su Cotizacion llenando el siguiente cuestionario con su informacion continue abajo).

Health Insurance - Major Medical Insurance: 
Annually renewable, major medical insurance for individuals and families; US citizens outside the US and non-US citizens anywhere including their home country, the US or other countries. No Social Security number is needed. These are Worldwide Health Plans that pay insurance claims in U.S. dollars and are highly rated by AM Best and Standard and Poor's. These are the BEST & we have comparsion sheets if you need them.  To review coverage & get a free instant Medical Insurance price quote, click on any of the following three companies. It is recommended to have a printer attached to your computer and  we endorse the following excellent companies.
for Multinational Underwriters click here  

for Specialty Risk International click here
or let Patty give you a free custom quote by filling in your information on the white lines below (scroll down).  

Seguro de Salud - Seguro de Gastos Medicos Mayores:
Renovable cada Ano, Seguro de Gastos Medicos Mayores para individuos y familias;  Ciudadanos Norteamericanos fuera the los U.S.A. y Ciudadanos de otras nacionalidades en cualquier parte incluyendo su pais de origen, los Estados Unidos o un tercer pais. Para Revision de cobertura y obtener una cotizacion de Precios de Primas, tenga una impresora conectada a su computadora y presione aqui para The Royal Company  
presione aqui para Multinational Underwriters
o permitale a Patty darle una Cotizacion completando su informacion en las lineas en blanco abajo (continue hacia abajo)

Please fill out if you wish Patty to provide you an accurate quote:
 (por favor llene esta forma para proporcionarle informacion adecuada )

    How did you hear about us? Television, a friend, newspaper, search engine, other? 
  

Your Name/ Nombre:
Street Address/ Direccion casa:
City/ Ciudad:
State/ Province/Estado:
Zip/ Codigo Postal:
Country of Residence/ Pais de Residencia Actual:
Work Phone/ Telefono Trabajo:
Home Phone/ Telefono Casa:
FAX/ FAX:
E-mail/ Direccion E-mail

Name of 1st person needing insurance: Nombre 1era. persona necesitando Seguro:
Date of Birth/ Fecha de Nacimiento:	Citizenship / Ciudadania:
Sex:	Male/Masculino  Female/Femenino

If person is inquiring about annually renewable Medical Insurance and has a pre-existing health condition, what is it? If none, just enter NONE in white box below.  If person does have a pre-existing condition, be aware if you are applying for renewable Medical Insurance that some health pre-existing conditions could be accepted by the insurance companies with a temporary or permanent exclusion waiver for Medical Insurance. In order to evaluate the situation, speed up processing and get pre-approval for insurance coverage, you may choose to obtain any medical records from  your doctor  and forward/fax the records to our office. These steps do not apply if you are applying for Travel Insurance. Our fax in USA is tel: 480-345-6834, our address is 
        International Insurance-Seguros
        1047 W. Madero
        Mesa, Arizona  85210-7635
Our office telephone for questions, USA tel: 480-345-0191 or email question to patty@seguros-insurance.net 

 Si la (s) personas tiene (n) condicion de salud pre-exsistente, cual (es) es (son)? Si ninguna, escriba NINGUNA en el recuadro blanco siguiente. Si la persona tiene condicion de salud pre-exsistentes, algunas condiciones de salud pre-exsistentes pudieran ser aceptadas por las cias. de Seguros, ya sea con clausula de exclusion temporal o permanente, con el fin de evaluar su situacion en particular, por favor proveanos con su solicitud completamente contestada asi como sus Records Medicos, algunas companias estan dispuestas a realizar una pre-evaluacion del Propuesto Asegurado, tenga en cuenta que algunas de estas condiciones pre-exsistentes pudieran ser aceptadas por las Companias de Seguros con una clausula de exclusion temporal o permanente, con el fin de evaluar la situacion,     acelerar el proceso y obtener pre-aprobacion de Cobertura del Seguro, por favor obtenga sus Records Medicos de su doctor ahora y   remitalos por fax a nosotros. Nuestro fax en USA es: 480- 345 6834, nuestra direccion es: 
        International Insurance-Seguros
        1047 w. Madero
        Mesa, Arizona  85210-7635
    Nuestro telefono de oficina en USA para preguntas es tel: 480-345 0191 o envienos 
   sus preguntas por e-mail a patty@seguros-insurance.net. 

   Do you or anyone applying for insurance have a pre-existing medical condition? 
   Yes/No  Explain.
   (If you are applying for Travel Insurance, you may skip this question)
   Condiciones de salud pre-exsistentes?
        

Name of 2nd person needing insurance: Nombre 2da. persona necesitando seguro:
Date of Birth/ Fecha de Nacimiento:	Citizenship / Ciudadania:
Sex:	Male/Masculino Female/Femenino

         List additional adults/children names, sex & date of birth for which you need a quote,
        Also you may add comments in the box below. Comments help us to help you!:
        Nombre y edades de personas adicionales necesitando Seguro y comentarios/ sugerencias:
       
        
        Important: What are your plans? (hold down Ctrl key & click to pick multiple answers)
        Importante: Cuales son sus planes?
        Need Medical Insurance for Visa Requirements (write details above) I wish worldwide coverage EXCLUDING USA & Canada (write details it in large box above) I wish worldwide coverage INCLUDING USA & Canada (write details it in large box above) Otra situation (escribir arriba) Viajar un ano o menos (escribir arriba) Viajar un ano o mas (escribir arriba) travel more than 1 year (write details in box above) I'm living in another country (write details in box above) Plan living in another country( write details in box above) No plans to travel No plans to live in another country Other- Add comments above Vivo fuera pais natal (escribir arriba) Planeo vivir fuera pais natal (escribir arriba) I wish to travel less than 1 year

        Important: How long is your stay? What are the dates of your trip? 
        Muy Importante: Cuantos dias /meses su visita ? Las fechas de su visita?
       

        Enter details to travel or move to another country.  Do you know the Address?:
         Planea ir a vivir o viajar a otro pais, vivir o viajar a otro pais? Direccion?:
           

        Best time of day to contact you:/ Horario para contactarlo:
        

        Select any of the insurance options for which you would like a quote:/
        Estoy interesado en:

Medical Insurance/ Seguros Gastos Medicos:
Life Insurance / Seguros de Vida:
Travel Insurance / Seguros de Viaje:
Group Insurance/ Seguros de Grupo:

        Which deductibles do you wish? A higher deductible will lower your premium (call us if questions)
        (hold down Ctrl key & click to pick multiple answers)
        Cual deducible desea?
          $100 $250 $500 $1000 $2000 $4000 $10000 $25000

        Are you interested about information on Pensions/ Investments?
        Desea informacion sobre Pension o Inversiones?
          Check if Yes ( Marke Si ) 

         Please let us know if someone you know might need a quote for International
        Insurance, for travel, medical or life:
        Conoce a alguien que necesite obtener su presupuesto de Seguro de Vida y Gastos Medicos?
         

If you are finished, please click on the "Submit Form" one time then the information you entered on the white lines above will be sent to Patty at email address patty@seguros-insurance.net  then just wait for a response from us. Please allow us a few days to respond. You may also want to print this completed form out and keep it, or fax it to Patty at USA tel: 480-345-6834. If you wish paper applications please let us know.  Information you provide us is confidential & will not be disclosed to any insurance company without your consent. 
   Si ha terminado, por favor presione en "Enviar Forma" una sola vez, la informacion que usted escribio en los renglones siguientes seran enviados a Patty a su e-mail patty@seguros-insurance.net espere por nuestra respuesta. Por favor permitamos unos cuantos dias para responderle. Probablemente usted querra imprimir esta forma contestada y guardarla, o enviarla por fax a Patty en USA tel.fax: 480-345 6834