PATRIOT
TRAVEL MEDICAL INSURANCE
PLAN DETAILS
IMG's International Travel Protection Package....
After purchasing online, you will then receive a policy confirmation by email and card and policy kit by post or courier (extra fee for courier delivery).
Contents:
3. Exclusions
4. Rates
To provide complete protection while you are traveling, each Patriot Travel Medical Insurance plan includes the following benefits:
OR Download Brochure Now in PDF format.
| SCHEDULE OF BENEFITS | |
| INTERNATIONAL EMERGENCY CARE | |
| Emergency Evacuation | To Policy Maximum when coordinated through the Plan Administrator |
| Each Patriot plan includes coverage for Emergency Medical Evacuations to the nearest qualified medical facility; expenses for reasonable travel and accommodations resulting from the evacuation; and the cost of returning to either the home country or the country where the evacuation occurred, up to the Policy Limit. | |
| Emergency Reunion | To US$15,000 when coordinated through the Plan Administrator |
| Each Patriot plan also
provides emergency reunion coverage, up to US$15,000 for a maximum of 15
days, for the reasonable travel and lodging expenses of a relative or friend
during an Emergency Medical Evacuation: either the cost of accompanying the insured during the evacuation or traveling from the home country to be reunited with the insured. |
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| Return of Mortal Remains | To US$25,000 when coordinated through the Plan Administrator |
| If a covered illness/injury results in death, expenses for Repatriation of bodily remains or ashes to the home country will be covered up to a maximum of US$25,000. | |
| Returning Minor Children | To US$5,000 when coordinated through the Plan Administrator |
| If an insured person is hospitalized due to a covered illness/injury and is traveling alone with child(ren) 19 or under that otherwise would be left unattended, the Patriot plans will pay up to US$5,000 for one way economy fare to their home country, including a chaperone, if necessary, for the safety of the child(ren). | |
| Political Evacuation | To US$10,000 when coordinated through the Plan Administrator |
If the United States
Department of State, Bureau of Consular Affairs issues a travel advisory
that becomes effective on or after the Insured Person’s date of arrival in
the Host Country, the Company will pay up to US$10,000 for transportation to
the nearest place of safety or for repatriation to the Insured Person’s home
country or country of residence provided that:
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| Dental | As Described Below |
| Injury due to an
accident: Each Patriot plan covers the cost of emergency dental
treatment and dental procedures necessary to restore sound natural teeth
lost or damaged in an accident up to the Policy Maximum. Sudden dental pain: Each plan will pay up to US$100 for the necessary treatment of sudden, unexpected pain to sound natural teeth. |
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| Additional Benefits | |
| Home Country Coverage | As described below |
| Incidental Home
Country Coverage - During the Period of Coverage an insured person
may return to their home country for incidental visits up to a cumulative
two weeks total, subject to: a. The insured person must
have left their home country, b. The total Period of
Coverage must be for a minimum of 30 days, and c. The
return to the home country may not be taken to receive treatment for an
illness or injury incurred while traveling. End of Trip Home Country Coverage - For every five months of continuous coverage you purchase, you can purchase one additional month of home country coverage as an accommodation and supplemental travel benefit, up to a maximum of two months. To purchase this special home country extension coverage, please check the appropriate box on the Application Form, and calculate your premium to include the additional month(s). |
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| Trip Interruption | To US$5,000 |
| If, during a covered trip, there is a death of an immediate family member (spouse, child, parent or sibling) or the substantial destruction of the insured’s principal residence, each Patriot plan will pay to return the insured to the area of principal residence. The plan will pay for a one way air or ground transportation ticket of the same class as the unused travel ticket, less the value of the unused return ticket. | |
| Lost Luggage | Up to US$50 per item or personal property; maximum of US$250 per Period of Coverage |
| This benefit will be paid in
the event that the Common Carrier permanently loses an insured person’s
checked luggage. This coverage is secondary to any other available coverage,
including the Carrier’s. |
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| Common Carrier Accidental Death | US$50,000 to Beneficiary; maximum of US$250,000 per family |
| If accidental death should occur while traveling on a commercial Common Carrier, US$50,000 will be paid to the designated beneficiary, to a maximum of US$250,000 per family. | |
| Terrorism Coverage | Up to US$50,000 lifetime maximum |
| Each Patriot plan provides
coverage for injuries and illness incurred as a result of an act of
Terrorism, limited in amount and by circumstances. If an insured person is
injured as a result of an act of Terrorism, and the insured person has no
direct or indirect participation in the act, the plan will reimburse
eligible medical claims subject to a US$50,000 lifetime maximum. However,
claims incurred as a result of radiological, nuclear, chemical or biological
weapons or events are not covered. Terrorism is defined as the systematic or planned use of violence, fear, or threat of violence in order to intimidate a population or government, especially as a means of coercion or to obtain a granting of any demand. However, this benefit does not cover an act of Terrorism in any country or location where the United States government has issued a travel advisory that has been in effect within the 6 months prior to the insured person's date of arrival. This benefit also does not cover an act of Terrorism in the event that an advisory to leave a certain country or location is issued by the United States government after the insured person's arrival date, and the insured person unreasonably fails or refuses to depart the country or location. |
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| MEDICAL BENEFITS | Usual reasonable and customary charges, subject to deductible and coinsurance |
| Hospital Room and Board | To Policy Maximum for average semi-private room rate |
| Intensive Care | To Policy Maximum |
| Medical Expenses | To Policy Maximum |
| Outpatient Medical | To Policy Maximum |
| Local Ambulance | To Policy Maximum> |
| Sports & Activities Coverage | Up to Policy Maximum for basic sports Coverage as described below |
| Each Patriot plan covers
injuries incurred during amateur athletic activities which are non-contact
and engaged in by the insured person solely for leisure, recreation,
entertainment or fitness purposes. However, activities not covered include
amateur or professional sports or other athletic activity which is organized
and/or sanctioned, or which involves regular or scheduled practices, games
or competition. The following hazardous activities are excluded: racing of any kind, aviation (except when traveling as a passenger in a commercial aircraft), BMX, BASE jumping, bobsleigh, bungee jumping, canyoning, caving, high diving, hang gliding, heli-skiing, hot air ballooning, inline skating, jet skiing, kayaking, luge, motocross (moto-x), mountain biking, mountaineering, parachuting, rappelling, rock climbing, rodeo, scuba diving, ski jumping, sky diving, snow skiing, snowboarding, snowmobiling, spelunking, snorkeling, surfing, wakeboarding, water skiing, windsurfing and whitewater rafting. Optional Leisure or Extreme Sports Riders: Please see the brochure for more information. |
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| Accidental Death & Dismemberment | US$25,000 principal sum |
| Each Patriot plan includes US$25,000 principal sum benefit for Accidental Death and Dismemberment occurring during the Period of Coverage: • Accidental Loss of life - principal sum; • Accidental Loss of two Members - principal sum; • Accidental Loss of one Member - 50% of principal sum. “Member” means hand, foot or eye. | |
| PLAN INFORMATION | |
| Deductible | Your choice of US$0, $100, $250, $500, $1,000 or $2,500 |
| On the Application Form, you will be asked to circle your choice of a deductible. Your premium rate is dependent on the deductible you choose. Please see the Application Form for more information. | |
| Coinsurance | As described below |
| For treatment
received outside the U.S. & Canada: No coinsurance For treatment received within the U.S. & Canada: In the PPO Network: The plan pays 90% of eligible expenses up to US$5,000, then 100% up to the Policy Maximum Outside the PPO Network: The plan pays 80% of eligible expenses up to US$5,000, then 100% up to the Policy Maximum
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| Benefit Period | Six months |
| If a covered injury or illness requires continuing treatment after the Period of Coverage expires, the six-month Benefit Period may provide continued coverage. When the certificate expires, the Company will review the date of initial treatment for the covered injury or illness. If treatment began less than six months before the Period of Coverage expired, benefits for the covered injury or illness will continue subject to the Policy Limits and the other terms of the plan until there have been six months of continuous coverage for the covered injury or illness. | |
| Additional Benefits for U.S. Citizens | |
| Sudden Recurrence of a Pre-existing Condition | |
| Up to US$15,000 will be paid for the eligible expenses of a sudden and unexpected recurrence of a Pre-existing Condition while traveling outside of the U.S.. In addition, up to US$25,000 will be paid for the eligible costs and expenses of an Emergency Medical Evacuation arising or resulting from a sudden and unexpected recurrence of a Pre-existing Condition. For the definition of a Pre-existing Condition, please see Exclusion number 1 in the Patriot Travel Medical Insurance brochure. | |
| Indemnity | |
| Patriot International will pay directly to the insured person US$100 for each night of a required overnight stay in a hospital. However, the hospital stay must be covered under this plan in order to receive this benefit. | |
The above outline is only a consolidated and summary description of all current Patriot Travel Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Policy Wording with all terms, conditions and exclusions will be included with the fulfillment kit. |
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| This web page contains only a consolidated and summary description of all current Patriot Travel Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request. | |
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Identity Theft Assistance |
Up to US$500 per Period of Coverage |
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If an imposter obtains key personal information such as a Social Security or Driver's License number, or other method of identifying an insured person in order to impersonate or obtain credit, merchandise or services in the insured person’s name, the Patriot plans will provide coverage for the reasonable, customary and necessary costs incurred by the insured for: re-filing a loan or other credit application that is rejected solely as a result of the stolen identity event; notarization of legal documents, long-distance telephone calls, and postage that has resulted solely as a result of reporting, amending and/or rectifying records as a result of the stolen identity event; up to three credit reports obtained within one year of the insured person’s knowledge of the stolen identity event; and stop payment orders placed on missing or unauthorized checks as a result of the stolen identity event. The identity theft event must occur during the Period of Coverage and must be reported within 6 months of the termination of coverage date. |
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Eligibility Requirements:
The following conditions apply for all Person's enrolling in Patriot Travel Medical InsuranceSM
For those over age 65 and visiting the US, your initial Period of Coverage must begin within 30 days of arrival in the U.S. Please attach a copy of your Visitors Visa to the Enrollment Form.
This insurance is not available to non-US citizens who are residing in New York, California or Florida at the time of Application. This does not apply when the Effective Date coincides with the individuals departure date.
*If you are not in the US at the time of application, please indicate Expected Date of Arrival on Enrolment Form.
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OR
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This brochure is only a summary of coverage provided. Other conditions and exclusions may apply. Please consult the policy itself for a full description of the coverage. In support of Patriot Travel Medical Insurance sm, IMG has established the Group Health, Accident and Travel Insurance Trust, in Indiana. The trust owns a master group international travelers insurance policy. Individual certificates of insurance
Underwritten by: Sirius International Insurance Corporation
Download brochure in PDF Format
Download brochure in PDF Format.
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Refund of Premium............................
IMG will refund premium only if a written request is received prior to the policy's effective date. The premium is non-refundable after that date.
For Precertification, Emergency Evacuation and Repatriation..............
Please call IMG
in the U.S. 1.800.628.4664
Outside the U.S. 01.317.655.4500
(collect if necessary).
IMG must be notified prior to treatment or within 48 hours of an emergency.
To Report
Claims...............................
Please mail to IMG
International Medical Group, Inc.
P.O. Box 88500
Indianapolis, IN 46208-0500 U.S.A.
Please include Identification Number in all correspondence.
Underwritten by: Sirius International Insurance Corporation
OR
Apply Now Using Enrollment / Application
Note: Some of the products and services described or advertised on this site may not be available to residents of certain jurisdictions, depending on regulatory constraints, including Canada and the U.S. Please contact TFG Global Insurance Solutions Ltd. sm for more information about your specific jurisdiction. The above coverage is NOT available to residents in British Columbia.
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