Azuria Life      Quotation     Individual & Family Medical Insurance Quotation

International Individual Health Insurance Quote


In order to receive personalized quotes please fill in the following Questionnaire. You are guaranteed complete confidentiality.

Your nationality
Country in which cover is required
Date you require cover to start      
Are you looking for comprehensive or standard cover? I only require hospitalization cover (No outpatient benefits.)
I require hospitalization and outpatient benefits.
I require dental benefits.
I require maternity benefits.

The length of time you will require Cover? Less than 6 months
From 6 to 11 months
One year and more

Are you currently insured?
Date of Birth      
Title
Your First name
Your Last name
Your E-mail address
Daytime telephone number (with country code)
Evening/Mobile Telephone Number
Occupation