10. Changing your sum assured You may apply to AIA in writing at any time to increase or reduce your sum assured. AIA does not have to accept an application for any increase in your sum assured. Any acceptance will depend on a number of factors, including the state of health of the life assured . Any increase or reduction in your sum assured will start from the next premium due date after AIA accepts your application. Your premium will be recalculated based on AIA’s underlying premium rates at that time. 11. How to make a claim 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 or your AIA Registered AIA will tell you about any other information that may be required once notice of the claim has been received. AIA is under no obligation to consider a claim unless all of the information requested is provided. Furthermore, AIA is under no obligation to assess or pay a claim prior to receiving notification. AIA may also ask you to undergo further medical examinations throughout the life of the claim. Any requests made by AIA for further medical information will be at our expense. To make an AIA Start-Up Income Protection claim, AIA will require: > the life assured to be examined by a registered medical practitioner acceptable to AIA , before accepting liability for a claim; and financial adviser for assistance. AIA Claims Hotline: 0800 500 108
12. Ongoing claim requirements For ongoing claims AIA will regularly require: > Completion of a monthly medical certificate by a registered medical practitioner (at your expense) and in a form from time to time approved by AIA for the purposes of determining ongoing entitlement to payment of a benefit. > Completion of a monthly individual declaration by the life assured in a form from time to time approved by AIA , which may include completion of daily activity logs detailing the life assured’s functional activities for the purposes of determining ongoing entitlement to payment of a benefit. > Proof of any remunerated or non-remunerated work completed by the life assured during the claim period. > Any other information that AIA may deem relevant to the ongoing assessment of the claim. 13. When will AIA cease paying a benefit? AIA will cease paying a benefit if: (a) The 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, which a registered medical practitioner approved by AIA considers reasonably necessary. (b) The life assured fails to undertake any medical examinations that AIA requires the life assured to have, at our expense. (c) The life assured fails to comply with the requirements of Section 12 above. (d) AIA determines that the life assured is no longer totally disabled . (e) The benefit payment period expires in relation to the life assured . (f) The life assured or anyone acting on behalf of the life (g) The life assured ceases to be actively involved in the business , unless the reason for this is related to the claim. (h) The life assured is in prison or sentenced to home detention for any reason. (i) The life assured dies. If AIA ceases paying a benefit in accordance with paragraphs (a), (b) or (c) and the life assured subsequently complies with the relevant requirement(s), then: > The date that the life assured complied with the relevant requirement(s) will, subject to the provisions of this policy , be treated as the disablement date for a new claim. assured makes a false or fraudulent statement in respect of a claim or supports any claim with false evidence.
an AIA claims form completed by the life assured and a registered medical practitioner (at your expense); and 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; and proof of financial information where applicable under Section 8; and the life assured to undergo medical and/or surgical treatment (including any operation or vocational, medical and/or social rehabilitation) at your expense which the life assured’s registered medical practitioner or a registered medical practitioner approved by AIA considers necessary; and any other information that AIA may deem relevant to the assessment of the claim.
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1180 A-SU IP version 3 Effective 23 July 2021
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