Patriot Travel

Applicant Information

Primary DestinationPrimary Destination

The insurance plan covers you internationally, everywhere outside of your residence country. The primary destination is for informational purposes only.

Date of Birth

Coverage Dates

Start Date

Date that coverage should begin. This date cannot be more than 6 months from today.

End Date

This date cannot be more than 12 months from the date coverage begins.

Yes, I need dependent coverage.

Coverage Options

Adventure SportsAdventure Sports

The Adventure Sports Rider is available on both Patriot plans for those up to the age of 65. Certain adventure sports are covered (to the maximum amounts listed on the Benefits page) as long as they are engaged solely for leisure, recreation, or entertainment purposes. This is only a summary of Adventure Sports coverage and exclusions, please see Exclusion 8 for the full list of covered activities, exclusions and more information

Need Assistance?

Toll Free: +1 (877) 758-4391

Direct: +1 (904) 758-4391

Fax: +1 (904) 212-0412

Email: Email

Twitter: @intl_insurance