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Making a claim

Online health claims and pre-approvals

The quickest and easiest way to submit a claim is online. The online claim form takes about 10 minutes to fill out, and Claims assessments are completed within 3 to 5 working days.

You can also complete a printable claim form. It usually takes 5 to 10 working days for us to assess your claim once we've received your form.

You'll need:

Your policy number
PDFs or photos of your invoices and receipts

Referral letter or medical certificates
Proof of your bank account (if we haven't paid into this account before)

Printable Claim and pre-approval forms

If you are needing pre-approval or the reimbursement of expenses under a health policy and would prefer to print and return a form please select one of the following:

For AIA policies purchased from 5 August 2019 and all Sovereign health policies:

Printable claim form for Sovereign and AIA Private Health

For AIA Health policies purchased before 5 August 2019:

Printable claim form for AIA Real / Superior Health

Health Claim FAQ

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Should I get prior approval?

Applying for prior approval means you can be confident you’ll be covered before undertaking treatment. We will also arrange to pay your providers directly, subject to any policy excess.

If you don’t receive prior approval before the procedure then you’ll need to pay the costs yourself and then claim them back by submitting a claim and providing itemised receipts.

How do I get prior approval?

You request prior approval by submitting a claim through the usual process, as described above. You should do this at least five working days before the procedure, and you’ll need to include the following documents:

A medical certificate completed by your medical practitioner. If you have a referral letter containing the date of first consultation, history of condition and treatment received, then this can be used instead.

If it’s a claim that ACC has accepted or declined, then a copy of that letter is required. If this information isn’t obtained, then it may delay the assessment of your claim.

If you submit your request online or by email then you can upload a scanned copy or clear photograph of these documents. The maximum file size is 10MB.

How long will my prior approval be valid for?

Your prior approval is valid for six months from the date it was issued.

How long will it take for my claim to be assessed?

We process and pay any claim refunds as quickly as possible – usually within 3-5 working days.

Why do I need to put down symptoms or a condition on my claim form?

To accurately assess your claim we need to know the symptom or condition that required you to contact your doctor. We need to be able to see if these symptoms or conditions are covered under your policy, and that they aren’t related to a pre-existing condition or general policy exclusion.

What if I have already had treatment done, how do I claim retrospectively for this?

The quickest and easiest way to submit a claim is online. Alternatively, you can download and complete a paper claim form and send it to us by email, post or fax. The process for all of these options is described above. You will need to include the following documents:

If it’s a claim that ACC has accepted or declined, then a copy of that letter is required. If this information isn’t obtained, then it may delay the assessment of your claim.

Any receipts or invoices. We will reimburse the treatment provider(s) directly unless receipts are received. Reimbursement of receipts are made by direct credit to your bank account.

If you submit your request online or by email then you can upload a scanned copy or clear photograph of these documents. The maximum file size is 10MB.

I have received some accounts, what do I do with them?

Simply submit your claim in the usual way and include any invoices or receipts that need to be paid. We will reimburse the treatment provider(s) directly unless receipts are received. Reimbursement of receipts are made by direct credit to your bank account.

Who do I pay my excess to?

When your invoices have been received, we will pay the providers, less any excess, and confirm this in writing to you. The letter will state who you will need to pay. The treatment provider will usually invoice you for the excess after payment is received from AIA.

What happens if I have an accident?

ACC is the primary insurer for any treatment relating to an accident. If ACC declines your claim, please enclose a copy of the letter from ACC with your claim form. If ACC is paying a part of the claim, AIA may be able to top this up. We also need a copy of ACC’s letter outlying their contribution to treatment.

For claims related to income protection, critical conditions, life insurance or credit cards.

Call us

Between 8am and 6pm, Monday to Friday please call us on

0800 500 108

Notify AIA of a claim

Start your claim online. Our Claims Team will be in touch as soon as possible.

FAQ

Making an insurance claim – life

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Who is entitled to receive the proceeds from my life insurance policy when I die?

The Policy Owner or the Policy Owner’s estate (if the policy was solely owned by the deceased).

What if more than one person owns the policy?

The surviving owners are entitled to the proceeds and they will all need to sign the discharge form before the proceeds can be paid.

Why is it important to have a will?

A will is your chance to say what you want to happen to your estate after you have died. You can choose an executor and beneficiaries and decide how your assets are to be distributed.

When does a will become null and void?

After marriage or divorce.

What does ‘certified’ copy mean?

A copy of the original document, sighted alongside the original and certified as a true copy of the original by a Justice of the Peace, solicitor or anyone else who is able to certify documents.

Why do I need to send in proof of age when it is on the death certificate?

The date of birth recorded on a death certificate is given verbally and no proof is required when the death certificate is completed.

What is the difference between the Life Assured and Policy Owner?

Life Assured: person who is insured

Owner: person who gets proceeds of the claim

Who has access to personal information on my policy including medical information?

Generally, AIA and the Life Assured only. If AIA has received a Consent to Disclose form, completed by the Life Assured and giving consent to release information to another specific person, then we can release information to that person. There are certain exceptions under privacy legislation relating to the disclosure of personal information which can apply. Please note that this does not apply to death claims.

Why is it important to have a power of attorney?

To ensure there is someone appointed to act on your behalf if you are unable to do so due to location, illness or injury.

What is the difference between a ‘power of attorney’ and ‘enduring power of attorney’?

Power of attorney: A person appointed under a ‘power of attorney’ acts on the appointee’s instructions. The power of attorney is valid until revoked, and may be granted for a limited period of time.

Enduring power of attorney: A person appointed under an ‘enduring power of attorney’ can act on your behalf if you are mentally incapacitated, and that power will not be revoked by your subsequent incapacity.

What is the difference between an executor and a beneficiary?

Executor: administers the estate and ensures the deceased’s will is followed.

Beneficiary: benefits from the estate as per the wishes of the will-maker.

Making an insurance claim – disability

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What does ‘certified’ copy mean?

A copy of the original document, sighted alongside the original and certified as a true copy of the original by a Justice of the Peace, solicitor or anyone else who is able to certify documents.

Who has access to personal information on my policy including medical information?

What does total permanent disablement mean?

This will depend on the wording of your policy, including the type of cover you have taken out and any exclusions on your policy. Generally, total permanent disablement means that you are, after consideration of medical and other evidence, so incapacitated that you are unlikely to ever be able to work (depending on the cover you have taken out, this will either mean working in your usual occupation, or in any gainful employment).

For the full definition please refer to your policy document. For more information on our current Total Permanent Disablement product, see our product page for this cover.

Why is it important to have a power of attorney?

To ensure there is someone appointed to act on your behalf if you are unable to do so due to location, illness or injury.

What is the difference between a ‘power of attorney’ and ‘enduring power of attorney’?

What is a certificate of non-revocation Power of Attorney (POA)?

A certificate of non-revocation is declaration by the appointed attorney that as at the date of the declaration the Power of Attorney has not been revoked. The certificate must be signed by the attorney every time they make an enquiry or process a transaction on the account holder’s behalf.

What is the difference between the Life Assured and Policy Owner?

Life Assured: person who is insured

Owner: person who gets proceeds of the claim

Making an insurance claim – Critical Conditions (Trauma)

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What does ‘certified’ copy mean?

A copy of the original document, sighted alongside the original and certified as a true copy of the original by a Justice of the Peace, solicitor or anyone else who is able to certify documents.

Who has access to personal information on my policy including medical information?

What conditions am I covered for?

Please refer to your policy document for the full list of conditions and the specified definition that you are covered for.

Why is it important to have a power of attorney?

To ensure there is someone appointed to act on your behalf if you are unable to do so due to location, illness or injury.

What is the difference between a ‘power of attorney’ and ‘enduring power of attorney’?

What is the difference between the Life Assured and Policy Owner?

Life Assured: person who is insured

Owner: person who gets proceeds of the claim

Claims Philosophy

We know making a claim is often a result of a difficult time in your life. It is the time when you need us the most. With one of the largest and most experienced claims team in New Zealand, nationwide rehabilitation support and a transparent claims review process, we ensure your claims experience is excellent, fair and fast.

Rehabilitation Philosophy

For us, getting your claim paid is just the beginning. With over $1.1m* paid to support customer rehabilitation, we believe your health and wellbeing journey goes beyond paperwork and claims payment. Our rehabilitation philosophy is based on the fundamental principles of Focusing on Ability, not Disability. With this proactive focus on rehabilitation, we are able to offer Rehabilitation Services at the right time in our customer’s journey, providing evidence based, results-focused programs nationwide. We work closely with you to understand what you need to get back on track, while supporting you through your rehabilitation.

*Claims statistics for Sovereign & AIA customers as at 30 June 2018 reported to Financial Services Council. Based on total number of claims FY2018.

CLAIMS PHILOSOPHY

Helping people when they need it most
Rehabilitation Philosophy

Focusing on ability, not disability

Claims Paid

We paid 94%* of the claims we received in 2019

AIA paid

$612.9 M

in claims combined

between 1 January and 31 December 2019.

*Combined AIA and Sovereign claims statistics (including maturities and surrenders) reported by AIA Business Insights Team

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Are you looking to update your personal or policy details? Find the answers and forms for our frequently asked questions.

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Making a claim

Online health claims and pre-approvals

Printable Claim and pre-approval forms

Health Claim FAQ

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- Close All

Call us

0800 500 108

Notify AIA of a claim

Contact our Claims Team

FAQ

Making an insurance claim – life

Making an insurance claim – life

Making an insurance claim – disability

Making an insurance claim – disability

Making an insurance claim – Critical Conditions (Trauma)

Making an insurance claim – Critical Conditions (Trauma)

Claims Philosophy

Rehabilitation Philosophy

CLAIMS PHILOSOPHY

Rehabilitation Philosophy

Claims Paid

AIA paid

$612.9 M

in claims combined

FAQ and Forms

Get advice

My AIA

Need help with your claim?

Need help with your claim?

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