5.
What does partially disabled mean?
than 10 hours per week; and
> not working or engaged in any other occupation or business.
In AIA’s opinion, the life assured is partially disabled, if as a direct result of sickness or injury he or she: > has a reduction in earning capacity resulting from the continuation of the disability; and > because of the reduction in earning capacity, the life assured earns less than 75% of pre-disability income .
For occupation class five:
In AIA’s opinion, the life assured is totally disabled , if as a direct result of sickness or injury, he or she is:
disabled to such an extent that necessitates confinement to the home under medical supervision or to a recognised medical institution and necessitates receiving regular medical care; or
6.
What is the amount of the Partial Disability Income Benefit?
The amount that AIA will pay monthly is the greater of calculation (i) or (ii) below, up to a maximum of 1/12 th of the benefit amount shown in the schedule : (i) (1/12 th of the benefit amount shown in the schedule ) less offsets shown below; or
unable to perform at least two of the Activities of Daily Living without the assistance of an adult; and not working in any gainful occupation or engaged in voluntary work.
4.
When will AIA pay a Partial Disability Income Benefit?
(ii) ( pre-disability income less offsets shown below) x 75%
If the life assured was on parental leave for 12 months or less or on a work sabbatical when the life assured became totally disabled , then pre-disability income will be based on the life assured’s income immediately before the life assured went on leave, as set out in Section 31 “Key Terms” .
AIA will pay a Partial Disability Income Benefit if, in AIA’s opinion, at any time during the benefit term , the life assured : > is in an occupation class other than occupation class five at the time of becoming totally disabled or partially disabled ; and > has been partially disabled during the waiting period, and is partially disabled at the end of the waiting period; or > becomes partially disabled, following a period of receiving a Total Disability Income Benefit under this appendix and the life assured is no longer totally disabled, provided:
Offsets:
> Any other income replacement or mortgage protection benefits that any person receives or is entitled to receive from any sources in relation to the life assured and in respect of the same or a related disability (for example payments from ACC or another insurer), other than Work and Income New Zealand (WINZ) payments, with the following provisions:
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the period in respect of which a Total Disability Income Benefit has been paid in advance has expired; and/or where a lump sum payment has been made in lieu of monthly benefit payments as set out in Section 1, the benefit period to which the lump sum corresponds has expired.
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Where the life assured is covered by income replacement or mortgage protection benefits held with more than one provider, AIA will negotiate with the other provider(s) to determine the amount to be offset. AIA will not seek to apply offsets under this sub-clause in respect of income replacement or mortgage protection benefits held with other providers which were accurately disclosed in your application, provided that there has been no change in the circumstances for you or the life assured .
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> because of the reduction in earning capacity, the life assured earns less than 75% of their pre-disability income . The Partial Disability Income Benefit will be paid monthly in arrears until, in AIA’s opinion, after considering the advice of a registered medical practitioner and other relevant information, the disability is no longer preventing the life assured from earning at least 75% of their pre-disability income, or until the end of the benefit payment period , whichever is the earlier. A Partial Disability Bridging Benefit (as set out in Section 7) will also be paid if you have been receiving a Total Disability Income Benefit under this appendix before you commence receiving a Partial Disability Income Benefit.
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Benefits payable under an AIA Key Person Disability Income policy will not be offset.
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If the life assured is entitled to receive a benefit from ACC but is not receiving that benefit because the life assured has either not applied for the benefit, or has not provided all of the requirements necessary to assess the benefit, or the benefit has been stopped due to any non-compliance with ACC requirements, AIA will offset the full ACC entitlement regardless of whether the life assured is receiving a payment or not. Where the life assured receives or is entitled to receive a benefit from ACC AIA will offset the gross entitlement amount.
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> Any income before income tax, as a result of the life assured being actively involved in or actively carrying on
1109 AL-LOE version 5 Effective 12 May 2026
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