5. When will AIA pay an Optional Partial Disablement Benefit? The Optional Partial Disablement Benefit only applies if shown in the schedule . AIA will pay an Optional Partial Disablement 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 Disablement Benefit under this appendix and the life assured is no longer totally disabled , provided: − the period in respect of which a Total Disablement Benefit has been paid in advance has expired; and/or
7. What is the amount of the Optional Partial Disablement Benefit? The amount that AIA will pay monthly is calculated in the following way:
( working hours at application time less post-disability working hours ) working hours at application time
monthly benefit as calculated in Section 3
X
For example: If the monthly benefit as calculated in Section 3 is $10,000, the working hours at application time are 50 hours and the post-disability working hours are 20 hours, the amount paid will be $6,000 per month.
$10,000 x (50 hours less 20 hours) 50 hours
$6,000 per month
=
8. What is the Partial Disablement Bridging Benefit and when will AIA pay it? Where the Optional Partial Disablement Benefit applies as shown in the schedule , AIA will pay you a Partial Disablement Bridging Benefit if: > you have been receiving a Total Disablement Benefit under this appendix ; and > the life assured is no longer totally disabled ; and > based on the information provided to, and requested by AIA , we reasonably expect that an Optional Partial Disablement Benefit (as set out in Section 5) will be payable for that life assured for the first month after the life assured ceased to be totally disabled . The Partial Disablement Bridging Benefit is a lump-sum payment equivalent to 1/3 rd (33.3%) of the final monthly Total Disablement Benefit paid before the life assured ceased to be totally disabled . The Partial Disablement Bridging Benefit is paid at the end of the final month in respect of which a Total Disablement Benefit was paid for the life assured . Payment of the Partial Disablement Bridging Benefit does not affect the amount of the Optional Partial Disablement Benefit (as set out in Section 7). The Partial Disablement Bridging Benefit is payable once for all claims resulting from the same or a related injury or illness. The Partial Disablement Bridging Benefit is not payable where a lump sum payment has been made in lieu of monthly benefit payments, as set out in Section 2.
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.
−
The Optional Partial Disablement 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 working at least 75% of their working hours at application time , or until the end of the benefit payment period , whichever is the earlier. A Partial Disablement Bridging Benefit (as set out in Section 8) will also be paid if you have been receiving a Total Disablement Benefit under this appendix before you commence receiving an Optional Partial Disablement Benefit. 6. What does partially disabled mean? 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 work capacity resulting from the continuation of the disability ; and > because of the reduction in work capacity, the life assured is working less than 75% their working hours at application time.
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1158 ALB-BC version 3 Effective 23 July 2021
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