International Student Insurance

Apply Online
1 Applicant Details
2 Cover Details
3 Additional Info
4 Summary &
Payment

Please complete the form below in English

Step 1 – Applicant Details

Family Name *

First or Given Name *

Date of Birth *

/ /

Gender*

Country of origin *

Phone Number *

Email Address *

Confirm Email Address *

Agent Email Address (optional)

School you are likely to attend *

Are you new OrbitProtect policy holder? *

Please complete the form below in English

Step 2 – Cover Details

Make a selection below

Student Prime

Medical care + medical evacuation + loss of deposits (including tuition fees) + property (NZ$3,000 per item, pairs or sets of items and maximum total value of NZ$10,000).

Student Lite

Medical care + medical evacuation + loss of deposits (including tuition fees).

Not sure which option you want? The Student brochure explains the difference between Lite and Prime.

Period of Insurance

Start date

End date

Specified items cover

Check this box if you want to specify items to be insured.

You have indicated you would like to specify items to be insured, our customer service officers will contact you to discuss with you the item(s) you can insure. Please note, additional premiums apply for this special cover.

Student Prime automatically covers property up to NZ$3000 per item, pairs or sets of items and up to a total value of NZ$10,000. Student Lite does not provide automatical property cover. However, you can choose to specify the items you want to insure. The additional premium you need to pay by choosing this option is 2% of the total value of items you specify. (e.g. if you specify $1000, then the additional premium you need to pay is NZ$20)

Please complete the form below in English

Step 3 – Additional Info

Do you have any pre-existing medical conditions?

A pre-existing condition is any medical or physical condition or circumstance that you are aware of, or ought to be aware of, that you have before the start date of the insurance. Remember: any existing condition (Asthma, Acne as examples) that may not have been active prior to the insurance start date that reoccurs after the start date will NOT be covered.

Additional information

Declaration confirmed

I agree to be bound by the OrbitProtect International student insurance Policy Wording (Lite or Prime as selected) and the Terms of Sale.

Your application for International Student Insurance

Policy Summary

Total Premium

$ NZD

Insured


Country of origin


Phone


Email



Start date


End Date

Medical Conditions Warning

Medical conditions that you already suffer from are not automatically covered under the Policy. Your application has been referred to our OrbitProtect team. Our Customer Service Officer will contact you. You will be notified in writing of the outcome of the assessment.

Underwriting Review

You are currently under underwriting review. Your application will be referred to our OrbitProtect team. Our Customer Service Officer will contact you. You will be notified in writing of the outcome of the assessment.

Please note that you are not insured until the premium has been paid in full.

High value items

You have indicated you would like to specify items to be insured, our customer service officers will contact you to discuss with you the item(s) you can insure. Please note, additional premiums apply for this special cover.

Select Payment Method

Credit Card

Pay instantly and securely online with your Credit Card via Payment Express.

Offline Payment via NZ Bank Transfer

An invoice with payment instructions will be sent to your email address


Offline Payment Warning

In order to make payment into our bank account in New Zealand:

  • You MUST have a New Zealand bank account if you are making payment through the internet.
  • You MUST be able to go to a Westpac Bank in New Zealand to deposit cash in to our bank account.

Offline Payment

Reference Number


Invoice and Payment instructions

An invoice with payment instructions has been sent to your email address.


Credit Card Payment

Reference Number


You may now proceed with your online payment.

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