UMVIM accident insurance application form
Please click on the following line to download the
COVER SHEET
for UMVIM insurance applications
(Word file)
* * *
Please click on the following line to download the current
This accident insurance policy is for participants in UMVIM work projects listed in the Jurisdictional UMVIM and Mission Volunteers websites, which can be accessed by going to http://umvim.info, as well as for participants in UMVIM projects which are Advance specials or which involve working with GBGM missionaries. It is not intended for non-work trips or for language study except when required by the Individual Volunteer program.
For UMVIM teams to Cuba: because the Chubb underwriter will require a copy of your U.S. Treasury Department license to travel to Cuba in order to provide coverage, you will need to email us a copy of the license 30 days or more before your departure so that Chubb can have the policy updated prior to the trip.
The cost of coverage is $0.75 per person per day, including days of departure and return. Please send the accident insurance applications in ONE BATCH together with ONE CHECK and a COVER SHEET giving the team leader's name, address, phone, and email; destination; and the names and number of persons per each distinct set of dates of coverage (i.e. having the same dates of departure and return) to:
Mission Volunteers GBGM
Room 1400
475 Riverside Drive
New York, NY 10115
Please click on the following line to download the current
UMVIM ACCIDENT INSURANCE APPLICATION FORM
including instructions on how to send them
and outline of coverage (pdf) *
* NOTE: to download a pdf file, you need the free Adobe Acrobat Reader
This accident insurance policy is for participants in UMVIM work projects listed in the Jurisdictional UMVIM and Mission Volunteers websites, which can be accessed by going to http://umvim.info, as well as for participants in UMVIM projects which are Advance specials or which involve working with GBGM missionaries. It is not intended for non-work trips or for language study except when required by the Individual Volunteer program.
For UMVIM teams to Cuba: because the Chubb underwriter will require a copy of your U.S. Treasury Department license to travel to Cuba in order to provide coverage, you will need to email us a copy of the license 30 days or more before your departure so that Chubb can have the policy updated prior to the trip.
The cost of coverage is $0.75 per person per day, including days of departure and return. Please send the accident insurance applications in ONE BATCH together with ONE CHECK and a COVER SHEET giving the team leader's name, address, phone, and email; destination; and the names and number of persons per each distinct set of dates of coverage (i.e. having the same dates of departure and return) to:
Mission Volunteers GBGM
Room 1400
475 Riverside Drive
New York, NY 10115
