Patriot Group
Travel Medical Insurance     Back to Plan Listings

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Premiums: Patriot International Group  |  Patriot America Group

Patriot International Group Travel provides coverage for US citizens traveling abroad for a minimum of 5 days up to a maximum of two years.

All premium rates are in US dollars and are effective through 12/31/2007. Rates include 2.5% surplus lines tax where applicable. A dependent child is a child shown on the Application Form over 14 days and under 18 years of age, traveling with the group as a dependent of a group member, and for whom premium has been paid.
Patriot International Group Premiums
Monthly Premiums: Premiums shown are for a $250 deductible.
Other deductibles available.
  $50,000 MAX $100,000 MAX $500,000 MAX $1,000,000 MAX $2,000,000 MAX
  One Month One Month One Month One Month One Month
18-29 $29.00 $33.00 $39.00 $43.00 $49.00
30-39 $33.00 $39.00 $51.00 $57.00 $65.00
40-49 $53.00 $59.00 $66.00 $73.00 $89.00
50-59 $86.00 $98.00 $110.00 $122.00 $138.00
60-64 $98.00 $116.00 $138.00 $162.00 $181.00
65-69 $116.00 $124.00 $142.00 $170.00 $219.00
70-79 $170.00 N/A N/A N/A N/A
80 Plus* $340.00 N/A N/A N/A N/A
Dep Child $16.00 $21.00 $24.00 $25.00 $31.00
Child Alone $29.00 $32.00 $37.00 $41.00 $47.00
*US$10,00 Maximum


Daily Premiums (Minimum length of coverage is 5 days)
  $50,000 MAX $100,000 MAX $500,000 MAX $1,000,000 MAX $2,000,000 MAX
18-29 $1.00 $1.10 $1.30 $1.45 $1.65
30-39 $1.10 $1.30 $1.75 $1.90 $2.20
40-49 $1.80 $2.00 $2.20 $2.45 $3.00
50-59 $2.85 $3.25 $3.70 $4.10 $4.60
60-64 $3.25 $3.90 $4.60 $5.40 $6.05
65-69 $3.90 $4.15 $4.80 $5.70 $7.30
70-79 $5.70 N/A N/A N/A N/A
80 Plus* $11.34 N/A N/A N/A N/A
Dep Child $0.54 $0.70 $0.85 $0.90 $1.05
Child Alone $1.00 $1.10 $1.25 $1.35 $1.60
*US$10,00 Maximum
Quality Guarantee

Your satisfaction is very important to the plan underwriter, and to IMG as the plan administrator. If, for any reason, you are not pleased with this product, you may submit a written request for cancellation and refund of your premium. In order to be considered for a full refund, your request for cancellation must be received by IMG prior to your effective date. If you do not have any claims filed with IMG, you may cancel your plan after your effective date, however, the following conditions will apply: 1) you will be required to pay a US$25 cancellation fee and 2) only full month premiums will be considered for refunds (e.g., if you choose to cancel your coverage two months and two weeks prior to the date your coverage ends, IMG will only consider the two full months for a refund). If you have filed claims, your premium is non-refundable.

Precertification, Emergency Evacuation and Repatriation

For precertification, emergency evacuation and repatriation, please call: IMG in the US: 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

Please mail completed claim forms to International Medical Group, Claims Department, P.O. Box 88500, Indianapolis, IN 46208-0500 USA. All IMG contact numbers, claim forms and Certificate Wordings will be included in the fulfillment kit. IMG may also be contacted by fax: 317- 655-4505 or e-mail: insurance@imglobal.com.

This web page contains only a consolidated and summary description of all current Patriot Group 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.
 

Globe Insure • • Phone & Fax: 632.451.1400
St. Francis Shangrila Place • Tower 1, Suite 52BC • Internal Road corner St Francis St. • Mandaluyong, Manila Philippines

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