Charges for certain services, treatments and/or conditions, among others, are excluded from coverage under the
Patriot plans and include but are not limited to:
- A Pre-existing Condition which is defined as any injury, illness, sickness, disease, or other physical,
medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed
at the time of application or at any time during the three years prior to the effective date of the
insurance, including any subsequent, chronic or recurring complications or consequences related thereto or
arising therefrom, whether or not previously manifested or known, diagnosed, treated, or disclosed.
- Treatment or surgeries which are elective, investigational, experimental or for research purposes.
- 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.
- Immunizations and routine physical exams.
- Treatment of Temporomandibular Joint or dental treatment, except as expressly provided for in the
Certificate of Insurance.
- Venereal disease, AIDS virus, AIDS-related illness, ARC Syndrome, or AIDS, and 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.
- Pregnancy, childbirth, birth control, artificial insemination, treatment for infertility or impotency,
sterilization or reversal thereof, or abortion.
- Any illness or injury sustained while taking part in: Amateur Athletics, Professional Athletics, or other
athletic activity which is organized and/or sanctioned by the National Collegiate Athletic Association
(and/or any other collegiate sanctioning or governing body), or the International Olympic Committee. The
following Adventure Sports are excluded unless the Adventure Sports Rider is purchased: abseiling, BMX,
bobsledding, bungee jumping, canyoning, caving, hang gliding, heli-skiing, high diving, hot air ballooning,
inline skating (with proper use of helmet and pads), jet skiing, jungle zip lining, kayaking, mountain
biking, parachuting, paragliding, parascending, piloting a non-commercial aircraft, rappelling, rock
climbing or mountaineering (ropes and guides to 4500m from ground level), scuba diving (to 50m), skydiving,
snow boarding, snowmobiling, snow skiing, spelunking, surfing, trekking, whitewater rafting (to Class V),
wildlife safaris, and windsurfing. All such activities must be carried out in strict accordance with the
rules, regulations and guidelines of the applicable Governing Body or Authority of each such activity.
Injury sustained while participating in contact sports of any kind, racing of any kind, any rodeo
activity, BASE jumping, kiteboarding, mountaineering or climbing or trekking above elevation 4500 meters
above ground level or without proper ropes or guides; luge, motocross, Moto-X, ski jumping, sub-aquatic
activities below 50 meters, whitewater rafting exceeding Class V difficulty, and/or adventure sports
activity not expressly covered hereunder are excluded regardless of which plan or rider is selected.
- Vision or ear tests and the provision of visual or hearing aids.
- Vocational, recreational, speech or music therapy.
- Treatment while confined primarily to receive custodial care, educational or rehabilitative care, or nursing
- 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.
- Treatment for, and injuries and/or illnesses resulting or arising from, substance abuse or drug
- Injury and/or illness resulting or arising from being under the influence of alcohol or drugs; and injury or
illness resulting from operating any type of vehicle after consuming any alcohol or drugs.
- Willful self-inflicted injury or illness.
- Treatment required as a result of or arising from complications from a treatment or condition not covered
under the certificate.
- Any services or supplies performed or provided by a relative of the Insured or provided at no cost to
- Treatment for mental and nervous disorders.
- Organ or tissue transplants or related services.
- Illness or injury where the trip to the host country is undertaken for treatment or advice for such illness
or injury, except as expressly provided for in the certificate of insurance.
- Treatment incurred as a result of or arising from exposure to nuclear radiation, and/or radioactive
- Any infection of the urinary tract (or Illness arising therefrom), that occurs within ninety (90) days of
the Effective Date of coverage and that requires Treatment of the Insured Person in a Hospital; provided
that any such Illness will be deemed by the Company to be a Pre-existing Condition. See the “Sudden and
Unexpected Recurrence of a Pre-existing Condition,” description within the benefits section.
This is a brief summary of the plan exclusions, for a more detailed list please request a copy of the plan