Request a Policy Extension

Complete this form to request an extension of your current insurance policy.

Your Name*
Your Policy Number*
Email*
Phone
Have you made, or do you believe you may have to make a claim under your existing travel insurance policy?*
- Yes
- No
Have you sought or undertaken any form of medical advice or treatment since the policy was purchased?*
- Yes
- No
Have there been any changes to the material facts on which your original application was based, such as: Areas of travel? Sports or pastimes / nature of any work undertaken / pre-existing medical conditions?*
- Yes
- No
Have you returned to Australia during your current policy period?*
- Yes
- No
If you have answered 'Yes' to any of the above, please provide further information
Are you currently fit and in good health?*
- Yes
- No
If you are travelling on a return basis, have you got a return ticket booked? If you are travelling on a one-way basis, do you have a pre-booked ticket for travel to your final destination?*
- Yes
- No
What date to you need to extend your policy to?*
The end date of the policy must coincide with your return to Australia

Go Insurance is a registered trading name of Go Unlimited Pty Ltd (ABN 74149217925) AFS License no 404782 of PO Box 5964 Brendale 4500.

1300 819 888