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Step 1/4 - Trip Details
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TRIP DETAILS
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COVERAGE
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APPLICANT DETAILS
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PAYMENT

Patriot Platinum International Insurance Application

Please note that :

  • Not available for the residents of Maryland (MD) state.
  • If initially purchased for a minimum of one month or more, coverage may be renewed.
All fields are required fields unless stated as optional
Where are you traveling to? : If any part of your trip includes the United States, please select United States as your Destination Country. Other countries except Home Country on your trip is automatically covered.

(17 years and under)
Dependent Child: Children 17 years and under of the primary insured on this policy. Grandchildren, nieces, nephews etc. are not considered as dependent children. Please fill a separate application in such cases or for older children.
You are not eligible to purchase Patriot Platinum International due to restriction of plan. You may be eligible to purchase Global Medical Insurance.
You are not eligible to purchase Patriot Platinum International due to restriction of plan.
PPI

Patriot Platinum International

Administrative Company

IMG

Carrier / Underwriter

Sirius International

Eligibility

  • For US citizens traveling outside their home country including USA.
  • Coverage for minimum 5 days to maximum up to 365 days in a policy period.
  • Renewal option available up to a maximum of 2 years.

Comprehensive Coverage Plan


Inside US and Canada


In-Network : : After the deductible, plan pays 100% up to chosen medical maximum.
Out of Network : After the deductible, plan pays 90% of first $5,000; then 100% up to chosen medical maximum.

Outside US and Canada


After the deductible, 100% up to the chosen medical maximum.

Review Policy document(Description of Coverage) ,for complete policy details including benefits and exclusions.

Review & Download

Plan Brochure Description of Coverage
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