The terms and conditions of the new policy will be those which are then offered by us to the general public;
unless AIA is satisfied that:
You and the life assured could not have known of the existence of the condition or the symptom or sign that led to the condition ; or The condition or symptom or sign that led to the condition was declared on your application and accepted by AIA . AIA will not pay a benefit under the Built-in Children’s Trauma Benefit or the Children’s Critical Conditions Benefit in the Optional Children’s and Maternity Benefit that arises as a direct or indirect consequence of:
Premiums will be calculated on the current age of the life assured ;
Any special terms, exclusions or premium loadings that applied to your existing Progressive Care Benefit under this policy will apply to your new Progressive Care Benefit under the new policy.
21.
Reducing your sum assured
You can write to AIA at any time to reduce your sum assured . You can make a reduction to your sum assured before you make a claim or after you have made a claim. In either case, the balance of the sum assured you have in each category will be reduced in proportion to the reduction in the sum assured . AIA will send you an endorsement letter, confirming the reduced sum assured and this will form part of your appendix .
a pre-existing condition ; or
any congenital condition , except where expressly covered under the Children’s Congenital Conditions Benefit.
These exclusions also apply to any subsequent sum assured increase you make.
23.
How to make a claim
22.
Exclusions: When AIA will not pay a benefit
To make a claim, refer to the section in your AIA Living policy entitled ‘How to make a claim’.
AIA will not pay a benefit under this appendix if any of the exclusions that are set out in each Schedule of Categories applies to the condition listed in that category . AIA will not pay any benefit under this appendix where any of the following directly or indirectly causes or contributes to the condition (whether or not the condition is a related condition ): The life assured (or a child in the case of a Built-in Children’s Trauma Benefit or the Optional Children’s and Maternity Benefit) deliberately injures himself or herself or attempts to do so. The life assured (or a child in the case of a Built-in Children’s Trauma Benefit, the Built-In Parents Grieving Benefit or the Optional Children’s and Maternity Benefit) engages in or is part of any conduct that is criminal. AIA will not pay any benefit under this appendix where any of the following occurs before a life assured (or any child in the case of a Built-in Children’s Trauma Benefit, Built-in Parents Grieving Benefit or the Optional Children’s and Maternity Benefit) reaches age 21, and (in each case either directly or indirectly) causes or contributes to a claim for that life assured (or child ):
In addition, for a Progressive Care 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 to have an examination by a registered medical practitioner or specialist appointed by AIA before accepting liability for a claim.
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 programme) at your expense which the life assured ’s registered medical practitioner or a registered medical practitioner approved by AIA considers necessary.
any intentional act by you or by any parent or guardian of the life assured, or child .
Any other information that AIA may deem relevant to the assessment of the claim.
any intentional act by someone who lives with or supervises the life assured, or child .
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
AIA will not pay any benefit under this appendix for:
Any condition ; or
Any symptom or sign that leads to a condition
that existed before the risk commencement date (whether or not a registered medical practitioner has been consulted),
Page 13 of 33
1106 AL-PC version 7 Effective 12 May 2026
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