Annual Evacuation, Medical and Accident Insurance for Traveling Executives



If you are an Executive that travels outside of the United States frequently throughout the year, don't risk finding yourself ill or injured in a foreign country without adequate resources to assist with securing medical care and covering the associated costs.

Many Executives travel outside of the United States frequently. Until now, obtaining medical insurance that covered the Executive throughout the year has been difficult. Minimum trip durations, lengthy applications, unsuitable coverage and restrictive policy benefits make the purchase of travel medical insurance a hassle for the frequent traveler at best.

IMG has designed Patriot Executivesm to take the hassle out of purchasing travel medical insurance. Patriot Executive provides coverage for up to US$ 1,000,000 in medical expenses, including US $5,000 for treatment of Pre-existing Conditions, as well as a package of other international insurance benefits.

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  1. Eligibility
  2. Medical Coverage
  3. Emergency Evacuation and Repatriation
  4. Emergency Reunion
  5. Accidental Death and Dismemberment
  6. Policy Limits
  7. Precertification
  8. Benefit Period
  9. Choosing Your Plan and Premium
  10. Exclusions
Eligibility

If you are a U.S. citizen, employed by a company with a location in the United States, are covered by an individual or group medical plan while in the United States and travel outside of the United States frequently throughout the year, you and your Spouse and Children are eligible for coverage under Patriot Executivesm, while traveling outside of the United States. All you have to do is complete the linked enrollment form and pay the required premium.



Medical Coverage

All benefits, except Accidental Death and Dismemberment are subject to the Deductible and Policy Limits.
  1. The usual, reasonable and customary fees of a physician, surgeon, radiologist, and any other specialist to whom the physician has referred the case.
  2. The cost of drugs as prescribed by such physician or specialist mentioned in 1. above.
  3. The cost of dressings or appliances prescribed by such physician or specialist as mentioned in 1. above.
  4. Maintenance and attendance in a hospital reimbursable according to the Policy Limits.
  5. Extended care in a licensed extended care facility upon direct transfer from an acute care hospital for the purpose of continued recovery requiring skilled nursing care.
  6. Outpatient skilled nursing care by a qualified licensed professional.
  7. The cost of emergency ambulance transport necessarily incurred in connection with injury or illness resulting in hospitalization within the country where the event occurs; reimbursable as outlined in the Policy Limits.
  8. The cost of emergency dental treatment and dental procedures necessary to restore sound natural teeth lost or damaged in an accident.
  9. The cost of oxygen and other gases and their administration.
  10. The cost of anesthetics and their administration.


Emergency Evacuation and Repatriation

Emergency Evacuations must be recommended by a physician who certifies that injury or illness necessitates such evacuation and must be agreed to by you or your representative. IMG must approve & coordinate all Emergency Evacuations and Repatriations. Any charges resulting from evacuations and repatriations not coordinated by IMG shall be excluded. Patriot Executive Insurancesm will pay expenses arising out of reasonable travel and accommodations in respect of evacuation to your country of citizenship or the nearest qualified medical facility.
Patriot Executive Insurance covers:
  1. Expenses for Emergency Evacuation incurred up to the Policy Maximum.
  2. Expenses for Repatriation of bodily remains or ashes to the U.S.A. up to a maximum of U.S. $20,000 for a covered injury or illness beginning during the period of coverage that results in death.



Emergency Reunion

In the instance of a physician recommended evacuation due to a covered injury or illness, where the physician feels that it would be beneficial to have a family member at your side during transport, you will be reimbursed for travel and lodging expenses incurred by that relative up to U.S. $15,000 provided that all travel arrangements are coordinated by IMG. The following benefits will be payable:
  1. The cost of an economy air ticket for one relative from the U.S.A. to the airport serving the area where you are hospitalized and the return trip.
  2. Reasonable travel and accommodation expenses incurred in relation to the emergency reunion.
  3. The period of emergency reunion is not to exceed ten days, including travel.



Accidental Death and Dismemberment

Patriot Executive Insurancesm includes a benefit of U.S. $25,000 principal sum for Accidental Death and Dismemberment. If Accidental Death or Dismemberment occurs during the period of coverage, Patriot Executive Insurancesm will pay as follows:
  • Accidental Loss of life: principal sum.
  • Accidental Loss of Life which occurred during a Hi-jacking, Kidnapping or attempted kidnapping: 2X Principal Sum
  • Accidental Loss of two Members: principal sum.
  • Accidental Loss of one Member: 50% of principal sum.

    "Member" means hand, foot or eye. Only one amount, the largest to which you are entitled, will be paid for all losses resulting from one illness or injury. The loss of a hand or foot means the complete severance at or above the wrist or ankle joint. The loss of an eye means the entire and irrecoverable loss of sight.




Policy Limits

  • Deductible - $250 per insured person, per each and every Claim. The deductible shall be waived for Claims incurred as a result of a covered Accident.
  • Maximum Policy Limit - U.S. $1,000,000 per insured Person per Policy Period
  • Pre-Existing Condition Benefit - U.S. $5,000 maximum per Insured Person per Policy Period
  • Emergency Medical Evacuation Expenses - U.S. $25,000 per Insured Person for Evacuations resulting from a Pre-existing Condition. U.S. $50,000 per Insured Person for Evacuations resulting from other covered Incidents.
  • Repatriation Expenses - U.S. $20,000 when coordinated & approved through IMG
  • Emergency Reunion Expenses - U.S. $15,000 when coordinated & approved through IMG
  • Local Ambulance Expense - U.S. $2,500
  • Accidental Death and Dismemberment - U.S. $25,000 principal sum
  • Hospital Room and Board - Average semi-private room rate up to the Policy Maximum
  • Intensive Care - 3x the average semi-private room rate up to the Policy Maximum
  • Medical Expenses - Usual, reasonable and customary up to the Policy Maximum
  • Outpatient Medical Expenses - Usual, reasonable and customary up to the Policy Maximum
  • Benefit Period - Six months
  • Period of Coverage - The period of time beginning on the date the Insured Person departs the home country and ending on the date the Insured Person arrives back in the home country. The Period of Coverage can be no longer that the option specified on the Insured's Enrollment Form and in any event no longer than thirty days.
  • Maximum Duration of Any One Trip - Your choice , 15 days or 30 days. Trips for covered dependents will be limited to 15 days for any one trip.



Precertification

All proposed hospital admissions and surgeries, whether inpatient or outpatient, will be subject to Precertification. You or your attending physician must call the number listed on your Confirmation of Coverage prior to admittance to a hospital or performance of a surgery. In the event of an Emergency Admission, the Precertification call must be made within 48 hours after the admission, or as soon as reasonably possible. In the event an admission or surgery is not pre-certified, eligible expenses will be reduced by 50%.

Benefit Period

The Benefit Period is the period of time specified in the Policy Limits. It begins once an eligible incident occurs to the insured. While coverage is in effect under this policy, the Benefit Period does not apply. When coverage under this policy terminates as defined, Patriot Executive Insurancesm will pay eligible expenses for covered Injuries or Illnesses which commenced during the period of coverage for up to, but not exceeding the Benefit Period, subject to the Policy Limits.

This is only a summary of the coverage provided. Other conditions and exclusions may apply. Please consult the policy itself for a full description of the coverage. In support of Patriot Executive Insurancesm, IMG has established the Group Health, Accident and Travel Insurance Trust, in Washington D.C. The trust owns a master group international insurance policy. Individual certificates of insurance are issued from the master policy. Rates include 2% surplus lines tax.



Choosing Your Plan and Premium

Maximum Trip Duration Annual
Premium		 Spouse & 2 Dependents Each Additional Dependent
15 Days U.S.$200.00 U.S.$100.00 U.S.$40.00
30 Days

U.S.$250.00

    

Underwritten by: Sirius International Insurance Corporation (publ)

PE98




Insurance Exclusions

Charges for the following conditions, services or treatments are excluded:
  1. Any injury or illness which is not incurred by an insured Person during the Period of Coverage.
  2. Charges for treatment which is not incurred by an insured person during the Period of Coverage or Benefit Period.
  3. Charges for injury or illness incurred during to Period of coverage which are not presented to the Company for payment within 3 months from the date of services rendered.
  4. Charges for treatment which is not administered by a physician.
  5. Charges for treatment which is not medically necessary.
  6. Treatment provided at no cost to the Insured Person.
  7. Charges exceeding usual, reasonable and customary.
  8. Treatment or surgeries which are investigational, experimental or for research purposes.
  9. Charges for treatment or surgeries which are Incurred by the Insured who was HIV+ at time of enrollment into this insurance.
  10. Routine Dental Treatment and the provision of false teeth or dentures: normal eye tests and the provision of visual aids; normal ear tests and the provision of hearing aids.
  11. Elective cosmetic surgery & associated treatment.
  12. Any Surgery or Treatment in respect of an injury or illness diagnosed at the time of inception of coverage.
  13. Pregnancy and childbirth costs.
  14. Injury sustained while taking part in mountaineering where ropes or guides are normally used, amateur or professional athletics, aviation (except when traveling as a passenger in a commercial aircraft), hang gliding and parachuting, snow skiing, racing by horse, motor or motorcycle, spelunking and subaqua pursuits involving underwater breathing apparatus.
  15. Injury sustained while under the influence of or disablement due wholly or partly to the effects intoxicating liquor or drugs other than drugs taken in accordance with treatment prescribed and directed by a Physician but not for the treatment of Substance Abuse or drug addiction.
  16. Willfully self-inflicted injury or illness.
  17. Venereal Disease.
  18. All costs arising from Medical Expenses incurred when the Insured Person was traveling against the advice of a Physician or medical professional.
  19. Testing for the following: HIV, seropositivity to the AIDS virus, AIDS related Illnesses, ARC Syndrome, AIDS.
  20. AIDS virus, AIDS related illness, ARC Syndrome, AIDS, and/or any illness arising as complications from these conditions.
  21. Illness or injury where the trip to the host country is undertaken for treatment or advice for such Illness or injury.
  22. Immunizations and routine physical examinations and associated laboratory tests and diagnostic procedures.
  23. Treatment in the United States.
  24. Treatment for mental and nervous disorders.
  25. Treatment by a chiropractor, unless ordered by a physician.
  26. Charges resulting from or occurring during the commission of a violation of law by the insured, including without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations.
  27. Treatment for substance abuse or drug addiction.
  28. Telephone consultations or failure to keep a scheduled appointment.
  29. Treatment while confined primarily to receive custodial care, educational or rehabilitative care, or nursing services.
  30. Any drug , treatment or procedure the either promotes or prevents conception, or prevents child birth, including but not limited to: artificial insemination, treatment for infertility or impotency, sterilization or reversal thereof, or abortion.
  31. Treatment of Temporomandibular Joint.
  32. Vocational, recreational or music therapy.
  33. Organ or tissue transplants or related services.
  34. Any services or supplies performed or provided by a relative of the insured.
  35. For Speech Therapy.
  36. Charges resulting from Emergency Evacuations or Repatriations of bodily remains that were not coordinated by the Company or its designee.
  37. Charges for Emergency Reunion expenses that were not coordinated by the Company or its designee.
  38. Treatment required as a result of complications from a treatment or condition not covered hereunder.
  39. Treatment incurred as a result of exposure to nuclear radiation, and/or radioactive material(s).
  40. Treatment incurred as a result of a Pre-existing Condition in excess of U.S. $5000.00.
  41. War; political insurrection, protest; or any act thereof.