23.
Definitions of medical conditions
AIA will not pay a benefit under the Built-in Children’s Trauma Benefit or the Optional Children’s and Maternity Benefit that arises as a direct or indirect consequence of:
Cancer
a pre-existing condition ; or
The life assured has suffered or undergone one of the following conditions :
any congenital condition , except where expressly covered under the Children’s Congenital Conditions Benefit.
Carcinoma-in-situ A focal autonomous new growth of carcinomatous cells which has not yet resulted in the invasion of normal tissues. ‘Invasion’ means an infiltration and/or active destruction of normal tissue beyond the basement membrane.
These exclusions apply to any subsequent benefit increase you make.
22.
How to make a claim
This benefit only covers carcinoma-in-situ of the following sites:
To make a claim, refer to the section in your AIA Living policy entitled ‘How to make a claim’.
Breast.
In addition, for a Critical Conditions Benefit claim, AIA will require information acceptable to us, including medical evidence and reports, showing proof of the condition giving rise to the claim. AIA may require the life assured or his or her child (if applicable) to have an examination by a registered medical practitioner appointed by AIA before accepting liability for a claim.
Cervix.
Vagina.
Vulva.
The carcinoma-in-situ must be positively diagnosed by biopsy and be classified as TIS according to the TNM staging method or FIGO Stage 0. The benefit payable is 25% of the sum assured to a maximum of $75,000 across all Personal AIA policies for the life assured . Carcinoma-in-situ radical surgery As a result of a carcinoma-in-situ, an operation to arrest spread of the malignancy is performed which involves the removal of the entire organ (which includes: breast, cervix, ovary, fallopian tube, vagina, vulva, prostate, colon/rectal, bladder) affected, or the organ requires systemic chemotherapy, radiotherapy or immunotherapy, and that treatment is considered medically necessary by an appropriate specialist . The carcinoma-in-situ must be positively diagnosed by biopsy and be classified as TIS according to the TNM staging method or FIGO Stage 0. Malignant tumours and blood cancers The presence of one or more malignant tumours, characterised by uncontrolled growth and spread of malignant cells, with the invasion and destruction of normal tissue for which major interventional treatment or surgery is considered medically necessary by an appropriate specialist .
Where the Optional Total Permanent Disablement condition is the condition giving rise to the claim, AIA will also require:
An AIA claims form completed by the life assured and a registered medical practitioner (at your expense).
Other information which AIA may reasonably request to help assess the claim, which may include evidence of earnings, taxable income, business accounts, ACC details or similar.
The life assured to undergo medical and/or surgical
treatment (including any operation or vocational, medical and/or social rehabilitation) at your expense which the life assured’s registered medical practitioner, or a registered medical practitioner approved by AIA , considers necessary.
Any other information that AIA may deem relevant to the assessment of the claim.
For advice about submitting a claim you can phone AIA on 0800 500 108 or your Adviser. Find claim information online at AIA.co.nz
The following tumours are excluded:
Tumours classified as carcinoma-in-situ (including intra- epithelial neoplasia). Prostate tumours with a Gleason score of less than 6. (If the Gleason score is unavailable, we will use the TNM classification and tumours classified as T1 or its equivalent will be excluded).
All malignant melanomas unless they:
− are at least 1.0mm in maximum thickness as determined by histological examination using the
1105 AL-CC version 9 Effective 22 September 2026
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