Order form - Asistur Insurance for Cuba

To book other Cuban Adventures' products, along with travel insurance, please click here.

  • Please fill out the form below with your insurance requirements.
  • No payment is required at this stage. We will respond to you within 2 working days with confirmation of your requirements and instructions for payment.
  • We accept payment with Visa, Mastercard, or bank transfer.
  • Once we have received payment, we will put your insurance in place and then within 48 hours, send you a printable certificate for the insurance by email.

Date of Arrival to Cuba

We require a minimum of 3 days to process insurance orders. We cannot process your order if you are due to arrive to Cuba in less than 3 days time.

Date of Departure from Cuba

Personal Details: (click to open section for each traveller)

Traveller #1

Traveller #2

Traveller #3

Traveller #4

Traveller #5

Traveller #6


Payment is required only after the reservation office respond to your order form. You will receive an email confirming the amount payable, detailing how to make payment, and a payment reference number.

Your preferred method of payment:

Currency of payment

We accept payments in all 4 currencies listed above. We will convert the value to the currency of your preference using the daily interbank "0%" rate on oanda.com. You are responsible for paying any bank fees for sending payment by bank transfer.

We do not charge a fee for paying by credit card, however your own bank may do so, depending on their policy. Only Visa and Mastercard are accepted.


Any other comments or questions:

Terms and Conditions

Asistur medical insurance is non-refundable.
Please select this box to agree with this condition of purchase and to confirm you accept the General Conditions of the policy.