Severity Level
Conditions
– Peripheral vascular disease leading to chronic infection or gangrene, requiring a surgical procedure.
– Neuropathy including:
• Irreversible autonomic neuropathy resulting in postural hypotension, and/or motility problems in the gut with intractable diarrhoea; or
• polyneuropathy leading to severe mobility problems due to sensory and/or motor deficits.
Advanced AIDS means HIV infection with a persistent CD4 cell count of less than 200/ul despite appropriate continuous antiretroviral therapy. 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.
– HIV wasting syndrome characterised by more than 10% weight loss, chronic intractable diarrhoea and chronic candidiasis of the respiratory tract or gastrointestinal tract.
Severe illness or injury means the life assured suffers a medical condition that does not satisfy any condition leading to a claim under this policy and it is deemed medically necessary to:
– undergo major invasive surgery ; or
– be treated using major interventional treatment ;
which results in:
– a stay in an intensive care unit for a period greater than 48 continuous hours; or
– a stay in a high dependency unit for a period greater than 96 continuous hours;
and the life assured is unable to perform at least one basic activity of daily living for a continuous period of 90 days from first being admitted into the intensive care unit or high dependency unit (as applicable) as certified by a registered medical specialist .
A medical condition arising from alcohol or drug abuse or other self-inflicted means is specifically excluded.
This benefit does not apply to any condition specifically excluded in this policy or where an underwriting exclusion has been applied.
Stage 4 Chronic Obstructive Pulmonary Disease (COPD) means a disease of the airways of the lung causing obstruction to the exhalation of air. There must be permanent and irreversible reduction of the maximum volume of air expelled in one second (FEV1) of 30% or less of predicted. There must be permanent and irreversible obstruction to airflow demonstrated by a FEV1/ FVC ratio of less than 50% and there must be less than 5% variation in three repeated measurements, (which must be performed under the direction of a specialist respiratory physician) whilst on optimal therapy. They must be measured in a respiratory laboratory, which has regular quality control audits available to AIA . These measurements must be repeated after an interval of at least three months and must also satisfy the criteria mentioned above for a claim to be considered. Major organ transplant (or Transplant waiting list) means the life assured has undergone, or been placed on the major organ transplant waiting list in New Zealand or Australia for, a transplant from a human donor of one or more of the following organs or substances:
2
– Kidney
– Heart
1156 ALB-PC version 7 Effective 12 May 2026
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