policy.
payable for a transfer of ownership of the policy.
> Pay premiums as and when they fall due to ensure that the policy is not cancelled. > Notify us as soon as possible of any change that might affect the policy. If in doubt, please call us to discuss. > Notify us if you change your contact details. All notices from AIA to you will be deemed delivered if we have sent them to you using the contact details you last provided us with. Claims on other insurers It is your responsibility to advise AIA if there is another insurer, who is responsible under any contract of insurance or indemnity to pay for any costs for which you make a claim under this policy. You must make every reasonable effort to make a claim or seek recovery of costs from that insurer for any expenses recoverable. Any expenses covered by another insurer in this way will not be covered by AIA under this policy. However, if there are other expenses that are not covered by your other insurer please send details of the level of payment to us along with your claim. We will deduct the payment made by your other insurer then reimburse you for the remaining costs in accordance with this policy. If you have two or more policies with AIA you cannot claim for, or be reimbursed for, an amount higher than the total cost of your treatment. Claims involving ACC This policy does not cover any costs arising from treatments or procedures for accidents or injuries including treatment injuries (medical misadventure) that ACC is legally responsible to pay. It is your responsibility to submit any accident related claim to ACC in the first instance. Where surgery is necessary, you must obtain prior approval from ACC before incurring private treatment costs. When ACC agrees to contribute to the life assured ’ s treatment costs, AIA may cover additional costs up to the reasonable charges or maximum cover of this policy. You must obtain AIA’s prior approval before incurring private treatment costs. If ACC declines the claim AIA reserves the right to require that the life assured applies to ACC for a review of that decision, before AIA has any obligation to consider a claim for treatment under this policy. If ACC upholds their decline decision AIA may cover your costs up to the reasonable charges or maximum cover of this policy. You must obtain AIA’s prior approval before incurring private treatment costs. AIA will not pay for any MRI or CT scans or other specialised imaging procedures recommended by a registered medical practitioner within seven days of an accidental injury claim being lodged with ACC .
When can AIA change the terms of this policy? It is AIA’s business practice to review this policy over its lifetime. This is to ensure it continues to provide cover for current medical treatments for common medical conditions at the time. It is also to ensure the insurance product remains commercially viable for AIA . Any changes to the terms of this policy will apply across all lives assured with the same policy. AIA will not make any changes to the terms of an individual policy owner’s policy (except for age related premium increases based on the existing schedule of premium rates) without the policy owner’s consent. The following are examples of circumstances when AIA may wish to change the terms of this policy across all policy owners : > To increase the level of benefits under the policy or to add new benefits. > To move all lives assured to a refreshed policy document with a new drafting style/layout and similar levels of benefits. > To take account of changes in the laws in New Zealand. > To allow for an unexpected increase in the type or level of claims that will not be sustainable long term based on the current schedule of premium rates or at any premium rates (uninsurable). > To take account of a significantly escalated or new public health threat e.g. a pandemic. AIA will give you at least 30 days’ prior notice of any change to the terms of the policy (unless the changes are given effect as a result of the Enhancement Pass Back Benefit). The notice will include an updated policy document and highlight any change to the premium and/or to your entitlements under it. You always retain the right to cancel this policy at any time. G. General terms and conditions Your obligations You and every life assured agrees to: > Provide complete and accurate information to AIA and comply with your duty of disclosure. > Provide all information reasonably required by AIA in relation to the policy, any claims and the policy owner and/or life assured . > Attend, at AIA’s request, an examination or consultation with a registered medical practitioner or specialist of AIA’s choosing and at AIA’s cost. The registered medical practitioner or specialist will advise AIA of the results of the examination or consultation in order to assist AIA to determine the nature and extent of any medical condition and the cover available under the
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1300 APH-UMB version 6 Effective 17 April 2025
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