In the event of a claim in respect of the reinstated Severe Trauma Benefit, no claim will be paid for:
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 ) reaches age 21, and (in each case either directly or indirectly) causes or contributes to a claim for that life assured (or child ):
Any condition for the subsequent claim that is a related condition to the condition which was the subject of the first Severe Trauma Benefit claim, as determined by AIA . The same condition for which AIA has paid a claim under a Severe Trauma Benefit for the life assured , unless the original claim was for any of the conditions under the category of cancer , in which case: o any subsequent claims under the category of cancer will be excluded if the condition occurs within 36 months immediately following the original claim event date; and
any intentional act by you or by any parent or guardian of the life assured , or child .
any intentional act by someone who lives with or supervises the life assured, or child.
following this period the same condition shall include any cancer that is either: − of the same organ system as the original cancer; − considered by the treating oncologist as likely to be a secondary cancer of the original cancer; or
o
AIA will not pay a 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 .
− a related cancer .
These exclusions apply to any subsequent benefit increase you make.
Any heart (or heart-related) condition if the original claim was for a heart condition or a stroke, except where the claim in respect of the reinstated Severe Trauma Benefit is for pulmonary hypertension, and it has not previously been claimed for and is not considered by an appropriate specialist as likely to be secondary or directly resulting from the original condition . Stroke, or any condition directly resulting from a stroke, if the original claim was for a heart (or heart- related) condition , except where the original claim was for pulmonary hypertension.
18.
How to make a claim
To make a claim, refer to the section in your AIA Living policy entitled ‘How to make a claim’.
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.
Any exclusion which applied to the original Severe Trauma Benefit.
Where the Optional Total Permanent Disablement condition is the condition giving rise to the claim, AIA will also require:
17.
Exclusions – when AIA won’t pay a benefit
An AIA claims form completed by the life assured and a registered medical practitioner (at your expense).
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 ) engages in or is part of any conduct that is criminal.
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 ,
Any condition or any symptom or signs leading to the
1119 AL- ST version 1 Effective 14 November 2025
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