4.
When will AIA pay a Partial Disability Income Benefit?
assured went on leave, as set out in Section 28 “Key Terms” .
Offsets:
AIA will pay a Partial Disability Income Benefit if, in AIA’s opinion, at any time during the benefit term , the life assured : > is in an occupation class other than occupation class five at the time of becoming totally disabled or partially disabled ; and > has been partially disabled during the waiting period, and is partially disabled at the end of the waiting period ; or > becomes partially disabled , following a period of receiving a Total Disability Income Benefit under this appendix and the life assured is no longer totally disabled , provided: − the period in respect of which a Total Disability Income Benefit has been paid in advance has expired; and/or − where a lump sum payment has been made in lieu of monthly benefit payments as set out in Section 1, the benefit period to which the lump sum corresponds has expired. We will pay you the Partial Disability Income Benefit monthly in arrears until, in AIA’s opinion, after considering the advice of a registered medical practitioner and other relevant information, the disability is no longer preventing the life assured from working at least 75% of their pre-disability working hours , or until the end of the benefit payment period , whichever is the earlier. A Partial Disability Bridging Benefit (as set out in Section 7) will also be paid if you have been receiving a Total Disability Income Benefit under this appendix before you commence receiving a Partial Disability Income Benefit.
Any mortgage or income protection benefits that you or your mortgage provider receive or are entitled to receive in relation to the life assured and in relation to the same or a related disability. This excludes ACC benefits and Work and Income New Zealand (WINZ) benefits received or entitled to be received. AIA will not seek to apply offsets under this clause in respect of mortgage or income protection benefits held with other providers which were accurately disclosed in your application, provided that there has been no change in the circumstances for you or the life assured .
For example :
pre-disability working hours
37.5 hours
post-disability working hours
15 hours
Benefit amount shown in the schedule
$72,000 per annum ($6,000 per month)
Offsets
Nil in this example
Calculation:
1/12 th x $72,000 x (37.5 – 15) 37.5 = $6,000 x 0.6
= $3,600 per month ($43,200 per annum)
7.
What is the Partial Disability Bridging Benefit and when will AIA pay it?
5. What does partially disabled mean?
In AIA’s opinion, the life assured is partially disabled, if as a direct result of sickness or injury he or she: > has a reduction in work capacity resulting from the continuation of the disability; and > because of the reduction in work capacity, the life assured is working less than 75% of pre-disability working hours.
AIA will pay you a Partial Disability Bridging Benefit if:
you have been receiving a Total Disability Income Benefit under this appendix ; and
the life assured is no longer totally disabled ; and
based on the information provided to, and requested by AIA , we reasonably expect that a Partial Disability Income Benefit (as set out in Section 4) will be payable for that life assured for the first month after the life assured ceased to be totally disabled. The Partial Disability Bridging Benefit is a lump-sum payment equivalent to 1/3 rd (33.3%) of the final monthly Total Disability Income Benefit paid before the life assured ceased to be totally disabled. The Partial Disability Bridging Benefit is paid at the end of the final month in respect of which a Total Disability Income Benefit was paid for the life assured . Payment of the Partial Disability Bridging Benefit does not affect the amount of the Partial Disability Income Benefit (as set out in Section 6). The Partial Disability Bridging Benefit is payable once for all claims resulting from the same or a related injury or illness.
6.
What is the amount of the Partial Disability Income Benefit?
The amount that AIA will pay monthly is calculated in the following way: 1/12 th of the benefit amount shown in the schedule ×
( pre-disability working hours – post-disability working hours ) pre-disability working hours
less offsets shown below.
If the life assured was on parental leave for 12 months or less or on a work sabbatical when the life assured became totally disabled , then pre-disability working hours will be based on the working hours immediately before the life
1110 AL-MIP version 4 Effective 4 August 2023
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