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AIA COVER FOR LIFE
This is your AIA Cover for Life policy document.
Understanding your policy document
We want you to feel confident about your insurance decisions. This policy document explains how your insurance cover works. It’s important that you read it and understand what your insurance does and doesn’t cover. If you have any questions or would like a more detailed explanation of your benefits, you can contact your adviser or get in touch with us directly using the details below.
Free look period - your time to review and reconsider
If you’re not happy with your insurance cover, or change your mind, you can ask us to cancel it. If you cancel within 15 days of receiving your policy documents and you haven’t made a claim, we’ll refund any premiums you’ve paid.
Making a claim
We understand that making a claim can be a stressful time in your life, and we’re committed to making the process as fast and simple as possible. We also have one of New Zealand’s largest and most experienced claims teams and a transparent review process. If you need to make a claim, we recommend doing so as soon as possible. Our claims team is here to guide you through the process and help you understand the information we need to assess your claim efficiently.
Reviewing your insurance cover
As life changes, insurance needs can change too. We recommend reaching out to your adviser regularly to review your insurance. This is especially important when celebrating a milestone – for example a change in relationship status or adding to the family.
We’re here to help
If you have any questions about your cover, would like to discuss other products and services, or need to make a claim or complaint, we’re always here to help.
Talk to your adviser
Keep in touch with your adviser, they’re there to help and will be able to support you at any stage should you need it.
Talk to us
Our Customer Relationship Team is available Monday to Friday, from 8:00am to 6:00pm. You can Live Chat with us at aia.co.nz/chat or call us on 0800 500 108.
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Contents
1
About this policy
3
Defined words
When does your policy start?
Policy ownership
Who does your policy cover?
2
Benefits – what you are covered for Life Cover Benefit Bereavement Support Benefit
3
Repatriation Benefit
3
Special Events Increase Facility
3
What is the Special Events Increase Facility?
What is the maximum cover that can be added? What are the other conditions applying to this Facility?
4
Exclusions – when AIA won’t pay a benefit
4
5
Your premiums
4
Premium
Premium payment term
Guaranteed premiums
Method of paying premiums
What happens if you do not pay the premium on time?
6
Paid-up option with reduced cover
4
When can the policy be made paid-up ?
How will the reduced sum assured be calculated if the policy is made paid-up ?
7
Changes to your policy
5
Decreasing your sum assured
Increasing your sum assured
Making your policy paid-up
Change of smoker status
Change of ownership
8
When can your policy be cancelled? When can you cancel your policy? When can AIA cancel your policy?
6
Cancellation due to Sanctions
Non-disclosure or the provision of false or misleading information
9
How to make a claim
6
10
Important information
7
What forms part of this policy contract?
Policy subject to laws of New Zealand
Statutory Fund
Notices
Information about your policy
Worldwide cover
How do you make a complaint?
No surrender value
11
Key terms
8
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1. About this policy
payment of the Life Cover Benefit. The Life Cover Benefit will then be reduced by the amount paid under the Bereavement Support Benefit. If the life assured has more than one policy with AIA , only one Bereavement Support Benefit will be payable for the life assured across all AIA policies .
Your AIA Cover for Life policy will pay a Life Cover Benefit when the life assured dies. Details of the Life Cover Benefit including the sum assured , the life assured , premium payment term and paid-up eligibility date are shown in the schedule . AIA Cover for Life offers lifelong protection with payment options that are designed to provide flexibility and certainty. When buying the policy, you choose your sum assured as well as the term during which guaranteed level premiums will be payable (the premium payment term ). At the end of the premium payment term the premiums stop but your cover continues until the death of the life assured . If you experience hardship or your circumstances change, the policy has an option to be made paid-up. This is available any time after the policy has reached the paid-up eligibility date and before the premium end date. If you do this, the premiums stop, but your cover continues until the death of the life assured, with a reduced sum assured that is intended to reflect the premiums you have already paid.
Repatriation Benefit
If the life assured dies, AIA will reimburse the policy owner(s) for the costs of returning the life assured’s body to New Zealand or their home country upon receipt of evidence acceptable to AIA . If the life assured is the sole policy owner , AIA will reimburse the person that has paid for the costs of repatriation upon receipt of evidence acceptable to AIA . The maximum amount of the Repatriation Benefit across all AIA policies for the life assured is the lower of:
the sum assured ; or
$20,000.
The Repatriation Benefit will be treated as an early payment of the Life Cover Benefit. The Life Cover Benefit will then be reduced by the amount paid under the Repatriation Benefit. The Repatriation Benefit may be paid in addition to the Bereavement Support Benefit but no more than the sum assured will be paid for both. If the life assured is the sole policy owner , AIA will pay a maximum of $40,000 in total across both the Repatriation Benefit and the Bereavement Support Benefit.
Defined words
Some words in this document are italicised indicating they are key terms that are defined in section 11: Key terms.
When does your policy start?
Your policy starts on the risk commencement date .
Policy ownership
Your AIA Cover for Life policy is a contract between the policy owner(s) and AIA . If more than one person is named in the schedule as policy owner, the policy is owned by all of them jointly. AIA will pay all benefits to the policy owner , or to the policy owner’s estate. If more than one person owns the policy then AIA will pay all benefits to the policy owners jointly or as they jointly direct, or to the survivor(s) of the policy owners .
3.
Special Events Increase Facility
What is the Special Events Increase Facility?
On each occasion when one of the following circumstances occurs for the life assured :
having a child (by birth or legal adoption);
becoming married or entering into a civil union;
Who does your policy cover?
becoming legally separated, divorced or the dissolution of the life assured’s civil union; experiencing the death of a spouse, civil or de facto partner, you may write to AIA asking us to increase the Life Cover Benefit for the life assured without the need to provide further health information or to undergo any medical examinations or tests. Each increase will be issued on a new policy and will require an additional premium . The premium will be calculated on the rates applicable at the time the Special Events Increase Facility is exercised. The new policy will be subject to the same age selected for the Premium Payment Term as the original policy, however the anniversary date and premium end date may be different from the original policy. Any loadings, exclusions or special terms on the original policy will also be applied to the special events increase.
AIA Cover for Life applies only to the life assured as named in the schedule .
2. Benefits - what you are covered for
Life Cover Benefit
AIA will pay the sum assured when the life assured dies.
AIA will pay the benefit once we are satisfied with all the information which must be presented at the time of making a claim (see section 9: How to make a claim).
Bereavement Support Benefit
Upon receiving evidence acceptable to AIA that the life assured has died, AIA will pay the lower of:
the sum assured ; or
$25,000.
This Bereavement Support Benefit will be treated as an early
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5. Your premiums
What is the maximum cover that can be added?
The maximum increase for each special event cannot exceed the lower of:
Premium
To ensure your policy remains in force you must pay the premium on a regular basis as agreed with AIA. The premium is shown in the schedule and the first payment is due to AIA on the first premium due date . No further premiums are payable after the premium end date .
50% of the Life Cover Benefit for the life assured ; or
$250,000.
The total of all increases made under this Facility cannot exceed the lower of:
100% of the Life Cover Benefit for the life assured ; or
Premium payment term
$750,000.
AIA calculates your premium based on the premium payment term chosen.
The maximum increases outlined above each apply in respect of all Life Cover and/or similar benefits for the life assured across all AIA policies .
The premium payment term you have selected cannot be changed after the risk commencement date . The premium payment term ends on the premium end date , being the anniversary date following the life assured reaching the age selected.
What are the other conditions applying to this Facility?
Any special events increase is subject to the following conditions: You must make the request within 12 months of the relevant special event and provide AIA with suitable evidence of the occurrence of the event. A life assured over the age of 55 is not eligible for Special Events Increases. In any 12 month period you can make only one increase under this Facility. No Special Events Increase can be exercised after the policy has become paid-up . AIA will issue a policy for the increased Life Cover Benefit for the life assured from the date we accept your request. Where this policy has been issued as the result of an increase under a Special Events Increase Facility, then: The Special Events Increase Facility will not be available under this policy. AIA will not pay the increased benefit amount if: − before the increase, the life assured qualified for payment of the Terminal Illness Benefit or the Specified Terminal Conditions Benefit under any other AIA policy ; or − within six months following the increase, the life assured : o dies except where accidental death under this benefit occurs, or o qualifies for payment of the Terminal Illness Benefit or the Specified Terminal Conditions Benefit under any other AIA policy.
Guaranteed premiums
The premium will remain level for the duration of the premium payment term (subject to relevant changes in taxation or legislation and provided no changes to your policy are made – see section 7: Changes to your policy).
Method of paying premiums
You must pay all premiums to AIA . Premiums can be paid by direct debit, credit card or debit card. Premium payments are not effective until after they have been credited and cleared to AIA’s bank account.
What happens if you do not pay the premium on time?
You have 30 days’ grace in respect of any premium due. If you have not reached the paid-up eligibility date , AIA will be entitled to cancel your policy by written notice to you, using your last known contact details, if a premium remains outstanding 31 days after a premium due date . If you want to have the policy reinstated, you must write to AIA . AIA does not have to reinstate the policy but may do so on any conditions it considers appropriate, including payment of all premium arrears. If AIA has to pay a claim under the policy when a premium is overdue, the overdue premium may be deducted from the claim payment. If you have reached the paid-up eligibility date , your policy will become paid-up instead of being cancelled. See section 6: Paid-up option with reduced cover for details.
4. Exclusions – when AIA won’t pay a benefit
6. Paid-up option with reduced cover
AIA will not pay any benefit where the life assured dies as a direct or indirect result of an intentional self-inflicted act (whether sane or insane) within 13 months of the risk commencement date or, if cover has been reinstated, the date of reinstatement.
Any time after you reach the paid ‑ up eligibility date , your policy can be made paid-up . If that happens your premiums will stop but cover will continue until the death of the life assured , with a reduced sum assured that is intended to reflect the premiums you have already paid.
When can the policy be made paid-up ?
Your policy can be made paid-up any time after the paid-up eligibility date in the following circumstances:
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All premiums due up to the date the policy is made paid- up must be paid. You contact AIA with a request to make your policy paid-up . Once this request has been processed by AIA , this cannot be reversed. If a premium remains outstanding 31 days after a premium due date , AIA will be entitled to make the policy paid-up by written notice to you using your last known contact details. If you want to reverse the paid- up status, you must write to AIA to request this. AIA does not have to accept your request but may do so on any conditions it considers appropriate, including payment of all premium arrears. If you request to cancel your policy (see section 8: When can you cancel your policy?) AIA will instead make your policy paid-up . How will the reduced sum assured be calculated if the policy is made paid-up ? If your policy becomes paid-up , we calculate the reduced sum assured by taking the proportion of the premium payment term you have already paid, multiplying it by your sum assured , and applying a 5% adjustment. The formula is: The proportion of the premium payment term you have already paid × sum assured × 0.95
Example 2: There are 10 years between your risk commencement date and your premium end date , and your policy is made paid-up after 5 and a half years
Premium payment term
10 years
Premiums already paid
5 years and 6 months
Sum assured
$200,000
Calculation:
1. Proportion of premium payment term already paid
5.5 ÷ 10 = 0.55
2. Apply to the sum assured
0.55 × $200,000 = $110,000
3. Apply 5% adjustment
$110,000 × 0.95 = $104,500
Your reduced paid-up sum assured would be $104,500
7. Changes to your policy
Decreasing your sum assured
You may apply to AIA in writing to reduce the sum assured . Any reduction in sum assured will start from the next premium due date after your request is accepted by AIA .
Example 1: There are 40 years between your risk commencement date and your premium end date , and your policy is made paid-up after 20 years
Increasing your sum assured
See section 3 for any increases that can be made under the Special Events Increase Facility. You cannot otherwise increase the sum assured on this policy. If you wish to increase your cover, you will need to apply for a new policy. AIA does not have to accept an application for any new cover. Any acceptance will depend on a number of factors including the health of the life assured .
Premium payment term
40 years
Premiums already paid
20 years
Sum assured
$200,000
Calculation:
Making your policy paid-up
1. Proportion of premium payment term already paid
See section 6: Paid-up option with reduced cover for details.
20 ÷ 40 = 0.5
Change of smoker status
2. Apply to the sum assured
If the life assured was classified as a smoker at application and has not smoked for a period of 12 months or more, you can apply to have the premium reduced to that for a non- smoker. The life assured will have to complete a non-smoker declaration. The premium reduction will be effective from the next premium due date after your request is approved.
0.5 × $200,000 = $100,000
3. Apply 5% adjustment
$100,000 × 0.95 = $95,000
Your reduced paid-up sum assured would be $95,000
Change of ownership
You may transfer the ownership of your policy at any time.
To be valid, the transfer must be on a transfer of ownership form and registered with us. If ownership of your policy has been transferred, references in this policy document to you, your and the policy owner(s) are references to the most recent transferee(s).
A trust cannot be the owner of this policy. No charge is payable for a transfer of ownership of the policy.
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8. When can your policy be cancelled?
States of America, or any of its states and/or any other applicable economic or trade sanction laws or regulations. This provision applies without limitation not only to the policy owner or holder, but to the life assured and any assignee, other third party, related party or beneficiary of the policy. Should we determine that the above is applicable, we may at our sole discretion terminate the policy with immediate effect.
When can you cancel your policy?
a. During the free look period If for any reason you are not happy with your policy, you may return it to us within 15 days from the date your
policy document is received. AIA will refund any premiums paid under your policy provided that no benefit has been paid or no claim has been made.
Non-disclosure or the provision of false or misleading information
b. Before the paid-up eligibility date You can cancel your policy prior to the paid-up eligibility date by giving AIA notice in writing. If you pay premiums quarterly, bi-annually, or annually, we will refund the unused part of your premium that covers the period more than one month after the date we receive your cancellation request. If you pay monthly, we will not refund any premiums that you’ve already paid. c. After the paid-up eligibility date If you request to cancel your policy, and you have reached the paid-up eligibility date , AIA will instead make your policy paid-up . See section 6: Paid-up option with reduced cover for details. From (and including) the date AIA receives notice of cancellation of your policy, you will not be entitled to any benefits under the policy, unless otherwise agreed in writing by AIA.
Any information you or the life assured gives us, and any information given to us on your behalf, must be complete, true and correct.
If you or the life assured :
fails to disclose material information to AIA prior to inception of this policy or any variation or reinstatement of this policy; or has made a substantially incorrect statement on the faith of which the policy was issued, renewed, varied or reinstated;
AIA may, at its complete discretion either:
subject to the Insurance Law Reform Act 1977, avoid your entire policy from its inception (this means the policy is deemed to have never existed); or alter the terms upon which cover is provided under your policy (such alteration of terms will be effective from the risk commencement date or such date of our choosing, at our discretion). If this policy is avoided or any terms altered, we may retain all premiums paid in relation to the policy.
When can AIA cancel your policy?
If you have not reached the paid-up eligibility date, AIA can cancel this policy by written notice to you, using your last known contact details, if the premium remains outstanding 31 days after the premium due date (see section 5: What happens if you do not pay the premium on time?). If AIA issues you this policy with the understanding that it is to replace a policy you already have, then you must cancel your existing policy. If you fail to cancel your existing policy, AIA can cancel this policy or decline liability for any claims made under this policy. A Replacement Policy Advice form (or equivalent), application form, illustration or quote which indicates this policy is intended to replace an existing policy will be sufficient evidence that your policy was issued on the basis that you would cancel the existing policy. AIA can cancel this policy and decline liability for any claims made under this policy if you or the life assured , or anyone acting on your or the life assured’s behalf, makes a claim under this policy that is false or fraudulent in any respect. In the event that a false or fraudulent claim is established after payment of a claim, all amounts paid in relation to the false or fraudulent claim must be repaid by you to AIA .
9.
How to make a claim
For any claims enquiries or advice about submitting a claim, please phone the AIA Claims Team or your adviser for assistance.
AIA Claims Hotline: 0800 500 108
To accept a claim for the Life Cover Benefit, AIA will require:
A full death certificate;
A coroner’s report, if applicable; and
A grant of administration – probate, or certificate of administration, or letters of administration, if the deceased was the sole policy owner . The requirements for the Bereavement Support Benefit or Repatriation Benefit may be different. AIA will tell you about any other information that may be required once notice of the claim has been received. AIA is under no obligation to consider a claim unless all of the information requested is provided. Furthermore, AIA is under no obligation to assess or pay a claim prior to receiving notification.
Cancellation due to Sanctions
We shall not provide cover for any risk and/or activity and shall not be liable to pay any claim or pay any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would be in respect of a person who is the subject of any sanction, prohibition or restriction under United Nations resolutions or trade or economic sanctions, laws or regulations of New Zealand, the European Union, United Kingdom or United
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10. Important information
AIA is not bound by anything contained in a letter or notice you send unless we actually receive the letter or notice at the relevant address. When AIA writes to you about this policy, we will send the letter or notice to the address for the policy owner shown in the schedule , or to the email address(es) provided for the policy owner in the application for this policy, or any substitute postal and/or email address(es) you give us. You must immediately notify AIA of any changes to your contact details including postal, residential or email address. Every notice required to be given to you by AIA shall be deemed to be delivered five days after having been posted, or, where the notice is sent by email, 24 hours after the email has been sent.
What forms part of this policy contract?
All the terms of this policy are contained in and based on:
This policy document including the schedule and any alterations made as permitted under the policy. Any application forms and declarations made by you or the life assured , at any time, concerning this policy.
All statements which the life assured has made to AIA .
Any provisions which any legislation states must be included in this contract, unless those provisions can be contracted out of, in which case they are not included.
Nothing else forms part of this contract.
Information about your policy
Policy subject to laws of New Zealand
Shortly before each anniversary date , AIA will send you a letter containing information about your policy. You may at any time write to AIA or your adviser for further information about your policy.
The laws of New Zealand govern this policy, which has been issued in New Zealand. If changes in the law occur after the risk commencement date and AIA believes on reasonable grounds that those changes will affect:
Worldwide cover
This policy covers the life assured anywhere in the world. All payments AIA makes under this policy will be in New Zealand dollars.
AIA’s liability to pay any tax; or
The tax treatment of any premiums payable or claims receivable in respect of the policy (such as GST); or The way in which the policy works or the amount which can be paid under benefits; then AIA can change the provisions of the policy or the benefits, but only to take into account the effect of the law change.
How do you make a complaint?
Complaints by policy owners to AIA must be made in writing. If the policy owner is not satisfied with the outcome of the complaint, they may have the right to refer the complaint to the Insurance and Financial Services Ombudsman . The Ombudsman can only deal with a complaint after AIA’s internal complaints procedure has been exhausted and a letter acknowledging this has been sent to the complainant. You can obtain more information about the Ombudsman from the website: www.ifso.nz
Statutory Fund
Your insurance policy is part of the Statutory Fund Number 1.
Notices
The Ombudsman’s address is:
When you write to AIA about this policy, you must send the letter to AIA’s head office in New Zealand, or a substitute address AIA gives you.
Insurance and Financial Services Ombudsman PO Box 10-845 Wellington 6143 Phone: (04) 499 7612 or 0800 888 202
The postal address of AIA’s head office is:
Freepost AIA Private Bag 92499 Victoria Street West Auckland 1142 New Zealand
No surrender value
This policy does not participate in the profits of AIA . The policy has no surrender value or cash value if it is cancelled.
The street address of AIA’s head office is:
AIA New Zealand Limited AIA House 74 Taharoto Road Takapuna Auckland 0622 New Zealand
If more than one person owns this policy, all the policy owners must sign any letter or notice to AIA . However, AIA will not be liable to any policy owner if we act on a letter or notice signed by one or more, but not all, of the policy owners .
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11. Key terms
In this policy document some words have special meanings:
premium due date
The date on which the premium is payable under the policy, as agreed with AIA .
accidental death
Death caused solely by violent, accidental, external and visible means. Means AIA New Zealand Limited, also referred to in this policy as ‘we’, ‘our’ or ‘us’. Any policy or policies where AIA is the insurer, this includes any related policy/policies issued by either: Sovereign Assurance
premium end date
The Premium End Date, as shown in the schedule.
AIA
premium payment term
Means the period from the risk commencement date to the premium end date, as determined by the age selected
AIA policy/policies
for the life assured in the schedule, during which premiums are payable .
Company Limited or AIA International Limited, New Zealand Branch.
related policy/policies
Any in force policy/policies for the life assured that were issued on or before the 4 th August 2019, where: Sovereign Assurance Company Limited (‘Sovereign’) was the insurer; and/or AIA International Limited, New Zealand Branch (‘AIA International’) was the insurer. AIA in its sole discretion may pay more than one benefit, or more than the stated maximum sum assured for the same claim event should the life assured have cover under one or more related policy/policies through both Sovereign and AIA International. The commencement date of the benefit, as shown in the schedule . A statement is substantially incorrect only if the difference between what was stated and what is actually correct would have been considered material by a prudent insurer. The amount of the Life Cover Benefit, as shown in the schedule . The most recent schedule for your policy and: any notice of a change to premiums ; and any policy alteration or
anniversary date
The date in each year that corresponds to the Anniversary Date specified in the schedule . Any biological child, adopted child or child under the legal guardianship of: the life assured ; or the spouse, civil or de facto partner of the life assured . The country in which the life assured was born or their country of permanent residence.
child
home country
life assured
The person insured for the benefit as named in the schedule.
material
A statement is material only if that statement would have influenced the judgment of a prudent insurer in fixing the premium or in determining whether they would have taken or continued the risk upon the same terms. The Paid-Up Eligibility Date shown in the schedule is the midpoint between the risk commencement date and the premium end date. Means the premium payments stop after the paid-up eligibility date and before the premium end date and the policy continues for a reduced sum assured with no further premiums payable. The person or people named as ‘policy owner’ in the schedule, also referred to in this policy as ‘you’ or ‘your’. The amount payable by you to AIA under this policy, comprising the cost of the benefits chosen by you.
risk commencement date
substantially incorrect
paid-up eligibility date
sum assured
paid-up
the schedule
endorsement documents recording a change to your policy.
policy owner(s)
transfer of ownership form
AIA’s standard form for an assignment of a policy by way of ordinary transfer.
premium
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