C. Cancellation of the policy You wish to cancel your policy
> has made a substantially incorrect statement on the faith of which the policy was issued, renewed, varied or reinstated; AIA may, at its complete discretion either: > subject to the Insurance Law Reform Act 1977, avoid this policy from its inception (this means the policy is deemed to have never existed); or > alter the terms upon which cover is provided under your policy (such alteration of terms will be effective from the risk commencement date or such date of our choosing, at our discretion); or > remove from cover any life assured from inception but leave the policy in force for the remaining lives assured . If this policy is avoided or any terms altered or a life assured is removed from cover, we may retain all premiums paid in relation to the policy or that life assured .
You can cancel your policy at any time by giving AIA notice in writing. You are liable for all premiums due up to the date of the cancellation. AIA will refund any unused part of the premium already paid for any period more than one month beyond the date of cancellation. Otherwise there is no refund of any premiums . From the date AIA receives notice that you wish to cancel the policy, you will not be entitled to claim any benefits under this policy, other than for any health care service covered by this policy which was carried out prior to the date of cancellation, unless otherwise agreed to and confirmed in writing by AIA . When can AIA cancel your policy? AIA can cancel this policy if the premium has not been paid within 31 days of the premium due date . AIA can cancel this policy and decline liability for any claims made under this policy if you or any life assured , or anyone acting on your or any life assured ’ s behalf, makes a claim under this policy that is false or fraudulent in any respect. In the event that a false or fraudulent claim is established after payment of a claim, all amounts paid in relation to the false or fraudulent claim must be repaid by you to AIA . Cancellation due to Sanctions We shall not provide cover for any risk and/or activity and shall not be liable to pay any claim or pay any benefit hereunder to the extent that the provision of such cover, payment of such claim or provision of such benefit would be in respect of a person who is the subject of any sanction, prohibition or restriction under United Nations resolutions or trade or economic sanctions, laws or regulations of New Zealand, the European Union, United Kingdom or United States of America, or any of its states and/or any other applicable economic or trade sanction laws or regulations. This provision applies without limitation not only to the policy owner or holder, but to the life assured and any assignee, other third party, related party or beneficiary of the policy. Should we determine that the above is applicable, we may at our sole discretion terminate the policy with immediate effect. Non-disclosure or the provision of false or misleading information Any information you or any life assured gives us, and any information given to us on your behalf, must be complete, true and correct. If you or any life assured : > fails to disclose material information to AIA prior to inception of this policy or any variation or reinstatement of this policy; or
D. How to make a claim Prior approval
We recommend you seek prior approval as soon as you are aware that you will need to make a claim. We need at least five working days to issue a prior approval. By seeking prior approval we are able to give you certainty of cover by addressing your eligibility prior to treatment taking place. There are some benefits for which prior approval is mandatory. These are listed in ‘Part H: Benefits – what you are covered for’ on pages 10-22. Applying for prior approval You can submit your prior approval request online or return the completed form to AIA as soon as you are aware that you will need to make a claim. You will also need to ask your registered medical practitioner to complete the relevant section of the claim form or to provide you with a referral letter as well as any relevant clinical notes that may be useful to assist us to assess whether the medical treatment or procedure is medically necessary and falls within the terms of this policy. The referral letter must include details of the initial consultation date, the history of the condition and details of any treatment received. When you apply for prior approval we also need an estimate of the costs of treatment. If your claim is pre-approved, AIA will allocate a claim number to your claim and will email, post or fax you or the life assured a letter confirming the claim has been pre- approved. The excess and any costs that are not covered, including costs which exceed the maximum cover will be clearly shown and you will need to pay these amounts directly to the health service provider. AIA will pay the health service provider directly upon receipt of the invoice or statement up to the maximum cover . Please
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1300 APH-UMB version 6 Effective 17 April 2025
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