working on contract or otherwise remunerated for his or her efforts.
rooms on a level surface with the assistance of a walking aid, including a wheelchair. Transferring - The ability to independently transfer from the bed to a chair with the assistance of a walking aid.
A specially staffed and equipped section of an intensive care complex that provides a level of care intermediate between intensive care and general ward care. Patients may be admitted to the high dependency unit: from the intensive care unit as a step-down prior to transfer to the ward; or
high dependency unit
One of five categories of conditions as set out in the Schedule of Categories below.
Category
Categories has the corresponding meaning.
directly from the ward, recovery or emergency areas.
claim event date
The date the medical treatment or event occurred, or the date the condition was diagnosed by a specialist .
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;
condition(s)
Any:
medical treatment;
the hand starts from the wrist joint;
event; or
illness as diagnosed by a specialist
the leg starts from the hip joint and ends at the ankle joint; and
that exactly matches one of the definitions listed in any of the five Schedules of Categories attached to this appendix .
the foot starts from the ankle joint.
Non-surgical procedures or treatments initiated to treat the claimed medical condition including but not limited to: stereotactic radiosurgery, laser therapy, ultrasonic aspiration, chemotherapy, radiotherapy, or immunotherapy. 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
congenital condition
A health anomaly or defect, regardless of whether diagnosed or not:
which is present at birth; and
for which the individual had signs or symptoms within
three months of birth.
Includes health anomalies or defects inherited or due to external environmental factors such as drugs, alcohol, or complications during pregnancy or delivery. The later of the effective date or the actual date from which we receive the increased premium for the Life Cover Benefit and accelerated Progressive Care Benefit cover. Working to generate income through personal efforts by using the life assured ’s time and skills. He or she can be self-employed, employed, earning fees, under contract, receiving commissions,
major invasive surgery
date of conversion
medically necessary
gainful employment
1156 ALB-PC version 7 Effective 12 May 2026
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