help assess the claim; and
(f) The life assured or anyone acting on behalf of the life assured makes a false or fraudulent statement in respect of a claim or supports any claim with false evidence. (g) The life assured is in prison or sentenced to home detention for any reason.
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.
(h) The life assured dies.
If AIA ceases waiving the regular premiums payable under this policy 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 appendix, be treated as the disablement date for a new claim.
4.
Ongoing Claim Requirements
For ongoing claims AIA 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 AIA for the purposes of determining ongoing entitlement to a Waiver of Premium 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 a Waiver of Premium Benefit. Proof of any remunerated or non-remunerated work completed during the claim period. Any other information that AIA may deem relevant to the ongoing assessment of the claim.
> The waiting period will be waived for the new claim.
> AIA will not waive the regular premiums payable under this AIA Living policy retrospectively for any period of time before the date that the life assured complies with the relevant requirement(s).
6.
Exclusions – when AIA won’t waive the regular premiums
AIA will not waive the regular premiums payable under this AIA Living policy where any of the following directly or indirectly cause or contribute to the disability: The life assured deliberately injures himself or herself or attempts to do so. The life assured engages in or is part of any conduct that is criminal. Pregnancy of, or childbirth by, the life assured , unless the disability lasts for more than 90 days after the end of pregnancy, in which case the waiting period will start from the 91 st day. The life assured does not comply with the treatment prescribed by the attending treatment providers. If the life assured is imprisoned or sentenced to home detention for any reason, regular premiums will not be waived during the term of imprisonment.
5.
When will AIA cease waiving the regular premiums payable under this AIA Living policy?
AIA will cease waiving the regular premiums payable under this policy 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 4 above. (d) AIA determines that the life assured is no longer totally disabled, or a partial disability benefit is no longer payable in respect of the life assured under another appendix of this AIA Living policy. (e) The waiver of premium term expires in relation to the life assured .
7.
Key terms
Activities of Daily Living are:
activities of daily living
> Bathing and showering.
> Dressing and undressing.
> Eating and drinking.
> Using a toilet.
Moving from place to place by walking, in a wheelchair or with a walking aid.
1164 ALB-WOP version 1 Effective 5 August 2019
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