1112 AL-AIC Version 2 Effective 26 April 2024
AIA LIVING - PERSONAL OPTIONAL BENEFIT APPENDIX
Accidental Injury Cover
This appendix only applies if cover under the schedule for your policy includes the Accidental Injury Cover. This appendix forms part of and is incorporated into your AIA Living policy, the terms of which apply to this appendix .
This is an Agreed Value Benefit. Details of the benefit and the life / lives assured are shown in the schedule .
1. When will AIA pay Accidental Injury Cover?
injury from the same event, AIA will pay the specified injury that provides the greatest benefit. However, if AIA pays a specified injury that provides a lower benefit and subsequently the same accidental injury would qualify for a specified injury providing a higher benefit, then AIA will pay the difference between the higher benefit and any lower benefit already paid for the same accidental injury.
AIA will pay Accidental Injury Cover if a life assured suffers a specified injury after the risk commencement date of this benefit and survives for at least 14 days thereafter. An Accidental Injury Cover claim must be supported by medical evidence acceptable to AIA confirming the specified injury giving rise to the claim. No waiting period applies and the Accidental Injury Cover will be paid once evidence of the specified injury is accepted by AIA .
3.
How to make a claim
To make a claim, the relevant procedures in the section of your AIA Living policy entitled ‘How to make a claim’ must be followed. In addition, AIA will not pay a claim under this Accidental Injury Cover until AIA has received medical evidence of the specified injury from a registered medical practitioner (at your expense).
2.
What amount will AIA pay for Accidental Injury Cover?
If a life assured suffers a specified injury the Accidental Injury Cover will be paid as a lump sum payment equal to the monthly benefit amount set out in the schedule multiplied by the applicable number of months set out in the table below.
4.
When will this appendix terminate for a life assured ?
Table of specified injuries .
This appendix will terminate and eligibility for the Accidental Injury Cover will cease for a life assured at the earliest of when:
Number of Months’ Benefit as Lump Sum
Category Number
Accidental Injury Categories
The life assured dies.
The life assured reaches age 70.
An accidental injury that leads to a fracture that requires immobilisation other than a cast
1
2
The benefit is cancelled.
All of the life assured’s other AIA Living benefits with AIA are cancelled.
An accidental injury that leads to a fracture that requires a cast
2
3
5.
Exclusions – When AIA won’t pay a benefit
An accidental injury that results in the life assured having had surgery under general anaesthesia An accidental injury that leads to amputation of a limb , permanent total blindness , permanent total loss of hearing , or permanent paralysis (diplegia, hemiplegia, paraplegia, quadriplegia)
3
3
AIA will not pay Accidental Injury Cover if a specified injury arises directly or indirectly from any of the following:
Any illness, disease or degenerative condition.
Any act or omission by the life assured intended to cause harm to him or herself. AIA will not pay any Accidental Injury Cover if the life assured participates in any criminal activity or suffers a specified injury when under the influence of alcohol or drugs, except where the drugs were prescribed by and were being used in accordance with the directions of a registered medical practitioner.
4
12
The Accidental Injury Cover is not subject to any offsets.
Only one Accidental Injury Cover will be paid for the same event. If the life assured suffers more than one specified
1112 AL-AIC Version 1 Effective 5 August 2019
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6.
Key terms
permanent total blindness
Irrecoverable loss of the sight of both eyes (whether aided or unaided). This is evidenced by:
accidental injury
Bodily injury caused solely, suddenly and directly by violent, accidental, external and visible means.
visual acuity of 6/36 or less in both eyes; or field of vision reduced to 10 degrees or less of arc in the better eye; or a combination of visual defects resulting in the same degree of visual impairment as either of the points above.
fracture
The disruption in continuity of bone, with or without displacement.
general anaesthesia
The induction of a state of unconsciousness with the absence of pain sensation over the entire body, through the administration of anaesthetic drugs. Means a registered medical practitioner has certified that, as part of the recommended medical treatment for that fracture , the life assured requires a:
immobilisation
permanent total loss of hearing
The life assured loses all hearing in both ears (aided or unaided). The loss must be total and permanent as assessed three months after the accidental injury . An accidental injury which falls within one of the Accidental Injury Categories set out in the table in Section 2.
moon boot;
halo;
specified injury
surgical wires;
externally or internally fixed plates and/or screws;
wrist guard;
splint;
support;
crutches;
sling;
wheelchair; and/or
other mobility equipment, aid or device.
limb(s)
An arm, leg, hand or foot. In respect of this definition:
the arm starts from the shoulder joint and ends at the wrist joint; the hand starts from the wrist joint; the leg starts from the hip joint and ends at the ankle joint; and
the foot starts from the ankle joint.
1112 AL-AIC Version 1 Effective 5 August 2019
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