International travel medical and health insurance

SCHEDULE OF BENEFITS

INTERNATIONAL EMERGENCY CARE
Emergency Evacuation	To Policy Maximum when coordinated through the Plan Administrator
Patriot Extreme includes coverage for Emergency Medical Evacuations from a medical facility to the nearest qualified medical facility; expenses for reasonable travel and accommodations resulting from the evacuation; and the cost of returning to either the country of residence or the country where the evacuation occurred up to the policy limit.
Emergency Reunion	To US$10,000 when coordinated through the Plan Administrator
Patriot Extreme also provides emergency reunion coverage, up to US$10,000 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.
Repatriation	To US$15,000 when coordinated through the Plan Adminstrator
If a covered illness/injury results in death, expenses for Repatriation of bodily remains or ashes to the country of residence will be covered up to a maximum of US$15,000.

SPECIAL COVERAGES
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 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	To US$50 per item; 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 beneficiary to a maximum of US$250,000 per family

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

Dental	To Policy Maximum
Patriot Extreme covers the cost of emergency dental treatment and dental procedures necessary to restore sound natural teeth lost or damaged in an accident
Sports & Activities	To Policy Maximum for basic and extreme sports as described below
Subject to the terms of the complete policy wording, Patriot Extreme covers injuries incurred during non-contact amateur athletic activities and certain Extreme Sports (see page 7 of the Patriot Extreme brochure). Activities may be organized and include scheduled practices, games, and/or competitions. Activities not covered include contact sports, professional sports and any athletic activities that are organized and/or sanctioned by the National Collegiate Athletic Association (or any other collegiate sanctioning body) or the International Olympic Committee.

PLAN INFORMATION
Deductible	US$250 per Period of Coverage

Coinsurance	As described below
The plan pays 80% of eligible expenses up to US$5,000 then 100% up to the Policy Maximum.
Benefit Period	Three months
If a covered injury or illness has continuing treatment after the certificate expires, the 3-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 three months before the certificate expired, benefits for the covered injury or illness will continue subject to the Policy Limits until there has been three months of coverage for the covered injury or illness.
Policy Maximum	US$50,000
The Patriot Extreme plan has a Policy Maximum of US$50,000.

The above outline is only a consolidated and summary description of all current Patriot Extreme 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.