Severity Level
Conditions
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 greater than 25% of the life assured ’s earnings during his or her last 12 consecutive months of work.”
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 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 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 after the incapacity began. A decision not to waive the three month waiting period will not affect our consideration of a claim under the 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 Total Permanent Disablement condition .
AIA will not pay a benefit under the Total Permanent Disablement condition if the life assured dies within three months of the date that the life assured became incapacitated.
Severe burns means the life assured has suffered tissue injury caused by thermal, electrical or chemical agents. As a result, the life assured has full thickness of third-degree burns to:
– at least 20% of the body surface area (as measured by age-appropriate use of The Rule of 9 or the Lund and Browder Body Surface Chart); or
– 50% of both hands, requiring surgical debridement and/or grafting; or
2
– 25% of the face, requiring surgical debridement and/or grafting.
Coma means a definite diagnosis of a state of unconsciousness resulting in for at least 72 hours:
– a documented Glasgow Coma Score of 7 or less; and
– the use of a life support system.
Coma arising from drug and alcohol abuse is specifically excluded.
Major burns means tissue injury caused by thermal, electrical or chemical agents causing third degree burns to:
– at least 9%, but less than 20%, of the body surface area as measured by The Rule of 9 or the Lund and Browder Body Surface Chart; or
3
– the whole of one hand or 50% of the surface area of both hands combined, requiring surgical debridement and/or grafting or
– the whole of one foot or 50% of the surface area of both feet combined, requiring surgical debridement and/or grafting.
Intensive care means a state of unconsciousness with no reaction to stimuli or internal needs, persisting continuously for at least seven days, requiring assisted ventilation (including the use of endo-tracheal intubation and/or tracheostomy) in the intensive care unit of a hospital. Unconsciousness caused by drug and alcohol abuse is specifically excluded.
Loss of sight in one eye means irrecoverable loss of sight in one eye (whether aided or unaided) as a result of sickness or injury. This is evidenced by:
4
– Visual acuity on the Snellen Scale after correction by suitable lenses is less than 6/60 in that eye; or
– Field of vision is reduced to 20 degrees or less of arc; or
1156 ALB-PC version 7 Effective 12 May 2026
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