disabled to such an extent that necessitates confinement to the home under medical supervision or to a recognised medical institution and necessitates receiving regular medical care; or
4.
Ongoing Claim Requirements
For ongoing claims we will require:
Completion of a monthly medical certificate by a registered medical practitioner (at your expense) in a form from time to time approved by us for the purposes of determining ongoing entitlement to a Waiver of Premium Benefit. Completion of a monthly individual declaration by the waiver of premium life assured in a form from time to time approved by us, which may include completion of daily activity logs detailing the waiver of premium life assured’s functional activities for the purposes of determining ongoing entitlement to a Waiver of Premium Benefit.
unable to perform at least two of the Activities of Daily Living without the assistance of someone else (if the waiver of premium life assured can perform an activity on his or her own by using special equipment AIA will treat the waiver of premium life assured as being able to perform that activity); and in each case, not working in any gainful occupation or engaged in voluntary work.
3.
How to make a claim for the Waiver of Premium Benefit
Proof of any remunerated or non-remunerated work completed during the claim period.
For any claims enquiries, advice about submitting a claim or before incurring any costs in respect to a claim, please phone the AIA Claims Team on 0800 500 108 or contact your adviser for assistance. We will tell you about any other information that may be required once notice of the claim has been received. You must give AIA written notice of a claim as soon as practicable but at least within 12 months of the event giving rise to the claim. We are under no obligation to consider a claim unless all of the information requested is provided. Furthermore, we are under no obligation to assess or pay a claim prior to receiving notification. We may also ask the waiver of premium life assured to undergo further medical examinations throughout the life of the claim. Any requests made by us for further medical information will be at our expense.
Any other information that we may deem relevant to the ongoing assessment of the claim.
5.
When will we cease waiving the regular premiums payable under this policy?
We will cease waiving the regular premiums payable under this policy if:
a. The waiver of premium life assured fails to undergo and complete:
any surgical operation; and/or
any medical rehabilitation; and/or
any social rehabilitation ; and/or
any vocational rehabilitation,
In order to assess your claim, we will require:
which a registered medical practitioner approved by us considers reasonably necessary.
the waiver of premium life assured to be examined by a registered medical practitioner , before accepting liability for a claim; and an AIA claims form completed by the waiver of premium life assured and a registered medical practitioner (at your expense); and
b. The waiver of premium life assured fails to undertake any medical examinations that we require the waiver of premium life assured to have, at our expense.
c. The waiver of premium life assured fails to comply with the requirements of Section 4 above.
other information which we may reasonably request to help assess the claim; and
d. We determine that the waiver of premium life assured is no longer totally disabled or a partial disability benefit is no longer payable in respect of the waiver of premium life assured under an AIA policy .
the waiver of premium life assured to undergo medical and/or surgical treatment (including any operation or vocational, medical and/or social rehabilitation) at your expense which the waiver of premium life assured’s registered medical practitioner or a registered medical practitioner approved by us considers necessary; and
e. The waiver of premium term expires in relation to the waiver of premium life assured .
f. The waiver of premium life assured or anyone acting on behalf of the waiver of premium life assured makes a false or fraudulent statement in respect of a claim or supports any claim with false evidence.
any other information that we may deem relevant to the assessment of the claim.
g. The waiver of premium life assured is in prison or
1301 APH-WOP version 1 Effective 5 August 2019
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