Patriot International^® Insurance

Plan Summary

Patriot International^® Insurance provides coverage for US citizens traveling abroad for a minimum of 10 days up to a maximum of one year. Patriot International^® Insurance is an excellent international travel insurance plan.

Policy Maximum	Maximum medical coverage options are $50,000, $100,000, $500,000 or $1,000,000. Additional maximum of $2,000,000.
Deductible	$0, $100, $250, $500, $1000 or $2500 per each injury or sickness.
Co-insurance	Plan will pay 100% of the covered amount.
Eligibility	- Patriot Travel Medical Insurance is travel insurance for U.S. citizens trvaeling outside the United States and for non-U.S. citizens traveling outside their home country. For those over age 65 and vsiting the U.S., your initial period of coverage must beging within 30 days of arrival in the U.S.
Pre-Existing Condition Coverage	- 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.
Pre-Existing Condition Definition	- A pre-existing condition is defined as any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the three years prior to the effective date of the insurance, whether or not previously manifested or symptomatic, diagnosed, treated, or disclosed prior to the effective date, including any subsequent, chronic or recurring complications or consequences related thereto or arising therefrom..
Coverage	- Hospital Room and Board - Hospital intensive care unit charges - Physician visits, surgeon, Private duty nurse fee	- Pre-admission tests - Diagnostics: X-Rays - Hospital emergency room - Prescription Drugs
Plan Life	1 year
Underwriter	Underwritten by Sirius International Insurance Corporation, a White Mountains Insurance Group company.
Buy - Online	Apply & purchase online Patriot International^® Insurance
Brochure	Complete, mail/fax the Patriot International^® Insurance Brochure along with payment

Patriot International^® Insurance

Patriot International^® Insurance provides coverage for US citizens traveling abroad for a minimum of 10 days up to a maximum of one year.

Although the Patriot International Plan is not renewable, it can be rewritten for succeeding or subsequent coverage periods. New Deductible, Coinsurance, Eligibility, Conditions of Coverage and Pre-Existing Condition Exclusions apply to any succeeding or subsequent Period of Coverage. A new application also must be completed.

ONE MONTH RATES (five Policy Maximum options)

	Option 5	Option 6	Option 7	Option 8	Option 9
	$50,000	$100,000	$500,000	$1,000,000	$2,000,000
AGE	One Month	One Month	One Month	One Month	One Month
18-29	$26	$31	$37	$42	$54
30-39	$31	$37	$49	$57	$72
40-49	$55	$60	$68	$75	$99
50-59	$90	$102	$114	$120	$153
60-64	$109	$1294	$153	$180	$201
65-69	$129	$138	$158	$189	$243
70-79	$189	N/A	N/A	N/A	N/A
80+*	$378	N/A	N/A	N/A	N/A
DEP. CHILD	$16	$21	$24	$25	$34
CHILD ALONE	$26	$31	$37	$42	$52

*US$10,000 limit

DAILY RATES (MINIMUM COVERAGE IS 10 DAYS)
	Option 5	Option 6	Option 7	Option 8	Option 9
	$50,000	$100,000	$500,000	$1,000,000	$2,000,000
AGE	Daily	Daily	Daily	Daily	Daily
18-29	$0.90	$1.05	$1.25	$1.40	$1.85
30-39	$1.05	$1.25	$1.65	$1.90	$2.45
40-49	$1.85	$2.00	$2.30	$2.50	$3.35
50-59	$3.00	$3.40	$3.80	$4.00	$5.15
60-64	$3.65	$4.35	$5.15	$6.05	$6.75
65-69	$4.35	$4.65	$5.35	$6.35	$8.15
70-79	$6.35	N/A	N/A	N/A	N/A
80+*	$12.65	N/A	N/A	N/A	N/A
DEP. CHILD	$0.55	$0.70	$0.80	$0.85	$1.20
CHILD ALONE	$0.90	$1.05	$1.25	$1.40	$1.80

*US$10,000 limit

All premium rates are in US dollars and are effective through 10/31/2008. Rates include 2.5% surplus lines tax. A dependent child is your child shown on the Application Form over 14 days and under 18 years of age, traveling with you, and for whom premium has been paid.

Refund of Premium

IMG will refund premium only if a written request is received prior to the certificate's effective date. The premium is non-refundable after that date.

Precertification, Emergency Evacuation and Repatriation

For precertification, emergency evacuation and repatriation please call IMG in the U.S. 1-800-628-4664 (toll free) or 1-317-655-4500. Call IMG outside the US: 001-317-655-4500 (collect if necessary). This information will also be provided on your ID card.

IMG must be notified prior to treatment or within 48 hours of an emergency.

To Report Claims

All IMG contact numbers, claim forms and Policy Wordings will be included in the fulfillment kit. Also be email to: insurance@imglobal.com.

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 Policy Wording with all terms, conditions and exclusions will be included with the fulfillment kit. IMG reserves the right to issue the most current Policy 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 Policy Wordings are available upon request.

Patriot International ® Insurance

Plan Summary