15. Exclusions – when AIA won’t pay a benefit
16. How to make a claim
To make a claim, refer to the section in your AIA Living policy entitled ‘How to make a claim’.
AIA will not pay any benefit described in this appendix where any of the following (and in each case either directly or indirectly) causes or contributes to the claim: The life assured (or the child in the case of a Built-in Children’s Trauma Benefit) deliberately injures himself or herself or attempts to do so. The life assured (or the child in the case of a Built-in Children’s Trauma Benefit or the Built-in Parents Grieving Benefit) engages in or is part of any conduct that is criminal. Any condition or any symptom or signs leading to the condition (whether or not a registered medical practitioner has been consulted) that existed before the risk commencement date , unless AIA is satisfied that you or the life assured could not have known of the existence of the condition or symptom or signs leading to the condition , or the condition or symptom or signs leading to the condition were declared on your application and accepted by AIA . AIA will not pay any benefit described in this appendix where any of the following occurs before a life assured (or any child in the case of a Built-in Children’s Trauma Benefit or the Built-in Parents Grieving Benefit) reaches age 21, and (in each case either directly or indirectly) causes or contributes to a claim for that life assured (or child ):
In addition, for a Severe Trauma Benefit claim, AIA will require information acceptable to us, including medical evidence and reports, showing proof of the condition giving rise to the claim. AIA may require the life assured or his or her child (if applicable) to have an examination by a registered medical practitioner appointed by AIA before accepting liability for a claim.
Where the Optional Total Permanent Disablement condition is the condition giving rise to the claim, AIA will also require:
An AIA claims form completed by the life assured and a registered medical practitioner (at your expense).
Other information which AIA may reasonably request to help assess the claim, which may include evidence of earnings, taxable income, business accounts, ACC details or similar. The life assured to undergo medical and/or surgical treatment (including any operation or vocational, medical and/or social rehabilitation) at your expense which the life assured ’s registered medical practitioner or a registered medical practitioner approved by AIA considers necessary.
Any other information that AIA may deem relevant to the assessment of the claim.
any intentional act by you or by any parent or guardian of the life assured , or child.
For advice about submitting a claim you can phone AIA on 0800 500 108 or your Adviser. Find claim information online at AIA.co.nz
any intentional act by someone who lives with or supervises the life assured, or child.
AIA will not pay a children’s benefit under the Built-in Children’s Trauma Benefit that arises as a direct or indirect consequence of:
a pre-existing condition ; or
any congenital condition.
These exclusions apply to any subsequent benefit increase you make.
1166 ALB-ST version 2 Effective 12 May 2026
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