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Benefits & Exclusions
Patriot Executive
The Patriot Executive ® plan is international travel insurance for frequent international travelers who take multiple short term trips during a given year. Avoid the hassle of applying for short term travel insurance every time you travel during a given year. This plan is underwritten by IMG, an international insurance company who knows international travel medical insurance. Below are specifics on benefits and exclusions under the Patriot Executive plan. For additional terrorism insurance coverage, see what NYIG has to offer under its Terrorism Insurance/War zone Insurance section.
Benefits
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 |
| Emergency
Room |
As Described Below |
Charges incurred for the use of the Emergency
Room due to an accident are covered up to the Policy Maximum.
Charges incurred for the use of the Emergency Room for treatment
of an illness are subject to an additional (extra) US$250 deductible
if treatment does not require admittance to the hospital. |
| Dental |
As
Described Below |
Injury due to an accident: The 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:
The plan will pay up to US$100 for the necessary treatment of sudden,
unexpected pain to sound natural teeth. |
| International Emergency
Care |
| Emergency Evacuation |
To
US$25,000 for pre-existing conditions, to US$50,000 for covered
incidents when coordinated through the Plan Administrator |
| The Patriot Executive®
plan includes coverage for emergency medical evacuation to the
nearest qualified medical facility or the country of citizenship;
expenses for reasonable travel and accommodations resulting from
the evacuation; and the cost of returning to either the country
of citizenship or the country where the evacuation occurred up
to the policy limit. The plan pays up to US$25,000 for evacuations
resulting from a pre-existing condition and up to US$50,000 for
evacuations resulting from other covered incidents. |
| Emergency Reunion |
To
US$15,000 when coordinated through Plan Administrator |
| The Patriot Executive® 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 of the insured
person: either the cost of accompanying the insured during the evacuation
or traveling from the country of residence to be reunited with the
insured. |
| Reparation |
To
US$25,000 when coordinated through Plan Administrator |
| If a covered illness/injury results in
death, expenses for repatriation of bodily remains or ashes to the
country of citizenship will be covered up to a maximum of US$25,000. |
| Returning Minor
children |
To
US$5,000 when coordinated through 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
Executive plan will reimburse 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), when coordinated through the Plan
Administrator. |
| Political Evacuation |
To
US$10,000 when coordinated through 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: -
The Insured Person contacts the Company within 10 days of the United States Department of State, Bureau of Consular affairs issues the travel advisory;
-
Political Evacuation and Repatriation is approved and coordinated by the Company.
|
| Plan Information |
| Deductible |
US$250
per each covered Illness; deductible waived for claims incurred
as a result of a covered accident |
| Coinsurance |
|
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
|
| Benefit Period |
Six
(6) 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 |
| Trip Cancellation |
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, the Patriot Executive plan will reimburse the insured
up to US$5,000 for the cost of returning the insured to the area
of principal residence. The plan will cover reimbursement 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 |
To
US$50 per item of luggage; maximum of US$250 |
| 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. |
| 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.* |
| Sports & Activities
Coverage |
To
Policy Maximum for basic sports as described below |
| The Patriot Executive plan
covers injuries incurred during certain amateur athletic activities
which are non-contact and engaged in by an 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 likewise excluded: Scuba
diving, mountain climbing (up to 4500 meters or where ropes or guides
are normally used), jet, snow and water skiing and snowboarding,
sky diving, amateur racing, piloting an aircraft, bungee jumping
and spelunking. |
| Terrorism Coverage |
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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| Accidental Death
& Dismemberment |
US$25,000
Principal Sum |
The Patriot Executive 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 life which occurred during
a hijacking, kidnapping or attempted kidnapping - two times the
principal sum* • Accidental Loss of two Members - principal
sum • Accidental Loss of one Member - 50% of principal sum.
“Member” means hand, foot or eye. For more information
see the Conditions of Coverage section on panel 9 of the Patriot
Executive brochure.* |
* Notwithstanding
separate benefits, limits and sublimits for Common Carrier Accidental
Death benefit and Accidental Death & Dismemberment benefits
(above), no more than US$50,000 dollars per individual will be
paid to a beneficiary in the event of any death that occurs while
covered by the Patriot Executive plan. |
Exclusions
Charges for the following services, treatments and/or conditions, among others,
are excluded from coverage under the Patriot Executive plan.
1. Treatment for pre-existing conditions in excess of US$5000, per Insured
Person, per Period of Coverage (not per trip). A pre-existing condition
is defined as any injury, illness, sickness, disease, or other physical,
medical, mental or nervous condition, disorder or ailment that existed
at the time of application or at any time prior thereto, including any
subsequent, chronic or recurring complications or consequences relating
thereto or arising therefrom, whether or not previously manifested or
known, diagnosed, treated, or disclosed.
2. Treatment or surgeries which are elective, investigational, experimental
or for research purposes.
3. War, military action, terrorism, political insurrection, protest, or
any act thereof. The Company will not pay for a Political Evacuation if there is a travel advisory in effect on or within six (6) months prior to the Insured Person’s date of arrival in the Host Country.
4. Immunizations and routine physical exams.
5. Treatment of Temporomandibular Joint or dental treatment, except as
provided for in the Certificate of Coverage.
6. Venereal disease, AIDS virus, AIDS related illness, ARC Syndrome, or
AIDS, the cost of testing for these conditions, and charges for treatment
or surgeries which are incurred by any Insured who was HIV+ at time of
enrollment into this insurance.
7. Pregnancy, childbirth, birth control, artificial insemination, treatment
for infertility or impotency, sterilization or reversal thereof, or abortion.
8. Injury sustained while participating in 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: Scuba diving, mountain climbing (up
to 4500 meters or where ropes or guides are normally used), jet, snow
and water skiing and snowboarding, skydiving, amateur racing, piloting
an aircraft, bungee jumping and spelunking.
9. Vision or ear tests and the provision of visual or hearing aids.
10. Vocational, recreational, speech or music therapy.
11. Treatment while confined primarily to receive custodial care, educational
or rehabilitative care, or nursing services.
12. Charges, injuries and/or illnesses resulting or arising from or occurring
during the commission or continuing perpetration of a violation of law
by the insured, including without limitation, the engaging in an illegal
occupation or act, but excluding minor traffic violations.
13. Treatment for, and injuries and/or illnesses resulting or arising
from, substance abuse or drug addiction.
14. Injury and/or illness resulting or arising from or sustained while
under the influence of or disablement of drugs or alcohol.
15. Willful self-inflicted injury or illness.
16. Treatment required as a result of or arising from complications from
a treatment or condition not covered hereunder.
17. Any services or supplies performed or provided by a relative of the
Insured or provided at no cost to Insured.
18. Treatment for mental and nervous disorders.
19. Organ or tissue transplants or related services.
20. Treatment for Illness or Injury where the trip is undertaken for the
purpose of obtaining such treatment or advice for a pre-existing condition.
21. Treatment incurred as a result of or arising from exposure to nuclear
radiation, and/or radioactive material(s).
This web page contains only a consolidated and summary
description of all current Patriot Executive benefits, conditions, limitations
and exclusions, and is subject to all of the terms and conditions of the
full Policy Wording. A certificate containing the complete Policy Wording
with all terms, conditions and exclusions will be included with the fulfillment
kit. The Company 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.
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