C. is constantly and permanently unable to perform at least two of the following activities without the physical assistance of someone else (if the life assured can perform the activity on his or her own by using special equipment AIA will treat the life assured as being able to perform that activity):
after the incapacity began. A decision not to waive the three month waiting period will not affect our consideration of a claim under the Optional Total Permanent Disablement condition if the life assured survives for three months after the incapacity began. Any condition that AIA has reasonable grounds to expect can be reversed or improved by surgery or other treatment will not be considered as having met this Optional Total Permanent Disablement condition . AIA will not pay a benefit under the Optional Total Permanent Disablement condition if the life assured dies within three months of the date that the life assured became incapacitated.
Bathing and showering.
Dressing and undressing.
Eating and drinking.
Using a toilet.
Moving from place to place by walking, in a wheelchair, or with a walking aid.
Other key conditions
Alternatively, the life assured has suffered Total Permanent Disablement if he or she is unable to perform one of the above activities and his or her intellectual capacity has reduced or deteriorated to such an extent that the life assured requires permanent and constant supervision. If the life assured commences full-time domestic duties, the definition of the Optional Total Permanent Disablement condition will change by replacing paragraph A above with:
The life assured has suffered or undergone one of the following conditions :
Advanced Acquired Immunodeficiency Syndrome (AIDS) The life assured has been unequivocally diagnosed by an appropriate specialist with Advanced Acquired Immunodeficiency Syndrome in the clinical setting, evidenced by the presence of HIV infection with a persistent CD4 cell count of less than 200/ul despite appropriate continuous antiretroviral therapy.
A. becomes totally and permanently incapacitated by illness or accident and, as a result of that incapacity:
For three consecutive months after that incapacity began, has not worked in any occupation or carried on any business or engaged in any other gainful employment ; and Following that three consecutive months is, in the opinion of AIA , after consideration of the medical and any other evidence satisfactory to AIA , so incapacitated that it is unlikely he or she will ever be able to work in any occupation or engage in any other gainful employment for which he or she may be reasonably suited by education, training or experience, which would pay remuneration at a rate
There must be an associated AIDS defining illness with AIDS resulting in at least one of the following:
Kaposi's Sarcoma or Lymphoma.
Pneumocystis Carinii infection, cryptococcal infection or any other opportunistic infection of the lungs or nervous system.
Tuberculosis or other mycobacterium infection at any site.
Progressive multifocal leukoencephalopathy.
HIV Encephalopathy.
greater than 25% of the life assured ’s earnings during his or her last 12 consecutive months of work .
HIV wasting syndrome characterised by more than 10% weight loss, chronic intractable diarrhoea and chronic candidiasis of the respiratory tract or gastrointestinal tract. Advanced diabetes The life assured : 1. has been unequivocally first ever diagnosed as suffering from insulin dependent diabetes mellitus Type 1 after the age of 30 by an appropriate specialist ; or 2. suffers severe diabetes mellitus, either insulin or non- insulin dependent, as certified by a consultant endocrinologist and resulting in at least one of the following:
AIA will at its discretion waive the three month waiting period when assessing Total Permanent Disablement if:
in AIA’s opinion, the life assured has met all other requirements for payment under the Optional Total Permanent Disablement condition ; and
AIA expects the life assured to survive beyond three months after the incapacity began.
In exercising this discretion, AIA will consider whether the medical condition of the life assured enables an assessment to be made immediately in respect of whether the life assured has met all other requirements of the Optional Total Permanent Disablement condition . AIA will not waive the three month waiting period if, in our opinion, after considering suitable medical evidence, we believe that the life assured may die within three months
Severe diabetic retinopathy resulting in visual acuity uncorrected and corrected of 6/36 or worse in both eyes; or
1155 ALB-CC version 8 Effective 12 May 2026
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