monthly earnings, taxable income, business accounts, ACC details or similar; 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 (this may include evidence of the life assured’s mortgage amount).
(g) The life assured is in prison or sentenced to home detention for any reason.
(h) 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 appendix, be treated as the disablement date for a new claim.
The waiting period will be waived for the new claim.
24. Ongoing claims requirements
If the benefit payment period is two or five years, the original claim and the new claim will be considered to be the same claim in respect of the benefit payment period .
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 payment of a Mortgage, Income or Rent Cover 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 Mortgage, Income or Rent Cover 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.
No monthly benefit payments will be payable retrospectively for any period of time before the date that the life assured subsequently complies with the relevant requirement(s).
26. When will this appendix terminate for a life assured ? This appendix will terminate and eligibility for the Mortgage, Income or Rent Cover Benefit will cease for a life assured : At the expiry of the benefit term as shown in the schedule .
When the life assured dies.
When the benefit is cancelled.
27. Exclusions – when AIA won’t pay a benefit AIA will not pay any of the benefits listed in this appendix 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 recommended by the attending treatment providers. If the life assured is imprisoned or sentenced to home detention for any reason, no monthly benefit will be payable during the term of imprisonment or home detention.
25. 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 24 above. (d) AIA determines that the life assured is no longer totally disabled or partially 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 assured makes a false or fraudulent statement in respect of a claim or supports any claim with false evidence.
1117 AL-MIRC version 1 Effective 31 July 2025
Page 7 of 9
Powered by FlippingBook