How does a critical illness policy work?

AIA has different options that provides cover for trauma. Our Critical Conditions cover provides a lump sum payment if you suffer from one of over 50 defined medical conditions. Our Progressive Care cover allows you to make multiple claims based on the severity of your illness or injury. Cover is provided for 70 defined medical conditions across five categories: Cancer Heart and arteries Brain and nerves Loss of function Other health events

What is the main difference between AIA Living Critical Conditions cover and AIA Living Progressive Care?

AIA’s Critical Conditions cover provides a lump sum payment to manage financial impact that is faced if you or one of your children suffer one of the listed conditions. Or choose our Progressive Care cover that allows you to make multiple claims based on the severity of your illness or injury.

What is covered by critical illness insurance?

AIA’s Critical Conditions cover provides a lump sum payment if you suffer one of over 50 defined serious medical conditions, such as cancer, certain heart conditions, major neurological disease, etc. It also provides several built-in benefits, such as a trauma benefit for your child, counselling, financial & legal advice benefit, and more. You can add more benefits for an additional premium to give you additional support. Talk to your insurance adviser or request an adviser call to find out more.

What is classed as a critical illness?

Our Critical Conditions cover provides a lump sum payment if you suffer one of over 50 defined medical conditions. A few of these are advanced diabetes, cancer, dementia, heart attack, heart surgery, permanent loss of hearing, stroke, meningitis, chronic lung disease, HIV, severe burns, permanent blindness, severe illness or injury, etc. Our Progressive Care cover allows you to make multiple claims, based on the severity of your illness or injury. You’ll be covered for 70 defined medical conditions across five categories: Cancer, Heart & Arteries, Brain & Nerves, Loss of Function and other health events.

What is a critical illness protection plan?

AIA’s Critical Conditions cover and Progressive Care cover are both trauma insurance options. Each of those provide a different level of cover. Critical Conditions cover - is designed to pay a one-off lump sum payment if you or one of your children face one of the listed medical conditions. Progressive Care cover - allows you to make multiple claims, based on the severity of your illness or injury. Please speak with your insurance adviser or request an adviser call to discuss your needs.

Is trauma insurance and critical illness insurance the same?

Critical Conditions cover and Progressive Care cover are both trauma insurance options with AIA. Each of those provide a different level of cover. Our Trauma insurance options mean that you can choose our Critical Conditions cover , which provides a lump sum payment to manage financial impact that is faced if you or one of your children suffer one of the listed medical conditions, or choose our Progressive Care cover that allows you to make multiple claims based on the severity of your illness or injury.

Critical Conditions

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What is Critical Conditions?

Critical Conditions is our most comprehensive trauma cover, designed to provide financial support through full or partial lump sum payments for a wide range of defined medical conditions.

Critical Conditions can make up for loss of income, which might otherwise be a drain on your finances and can also help cover large expenses often incurred with private treatment. Plus, with the option to buy back your cover after a claim, you can maintain long-term protection and peace of mind.

Whether you are given a major diagnosis or a life changing injury, Critical Conditions gives you the financial freedom to focus on your health and recovery.

Why get insurance advice?

Our insurance advisers can help you choose the right policy for your needs and budget. They will work with you to understand your financial situation and identify the risks that are most important to protect against. With their help, you can be sure that you are getting the coverage you need to protect yourself and your loved ones.

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Built-in benefits of AIA Living Critical Conditions^

Return home

Provides up to $10,000 to cover the cost for you and a support person to return to New Zealand if you're diagnosed with a defined medical condition for the first time while overseas.

Medical advancements provision

At claim time we’ll consider the latest recognised diagnosis techniques and investigations used to assess your covered medical conditions.

Financial and legal advice

Provides up to $2,500 to help you access advice from an approved financial adviser or legal professional.

Standalone conversion facility

You may convert your standalone trauma insurance to accelerated with an equal amount of Life Cover without any further medical evidence.

Premium conversion facility

Before reaching the age of 65 years, you have the option to convert all or part of your sum assured to a level premium structure without any further medical underwriting.

Future insurability

You can apply to increase your Trauma sum assured at every third policy anniversary without providing any further medical information. Limits and conditions apply and every increase in cover will result in an increase in premium.

Counselling  

Access up to $2,500 of financial support to cover the cost of a Psychiatrist or Psychologist consultation and counselling for you and/or your family where the treatment directly relates to a claim.

Children’s trauma

Provides cover for your children from three months old up to their 21st birthday. The benefit is the lower of $50,000 or 50% of your sum assured.

Parents grieving

Offers financial support if your child passes away - $2,000 for children under 10, and $15,000 for those aged 10–21.

Children’s trauma conversion facility

When your child turns 21, the Built-in Children’s Trauma Benefit and/or Optional Children’s and Maternity Benefit (where applicable), can be converted to an adult trauma insurance policy. This can be done on a standalone basis or accelerated with the same amount of Life Cover, without any further medical evidence required, provided there is no increase in cover.

Worldwide cover

Whether you’re at home, travelling or living overseas for any period, you remain insured.

Suspension of cover

AIA provides the flexibility to suspend your cover for up to 12 months, if you meet the conditions outlined in the policy. No benefits will be payable for any claim event which occurs during this suspension period.

Enhancement pass back

At claim time, we’ll compare your purchased product’s policy wording with the latest version of that product’s policy

Special events increase facility

You can increase the sum assured without further medical underwriting following one of the significant events mentioned in the policy.

Newborn children

Financial support if your child is born with one of eight specific congenital conditions and survives 30 days. The lower of $50,000 or 50% of the sum assured.

Optional benefits you can add on^

Specialist and Testing Support

Covers the cost of private specialist consultations (up to $10,000 annually) and medical diagnostic tests and procedures (up to $100,000 annually).

Specified Accidental Injury Cover

Short term financial support, helping you continue daily life while recovering from an accident.

Waiver of Premium

We will waive your premium payments, while your insurance remains in place when you are unable to work due to a total disability.

Early cancer upgrade

Covers costs for a number of minor cancer conditions that are treatable and non-life threatening and at the early stages of diagnosis.

Critical Conditions buy-back

Reinstate your level of cover under your original AIA Living Critical Conditions policy, without having to provide further medical information.

Life cover buy-back

Ability to reinstate your level of cover under your original AIA Living Life Cover policy following an accelerated Severe Trauma claim, without having to provide further medical information.

Total permanent disablement condition

Include an additional claimable condition that provides cover if you were to become permanently disabled and are unable to work as a result of accident or illness. This applies to own occupation cover only.

Children and maternity

Provides limited cover for three defined serious pregnancy complications, eight children’s congenital conditions and other eligible conditions. One claim per child to maximum of $75,000 or 50% of the sum assured across all AIA policies for a life assured.

^This is a summary only. For all terms, conditions, limits and exclusions, please read the policy wording.

What conditions are covered?

The below table provides a high-level overview of conditions covered.

Medical condition

	Full Payment	Partial Payment
Advanced AIDS	•
Advanced diabetes*	•
Alzheimer’s disease	•
Angioplasty – 3 vessels or more*	•
Angioplasty – less than 3 vessels*		•
Aortic surgery*	•
Aplastic anaemia	•
Benign brain or spinal cord tumour	•	•
Cardiac Defibrillator Insertion*		•
Carcinoma-in-situ*		•
Carcinoma-in-situ radical surgery*	•
Cardiomyopathy	•
Cerebral Aneurysm*		•
Chronic liver failure*	•	•
Chronic lung disease*	•
Chronic renal failure	•
Cognitive Impairment	•
Coma	•
Coronary artery bypass surgery*	•
Creutzfeldt-Jakob disease	•
Dementia	•	•
Diplegia	•
Encephalitis	•	•
Heart attack*	•
Heart valve surgery*	•	•
Hemiplegia	•
Idiopathic Parkinson’s disease	•
Intensive care benefit	•	•
Loss of independent existence	•
Major head trauma	•

Medical condition

	Full Payment	Partial Payment
Major transplant surgery	•
Malignant tumours and blood cancers*	•
Meningitis	•
Motor neurone disease	•
Multiple sclerosis*	•
Muscular dystrophy	•
Optional Total Permanent Disablement condition	•
Out-of-hospital cardiac arrest	•
Pacemaker Insertion*		•
Paraplegia	•
Peripheral neuropathy	•
Permanent blindness*	•	•
Permanent loss of hearing	•	•
Permanent loss of speech	•
Permanent loss of use of limbs	•	•
Pneumonectomy	•
Prostate cancer*	•
Pulmonary hypertension	•
Quadriplegia/Tetraplegia	•
Severe burns	•	•
Severe Crohn's disease*		•
Severe illness or injury*	•
Severe osteoporosis*		•
Severe rheumatoid arthritis*		•
Severe ulcerative colitis*		•
Stroke*	•
Systemic Lupus - Erythematosus with lupus nephritis	•
Systemic Sclerosis	•
Terminal illness	•

*Certain conditions have a stand down period. There is no cover under the policy if you suffer any of these conditions (or signs or symptoms which lead to these conditions) within the first 90 days of the receipt of application by AIA. For details of each condition please refer to the policy wording or speak to your Adviser.

Why choose AIA?

With AIA Vitality

The ride is rewarding

Get the most out of the ride when you add AIA Vitality to any eligible insurance product and receive an initial 10% premium discount plus an array of rewards. T&Cs apply.

92% Claims paid

in 2024

$829.6M

Paid

Between 1 January and
31 December 2024.

Multi-benefit Discount

Save up to 15% on your premiums when you buy multiple eligible insurance policies.

T&Cs apply.

Financial Strength

Rating

AA

(VERY STRONG)
RATING

More about AIA Critical Conditions

FAQs

View frequently asked questions about AIA Critical Conditions insurance.

+ Expand All

Can I add AIA Vitality to Critical Conditions cover?

AIA Vitality is our personalised, science backed health and wellbeing programme that supports you every day to make healthier lifestyle choices. It takes you on a journey to better health - where you get to know your health, improve it, and enjoy the rewards for doing so.

Add AIA Vitality for $11.50 per month when you purchase trauma insurance to receive:

an initial 10% premium discount* on your first year's premium

earn up to $560 in vouchers or Airpoints Dollars™ per membership year

exclusive rewards and discounts from our partners.

*T&C's apply.

Can I claim more than once with Critical Conditions insurance?

Yes, depending on the condition and policy terms you can claim more than once. You may also be eligible for the buy back option to restore your full cover after you have made a claim.

What is a good trauma insurance amount to be covered for?

The amount of trauma insurance you need would depend on individual circumstances. It is recommended that you discuss this with an insurance adviser who will then be able to help you work out what amount you should be covered for.

Can children’s benefits be converted into their own cover?

Yes, the Built-in Children’s Trauma Benefit and Optional Children’s and Maternity Benefit can be converted into standalone or accelerated Critical Conditions cover (up to $75,000) without medical evidence, if requested within 60 days after the child turns 21.

Will I still be covered if I travel or move overseas?

Critical Conditions trauma insurance provides worldwide cover. Whether you’re at home, travelling or living overseas for any period, you remain insured.

Product Brochure

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Policy Wordings

AIA Living Trauma Personal

- +

Umbrella

Critical Conditions

Waiver Of Premium

AIA Living Trauma Business

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Umbrella

Critical Conditions

Waiver Of Premium

Disclaimer

Other things you should know: the availability of insurance cover is subject to your application being approved. All applications are subject to individual consideration. Special conditions, exclusions and premium loadings may apply. This insurance is underwritten by AIA New Zealand Limited (‘AIA’). For full details of the products and benefits offered by AIA, please refer to the policy document(s) which are available from AIA. The information contained in this publication is general in nature and is not intended as advice. It may not be relevant to individual circumstances and before making any insurance decision, you should consult a professional Adviser.

A note on exclusions and benefits
This insurance (including the built-in and optional benefits) is subject to certain stand down periods and exclusions. Please also note that the optional benefits are subject to an increase in premium and their own terms and conditions.

Terms and conditions apply
AIA Vitality is available with eligible AIA health or life insurance policies and has a monthly membership fee of $11.50 (including GST). View the full AIA Vitality terms and conditions.

Your Duty of Disclosure

When you apply for insurance with AIA New Zealand Limited, you have a legal duty of disclosure to AIA.

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