27.
Ongoing Claim Requirements
b) Permanent Disablement Benefit
A Permanent Disablement Benefit will be paid if:
For ongoing claims AIA will require:
a Total Disability Income Benefit has been paid for 24 consecutive months in respect of a life assured ; and in AIA’s opinion that life assured is permanently disabled . The benefit is a monthly payment equivalent to 1/3 rd (33.3%) of the life assured’s monthly Total Disability Income Benefit as calculated in Section 2. The additional monthly payment will commence from the date when the Permanent Disablement Benefit claim is accepted by AIA. The benefit will cease when the earliest of the following occurs:
> Completion of a monthly medical certificate by a registered medical practitioner (at your expense) in a form from time to time approved by AIA for the purposes of determining ongoing entitlement to payment of a Loss of Earnings Benefit. > Completion of a monthly individual declaration by the life assured in a form from time to time approved by AIA , which may include completion of daily activity logs detailing the life assured’s functional activities for the purposes of determining ongoing entitlement to payment of a Loss of Earnings Benefit. > Proof of any remunerated or non-remunerated work completed during the claim period. > Any other information that AIA may deem relevant to the ongoing assessment of the claim.
the benefit payment period ends; or
the life assured dies; or
the life assured is no longer permanently disabled .
28.
When will AIA cease paying a benefit?
c) Bereavement Grant
AIA will cease paying a benefit if:
If the life assured dies while AIA is paying a Total Disability Income Benefit for that life assured , then AIA will pay a Bereavement Grant of three times the monthly Total Disability Income Benefit as calculated in Section 2.
(a) The life assured fails to undergo and complete:
any surgical operation; and/or
−
any medical rehabilitation; and/or
−
No Bereavement Grant will be paid if:
any social rehabilitation; and/or
−
> the life assured dies as a direct or indirect result of deliberately injuring himself or herself or attempting to do so; or
any vocational rehabilitation,
−
which a registered medical practitioner approved by AIA considers reasonably necessary. (b) The life assured fails to undertake any medical examinations that AIA requires the life assured to have, at our expense. (c) The life assured fails to comply with the requirements of Section 27 above. (d) AIA determines that the life assured is no longer totally disabled or partially disabled . (e) The benefit payment period expires in relation to the life assured . (f) The life assured or anyone acting on behalf of the life assured makes a false or fraudulent statement in respect of a claim or supports any claim with false evidence. (g) The life assured is in prison or sentenced to home detention for any reason.
> the life assured dies during the waiting period .
AIA will only pay one Bereavement Grant for each life assured across all AIA policies .
26.
How to make a claim
To make a claim, the relevant procedures in the section of your AIA Living policy entitled ‘How to make a claim’ must be followed. In addition, for a Loss of Earnings Benefit claim, AIA will require: > the life assured to be examined by a registered medical practitioner acceptable to AIA , before accepting liability for a claim; and > an AIA claims form completed by the life assured and a registered medical practitioner (at your expense); and > other information which AIA may reasonably request to help assess the claim, which may include evidence of monthly earnings, taxable income , business accounts, ACC details or similar; and > 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; and > any other information that AIA may deem relevant to the assessment of the claim.
(h) The life assured dies.
If AIA ceases paying a benefit in accordance with paragraphs (a), (b) or (c) and the life assured subsequently complies with the relevant requirement(s), then: > The date that the life assured complied with the relevant requirement(s) will, subject to the provisions of this appendix, be treated as the disablement date for a new claim.
> The waiting period will be waived for the new claim.
> If the benefit payment period is one, two or five years, the
1109 AL-LOE version 5 Effective 12 May 2026
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