9. What is the Recurrent Disablement Benefit? The waiting period will be waived if not later than 12 months after the benefit payments related to the original claim ceased, the life assured becomes disabled again and, in AIA’s opinion, after considering the advice of a registered medical practitioner and other relevant information, this is caused by the same or a related illness or injury as the original period of total or partial disablement (if applicable). The provisions of Sections 2, 3, 4, 5 and 6 of this appendix will apply to any benefit claimed. All claims resulting from the same or a related illness or injury will be considered to be the same claim in respect of the benefit payment period . 10. What is the Business Mentors Benefit? Business Mentors is available to the policy owner following an accepted claim for a life assured under this appendix . Business Mentors provides independent, impartial advice on your business by one of over 1,700 mentors around the country. If a claim is approved under this appendix , AIA will pay the costs of a two year membership to Business Mentors. Business Mentors is independent of AIA and Business Mentors terms and conditions and eligibility criteria apply. AIA may withdraw access to the service or change the terms on which access to the service is made available with 90 days’ notice. Neither AIA , its related companies, nor their directors, officers or employees accept any liability whatsoever for any loss or damage arising out of the use of the Business Mentors service, or the unavailability of Business Mentors. AIA is not responsible for any cost associated with becoming eligible to use, or use of, the Business Mentors service (including without limitation the cost of any travel, lodging, telephone calls, faxes or mail), unless covered by an AIA policy. AIA will only pay one Business Mentors Benefit for each business . 11. Rehabilitation and Support On receiving notification of a new or potential claim, we will appoint the life assured a Case Manager, who will work with the life assured to understand their personal situation and assist them with the claims process. They will work with the life assured to consider what rehabilitation or functional support could assist the life assured’s return to work or improve their capacity to work, either during or after the waiting period as appropriate in the opinion of AIA . Acceptance of any costs associated with the agreed rehabilitation and functional support by AIA does not mean that we will accept liability for any other benefit under this appendix and are accepted at the sole discretion of AIA .
12. 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 Business Continuity 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; and where the “Business Indemnity Benefit” has been chosen, you will be required to provide AIA with financial information and accounts for the 12 months immediately prior to the disablement date ; 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
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any other information that AIA may deem relevant to the assessment of the claim.
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13. Ongoing Claims Requirements For ongoing claims AIA will require: >
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 Business Continuity 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 Business Continuity 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.
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14. When will AIA cease paying a benefit? AIA will cease paying a benefit if: (a) The life assured fails to undergo and complete: – any surgical operation; and/or
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1158 ALB-BC version 3 Effective 23 July 2021
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