the final month in respect of which a Total Disablement Benefit was paid for the life assured . Payment of the Partial Disablement Bridging Benefit does not affect the amount of the Partial Disablement Benefit (as set out in Section 7). The Partial Disablement Bridging Benefit is payable once for all claims resulting from the same or a related injury or illness.
> becomes partially disabled , following a period of receiving a Total Disability Income Benefit under this appendix and the life assured is no longer totally disabled , provided the period in respect of which a Total Disability Income Benefit has been paid in advance has expired. The Partial Disablement Benefit will be paid monthly in arrears until, in AIA’s opinion, after considering the advice of a registered medical practitioner and other relevant information the disability is no longer preventing the life assured from working at least 20 hours per week, or until the end of the benefit payment period , whichever is the earlier. A Partial Disablement Bridging Benefit (as set out in Section 8) will also be paid if you have been receiving a Total Disablement Benefit under this appendix before you commence receiving a Partial Disablement Benefit. 6. What does partially disabled mean? In AIA’s opinion, the life assured is partially disabled, if as a direct result of sickness or injury he or she: > has a reduction in work capacity resulting from the continuation of the disability ; and > because of the reduction in work capacity, the life assured is working less than 20 hours per week. 7. What is the amount of the Partial Disablement Benefit? The amount that AIA will pay monthly is calculated in the following way: (50% x 1/12 th of the benefit amount shown in the schedule , noted under the Business Income Support Benefit) less offsets as defined in Section 3. For example, for a benefit amount shown in the schedule of $48,000 per annum ($4,000 per month) with offsets of $1,000, the amount that AIA will pay monthly is: (50% x $4,000) - $1,000 = $1,000 8. What is the Partial Disablement Bridging Benefit and when will AIA pay it? AIA will pay you a Partial Disablement Bridging Benefit if: > you have been receiving a Total Disablement Benefit under this appendix ; and > the life assured is no longer totally disabled ; and > based on the information provided to, and requested by AIA , we reasonably expect that a Partial Disablement Benefit (as set out in Section 5) will be payable for that life assured for the first month after the life assured ceased to be totally disabled . The Partial Disablement Bridging Benefit is a lump-sum payment equivalent to 1/3 rd (33.3%) of the final monthly Total Disablement Benefit paid before the life assured ceased to be totally disabled . The Partial Disablement Bridging Benefit is paid at the end of
9. What is the Recurrent Disablement Benefit?
The waiting period will be waived if not later than 12 months after the benefit payments related to the original claim ceased, the life assured becomes disabled again and, in AIA’s opinion, after considering the advice of a registered medical practitioner and other relevant information, this is caused by the same or a related illness or injury as the original period of total or partial disablement . The provisions of Sections 2, 3, 4, 5, 6 and 7 of this appendix will apply to any benefit claimed. All claims resulting from the same or a related illness or injury will be considered to be the same claim in respect of the benefit payment period . 10. Rehabilitation and Support On receiving notification of a new or potential claim, we will appoint the life assured a Case Manager, who will work with the life assured to understand their personal situation and assist them with the claims process. They will work with the life assured to consider what rehabilitation or functional support could assist the life assured’s return to work or improve their capacity to work, either during or after the waiting period as appropriate in the opinion of AIA . Acceptance of any costs associated with the agreed rehabilitation and functional support by AIA does not mean that we will accept liability for any other benefit under this appendix and are accepted at the sole discretion of AIA . 11. What is Vocational Assistance and when will AIA pay it? AIA may agree to pay for vocational assistance for the life assured if, in AIA’s opinion, the life assured is unlikely to return to paid work in their pre-disability occupation without assistance. The Case Manager appointed to the life assured’s claim will work to understand their personal situation and consider what assistance could aid the life assured’s return to gainful employment at an earlier date than would otherwise be possible. In all cases: > the assistance must be approved in advance by AIA , and reviewed regularly; and > the life assured must actively participate and comply with the assistance as agreed with AIA ; and > the total amount which AIA will pay for any vocational assistance is limited to a maximum of 12 times the monthly benefit amount as calculated in Section 3; and > the life assured must be receiving a Total
1160 ALB-BI version 3 Effective 23 July 2021
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