transfer to the ward, or
pre-existing condition
Any disease or medical condition for which, prior to becoming covered under this policy, the individual consulted a registered medical practitioner , received treatment or services from a r egistered medical practitioner , or took prescribed drugs and medicines. Means the date the application for cover is received by AIA along with a valid payment instruction. Any condition that AIA , in its sole discretion, deems to be directly or indirectly related to a previous claim's condition . This includes:
directly from the ward, recovery or emergency areas.
limb(s)
An arm, leg, hand or foot. In respect of this definition:
the arm starts from the shoulder joint and ends at the wrist joint;
receipt of application
the hand starts from the wrist joint;
the leg starts from the hip joint and ends at the ankle joint; and
related condition
the foot starts from the ankle joint.
(a) any increase in severity
Non-surgical procedures or treatments initiated to treat the claimed medical condition including but not limited to: stereotactic radiosurgery, laser therapy, ultrasonic aspiration, chemotherapy, or radiotherapy. Pharmaceutical therapies administered outside of a clinical setting are excluded. An invasive procedure occurring in a hospital operating theatre involving the incision, excision, manipulation, or suturing of tissue, under general anaesthesia, spinal anaesthesia, or epidural. Elective cosmetic procedures are excluded. A service or supply provided by a registered medical practitioner or specialist that AIA deems on reasonable grounds is necessary for the treatment of the disease, illness, or injury involved. Under no circumstances shall the following services or supplies be considered medically necessary:
major interventional treatment
level of the same condition , and
(b) any condition that:
arises in connection with;
is a complication of;
results from;
is a consequence of; or
is a complication of treatment for;
a condition for which AIA has paid a claim under the original Critical Conditions Benefit. Any two conditions that are both related conditions of a third condition will be treated as related conditions to each other for calculating the amount payable. As defined in the ‘Guides to the Evaluation of Permanent Impairment – 4th Edition’ (or subsequent editions), produced by the American Medical Association and measured six months beyond initial diagnosis. Personal effort using the life assured ’s time and skills, whether or not income is generated for the life assured . Worked and working have similar meaning.
major invasive surgery
medically necessary
whole person functioning
work
Those services or supplies that do not require the skills or services of a registered medical practitioner or specialist ; and Those services or supplies provided mainly for the comfort or convenience of the life assured .
1155 ALB-CC version 8 Effective 12 May 2026
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