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.
Benefit or the Optional Children’s and Maternity Benefit) engages in or is part of any conduct that is criminal.
Any condition or any symptom or signs leading to the 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, the Built- in Parents Grieving Benefit or the Optional Children’s and Maternity 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 other information that AIA may deem relevant to the assessment of the claim.
For advice about submitting a claim you can phone AIA on 0800 500 108 or your Adviser. Find claim information online at AIA.co.nz
20. Definitions of medical conditions
Cancer
The life assured has suffered or undergone one of the following conditions :
any intentional act by you or by any parent or guardian of the life assured , or child.
Carcinoma-in-situ A focal autonomous new growth of carcinomatous cells which has not yet resulted in the invasion of normal tissues. ‘Invasion’ means an infiltration and/or active destruction of normal tissue beyond the basement membrane.
any intentional act by someone who lives with or supervises the life assured, or child.
AIA will not pay a children’s benefit under the Children’s Trauma Benefit or the Optional Children’s and Maternity Benefit that arises as a direct or indirect consequence of:
This benefit only covers carcinoma-in-situ of the following sites:
Breast.
a pre-existing condition ; or
Cervix.
any congenital condition , except where expressly covered under the Children’s Congenital Conditions Benefit.
Vagina.
Vulva.
These exclusions apply to any subsequent benefit increase you make.
The carcinoma-in-situ must be positively diagnosed by biopsy and be classified as TIS according to the TNM staging method or FIGO Stage 0. The benefit payable is 25% of the sum assured to a maximum of $75,000 across all Business AIA policies for the life assured . Carcinoma-in-situ radical surgery As a result of a carcinoma-in-situ, an operation to arrest spread of the malignancy is performed which involves the removal of the entire organ (which includes: breast, cervix, ovary, fallopian tube, vagina, vulva, prostate, colon/rectal, bladder) affected, or the organ requires systemic chemotherapy, radiotherapy or immunotherapy, and that treatment is considered medically necessary by an appropriate specialist . The carcinoma-in-situ must be positively diagnosed by biopsy and be classified as TIS according to the TNM staging method or FIGO Stage 0. Malignant tumours and blood cancers The presence of one or more malignant tumours, characterised by uncontrolled growth and spread of malignant cells, with the invasion and destruction of normal tissue for which major interventional treatment or surgery is considered medically necessary by an appropriate specialist .
19. 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 Critical Conditions 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.
Where the Optional Total Permanent Disablement condition is the condition giving rise to the claim, AIA will also require:
An AIA claims form completed by the life assured and a registered medical practitioner (at your expense).
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
1155 ALB-CC version 8 Effective 12 May 2026
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