PATRIOT TRAVEL MEDICAL INSURANCE^sm
Conditions and Exclusions

Conditions of Coverage

1. Coverage is subject to the deductible and coinsurance.
2. Coverage under this program is secondary to any other insurance.
3. Coverage is for medically necessary, usual, reasonable and customary charges only.
4. Charges must be administered or ordered by a physician.
5. Charges must be incurred during the Policy Period or the Benefit Period.
6. Claims must be presented to IMG for payment within the Policy Period, Benefit Period or three months immediately following the policy Period.

Emergency Evacuation, Emergency Reunion and Repatriation Coverage

1. All Conditions and Exclusions apply to this Coverage.
2. Emergency Evacuation, Emergency Reunion or Repatriation expenses must be approved and coordinated in advance by IMG.
3. All costs arising from trips outside the country where the Incident which gave rise to the claim occurred must be approved in advance and coordinated by IMG.

 Exclusions

1. A pre-existing condition defined as any injury, physical defect, infirmity, medical condition, or chronic or recurring illness which existed at or during the five years prior to the date of entry of an insured person into this insurance.
2. Treatment or surgeries which are elective, investigational, experimental or for research purposes.
3. War; political insurrection, protest; or any act thereof.
4. Immunizations and routine physical exams.
5. Treatment of Temporomandibular Joint or dental treatment, except as provided for herein.
6. Venereal disease, AIDS virus, AIDS related illness, ARC Syndrome, AIDS or the cost of testing for these conditions and charges for treatment or surgeries which are Incurred by the 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 an professional, club, interscholastic, or intercollegiate sport.
9. Visual 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 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.
13. Treatment for substance abuse or drug addiction.
14. Injury sustained while under the influence of or disablement of drugs or alcohol.
15. Willfully self-inflicted injury or illness.
16. Treatment required as a result of 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. Illness or injury where the trip to the host country is undertaken for treatment or advice for such Illness or injury, except as provided for herein.
21. Treatment incurred as a result of exposure to nuclear radiation, and/or radioactive material(s).

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