ELIGIBILITY
20 All Lives Assured must be eligible for publicly funded health and disability services as per the New Zealand Public Health and Disability Act 2000. We may request to see original or certified copies of the Lives Assureds’ documents, including visas or work permits in passports, birth certificates or driver’s licenses. We reserve the right to cancel the relevant Life Assured’s cover if the relevant person no longer meets the criteria.
NO SURRENDER VALUE
21
This Policy has no surrender or cash value if it is cancelled.
COMPLAINTS
22 You may at any time write to Us or to Your Insurance Adviser for further information about Your Policy . We have a complaints procedure that is intended to resolve any problem quickly and fairly. If You have any questions or complaints about this Policy please phone Us on 0800 800 242 or write to Us . If You have been through Our internal complaints procedure and the situation has reached a 'deadlock', then We will advise You of how to contact the Insurance and Financial Services Ombudsman Scheme for further assistance.
Where the ACC provides cover for an injury, illness, or condition, You must obtain approval of the ACC for the provision of treatment in a Private Hospital ; or Where the ACC approves the claim but declines to pay the costs of surgical treatment, We may meet the cost of that treatment when You provide Us , prior to Your treatment, with a copy of the ACC's decision; or Where the ACC accepts Your claim, We will provide Top-Up payments for the difference between ACC reimbursements and Our Usual, Customary and Reasonable charges applicable for eligible surgical and medical costs. Where ACC declines Your claim outright, We may require You to appeal the ACC decision through the documented ACC Review Process. All appeals must be made within the ACC timeframes of three (3) months post original decision.
ACCIDENT COMPENSATION ACT 2001 (ACC)
23
DEFINED TERMS
24 In this REAL Health Policy certain words have particular meanings. These words are in Bold and the meanings are explained below.
Interpretation Throughout this Policy ' We ' , ' Our ' ' Us ' or ' AIA New Zealand ' means AIA International Limited - New Zealand Branch, and/or any related and/or authorised companies and agents (including company officers acting in the scope of their authority). ' You ' or ' Your ' means the Life Assured. ACC Means the Accident Compensation Corporation as defined by the Accident Compensation Act 2001, or its successor under any subsequent legislation.
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