10. Exclusions – what you are not covered for
There is no cover under any of the benefits for costs that exceed the reasonable charges for the applicable consultation or procedure.
There is no cover under any of the benefits for costs arising from, or related in any way to, any of the exclusions listed below.
Exclusion name
Exclusion wording
Acne
Except where classified by a specialist as Grade 4 acne with serious medical implications.
Care provided for a sign, symptom, condition or disease that requires immediate or same day hospital admission for treatment or monitoring. Any treatment by a physiotherapist, chiropractor, osteopath, naturopath, homeopath, acupuncturist, podiatrist, dietitian, counsellor or speech therapist.
Acute care
Allied health
Congenital conditions
Any congenital conditions.
Contraception
Contraception of any type.
Criminal activities
Any injury or condition arising from participation in a criminal activity.
The misuse of prescribed or non-prescribed drugs, including where they have not been taken in accordance with the manufacturer’s or registered medical practitioner’s directions. Any elective or cosmetic procedure or any surgery, procedure or treatment that improves, alters or enhances appearance, whether or not undertaken for medical, physical, functional, psychological or emotional reasons. Any injury, illness, condition or disability arising from, caused or contributed by, drug taking, intoxication or misuse of alcohol. Diagnosis, management and treatment of infertility, except as specifically provided by the Pregnancy, Maternity and Infertility Benefit. Psychiatric, psychological and/or neurodevelopment disorders including treatment or counselling for but not limited to pre-senile dementia, senile illness or dementia, geriatric care including geriatric in- patient care and disability support services, intellectual disability (intellectual development disorder), autism spectrum disorder, attention deficit/hyperactivity disorder, specific learning disorders, motor disorders (including but not limited to Tourette’s disorder) or dyslexia.
Drugs
Elective or cosmetic
Illness arising from drugs/alcohol
Infertility
Mental illness
New medical services
New medical services that have not been approved by AIA in its sole discretion.
Obesity related medical services (including treatment of complications arising from any treatment for obesity; any disease or disorder of the skin or psychological treatment). Obstetric visits, pregnancy, childbirth or any associated conditions or complications except as specifically provided by the Pregnancy, Maternity and Infertility Benefit.
Obesity
Obstetrics
Out of scope services
Services not provided by a registered medical practitioner practising within their scope of practice.
Any pre-existing condition , unless the symptom or condition was disclosed to AIA at the time of your application and accepted as covered by AIA in writing. Preventative medical services, health surveillance screening or treatment or investigation (including as a result of family history) where the life assured has no medical symptoms or where the condition will not cause significant problems for the health of the life assured if medical treatment is not received, except where expressly covered by a benefit in this policy.
Pre-existing conditions
Preventative medical services and routine screening
Public hospital
Services carried out in a public hospital.
Correction of refractive visual errors or astigmatism by surgery, surgically implanted intraocular lens(es), or laser treatment. This includes any consultations relating to refractive visual errors.
Refractive visual errors
Services outside of New Zealand
Services carried out outside of New Zealand.
Snoring
Diagnosis, management and treatment of snoring.
Cystic fibrosis, polycystic kidney, Marfans syndrome, Loeys-Dietz syndrome, spina bifida, scoliosis, kyphosis, pectus excavatum and pectus carinatum.
Specified conditions
Termination of pregnancy Termination of pregnancy.
War/terrorism
Injuries of war or resulting from any terrorist act (whether war is declared or not).
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1118 AL-STS Version 1 Effective 1 October 2025
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