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PASSENGER PROTECTION PLAN - ONLINE QUESTIONNAIRE
Please use this online form or download the PDF file which can then be faxed or mailed to MDM Group Associates.

PDF file for Passenger Protection Plan Application. Click on button to the right if you do not have Adobe Acrobat. The download is free.

Company Name:

Name of Contact Person:

Title:

Mailing Address:

City, State and Zip Code:

Telephone Number(s):

Fax:

E-mail:

 
ARC/IATA Number:

In Business in the U.S. since:

Holding Company, if any::

Address:

Does the operator own a Retail Travel Agency?

Yes    No

Name:

Address:

Profile of Travel Business Sold Annually:

Total Gross Receipts per year

%

Average Number of Travelers per Reservation

Average Number of Reservations per year

Average Cost of Trip:

Leisure Travel:

Business Travel:

%

%

Wholesale:

%

Direct to Passenger: %

Thru Retail Travel Agencies: %

Travel Destination:

Foreign:

Domestic:

%

%

Packaged Tours:

%

FIT:

Escorted Tours:

%

%

Please include the following information in addition to this questionnaire:

A) A full set of all current and valid Tour brochures

B) In cancellation penalties differ from penalties published in the brochures, please state below:

Package Tour Composition:

Land Cost: %

Air Cost: %

Other(ski tickets): %

Maximum Land: $

Maximum Air Cost: $

Average ADD ON AIR $

Tour/Cruise Duration:

One week: %

Two week: %

Three weeks: %

Four weeks: %

Preferred Suppliers (Top 5 most often used)

Airlines:

Motor Coaches:

Others:

Passenger Data:

AGE: Over 60 %   Under 18 %

Singles: %
Couples: %
Families: %
Citizens of: U.S. %   Other %
Passenger Totals:

Total for Prior Year:

Est. Total for this Year:

Est. Next Year:

Passenger Distribution per Quarter:
1st  %   2nd  %   3rd  %   4th  %
Passengers aboard same flight same day (concentration):
Maximum Number of Passengers per flight?

Average Number of Passengers per flight?

Percent of all trips that use Charter flights or that have a concentration of Passengers on any one flight?
Name of Charter Company most often used:
In order to effectively quote this product, please review the booking and cancellation schedules in the Tour brochures
What percentage of passengers book the trip within the schedule below (days prior to departure)

0-7  %   8-15 %   16-22 %   23-30 %

  31-45 %   46-60 %   61-90 %

Using the cancellation penalty schedule printed in the Tour Brochure - of the passengers who cancel, outline the percentage that cancel within each penalty band, (for example, if there are three cancellation penalty bands; 30-15 days, 14-4 days and 3-0 days prior to departure, of the 8% of the total passengers who cancel - 30% cancel 30-15 days, 60% cancel 14-4 days and 10% cancel 30-0 days prior to departure):
Current Travel Insurance Product (if Applicable)

Current Carrier:   
Since when?

How is the current plan sold?

Mandatory for all passengers:
Automatic invoicing on all invoices?
Voluntary plan with individual enrollment forms?
How does account remit premium - collections or departure, month before or after?
Administrative Fee paid to the account: %
Customer Participation: %
Insured Customers last year:
Number of Claims last year:
Total Premium collected last year: $
Total Amount paid in claims last year: $
Total Amount reserved in claims: $


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MDM Group Associates, Inc.
2620 S. Copper Frontage, G-3     P.O. Box 775330
Steamboat Springs, Colorado 80477
970.879.5560 - Fax 970.879.1462 - 800.942.5913
info@mdmgroup.net
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