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Through our commitment to claims excellence and innovation, our group life insurance offering takes care of the health, insurance and rehabilitation needs of our group insurance customers.
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Claims & Rehabilitation

Find out how we helped our customers in 2017.

Making A Billion Dollar Difference

See our infographic on how much claims benefits we paid to our customers in 2015.
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IN YOUR MEMBERS’ MOMENT OF NEED, WE’RE HERE

In 2017 alone, we paid over $1.3 billion in claims to both Group members and Retail clients. That’s over $5 million every working day. Because we’re here for your members when they need it.

CLAIMS WE PAID IN 2017

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Total claims benefits paid to AIA Australia clients in 2017

$1,342,027,249

$5,389,668 paid on average each working day.*

Total Permanent Disability

A lump sum amount if permanently unable to work due to accident or illness.

28.46%

Claims by condition

- +

Musculoskeletal

32.3%

Diseases of the musculoskeletal system & connective tissue e.g. Osteoarthritis, Bone Fractures & Osteomyelitis

28.2%

Other e.g. Cancer, Respiratory Diseases, Infectious Diseases & Chronic Pain

Other

Mental & Behavioural Disorders

17.4%

Mental & Behavioural Disorders

12.2%

Injury, poisoning & certain other consequences of external causes e.g. Accidents & Injuries & Substance Abuse

Injury

Nervous system

9.9%

Diseases of the nervous system e.g. Motor Neurone Disease, Alzheimer’s Disease, Multiple Sclerosis & Epilepsy

Claims by gender

- +

46.1%

Female

Gender graph

53.9%

Male

Claims by age

- +

Age graph

Crisis Recovery

Pays an agreed lump sum amount if diagnosed with a specified critical illness, such as Cancer or Heart Disease.

4.95%

Claims by condition

- +

Neoplasms

45.2%

Neoplasms e.g. Cancer

Other

21.3%

Other e.g. Respiratory Diseases, Infectious Diseases & Chronic Pain

20.0%

Diseases of the circulatory system e.g. Stroke, Hypertension & Heart Failure

Circulatory system

Nervous system

7.6%

Diseases of the nervous system e.g. Motor Neurone Disease, Alzheimer’s Disease & Multiple Sclerosis

5.9%

Unclassified symptoms, signs & abnormal clinical & laboratory findings e.g. Glycosuria

Unclassified

Claims by gender

- +

39.5%

Female

Gender graph

60.5%

Male

Claims by age

- +

Age graph

Income Protection

Replaces income during a recovery period if temporarily unable to work through illness or injury.

23.22%

Claims by condition

- +

Other

24.3%

Other e.g. Diseases of the Circulatory System, Respiratory Diseases, Infectious Diseases & Chronic Pain

23.2%

Diseases of the musculoskeletal system & connective tissue e.g. Osteoarthritis, Bone Fractures & Osteomyelitis

Musculoskeletal

Injury

23.0%

Injury, poisoning & certain other consequences of external causes e.g. Accidents & Injuries & Substance Abuse

15.1%

Mental & Behavioural Disorders

Mental & Behavioural Disorders

Neoplasms

14.4%

Neoplasms e.g. Cancer

Claims by gender

- +

53.8%

Female

Gender graph

46.2%

Male

Claims by age

- +

Age graph

Death

Ensures a lump sum payment to the family or estate in the event of death.

42.93%

Claims by condition

- +

Neoplasms

38.1%

Neoplasms e.g. Cancer

22.7%

Other e.g. Respiratory Diseases & Infectious Diseases

Other

17.1%

Unclassified symptoms, signs & abnormal clinical & laboratory findings e.g. Glycosuria, Hyperhidrosis & Dysphagia

Unclassified

Circulatory system

14.1%

Diseases of the circulatory system e.g. Stroke, Hypertension & Heart Failure

8.0%

External causes of morbidity & mortality e.g. Cause of death unknown or subject to coronial enquiry & Multiple Injuries

External causes

Claims by gender

- +

38.3%

Female

Gender graph

61.7%

Male

Claims by age

- +

Age graph

Our claims philosophy

Our claims philosophy is simple: helping people when they need it most. Our claims team adopts a professional and positive approach towards assessments and looks for ways to pay claims promptly.

We know when it comes to claims processing, timeliness and accuracy are critical to getting the experience for members right. At every opportunity we look for innovative ways to make our process as efficient as possible.

Our claims assessors take ownership of the entire claim process from start to finish. That way you know one person will be on top of the details of a claim.

We are in business to:

Pay valid claims on valid policies.
Assess each claim on its own merits.
Focus on members ability, not disability.
Be genuine, sensitive and professional in our approach.

EARLY INTERVENTION

We undertake an in-house rehabilitation assessment as soon as we can helping people sooner with their recovery journey.

Returning to work can be one of the best forms of treatment, and we can assist with specialised rehabilitation services at the right time in the recovery journey. At AIA Australia our service focuses on occupational rehabilitation – assisting people returning to work and wellness after illness or injury.
OCCUPATIONAL REHABILITATION

Our focus is on ability rather than disability and we work in partnership with medical practitioners and employers to help people return to wellness and work.

An assessment of an individual’s social situation, psychological factors and other health conditions, which includes the member, the doctor, and the employer at just the right time, helps to ensure we draw on best practice to achieve success.

We have one of the largest and highly experienced teams in the industry which includes Occupational Therapists, Rehabilitation Counsellors, an Exercise Physiologist, Psychologist and Registered Nurse.
PRINCIPLES OF BEST PRACTICE IN OCCUPATIONAL REHABILITATION

The aim of the principles-based best practice occupational rehabilitation framework (The Best Practice Framework) is to provide an evidence-based approach to the provision of occupational rehabilitation services in the life insurance industry.

The Best Practice Framework is based on contemporary research evidence and outlines six principles to guide the life insurance industry’s occupational rehabilitation services.

Find out more

Our Restorative services

Restore TM

RESTORE™

Recognising that people with mental health conditions require additional support during their recovery journey, AIA Rehabilitation developed RESTORE™ in 2013, a wellness and work readiness program to assists people with anxiety and depression incorporating local and international best practice.

Key elements of RESTORE™ include:

A routine that can assist in increasing wellness and work readiness
An exercise program to complement the treatment plan
Provision of resources to increase community engagement, tailored to their specific needs
Discussion and consideration around attending a regular support group, short term course and/or voluntary work
Identification of a long term work goal.

Restore Active TM

RESTORE Active™

RESTORE Active™ incorporates AIA Vitality into the program to assist members with complex musculoskeletal conditions.

Elements of AIA Vitality include utilisation of online assessment to develop a baseline; targeted dietetic services and nutritional counselling to assist with wellness and mindfulness to assist with recovery and pain management. In addition, graded exercise programs are developed to increase work fitness and aligned to RESTORE Active™ goals. Pain management education is included to maximise recovery as well as evidence based musculoskeletal recovery tools.

Restore Care TM

RESTORE CARE™

Incorporating learnings from RESTORE™, AIA Rehab has developed RESTORE CaRe™, a wellness and work readiness programs for individuals recovering from cancer, addressing specific challenges including fatigue, cognitive changes and other side effects.

A key element of both RESTORE™ and RESTORE CaRe™ is functional upgrading programs designed by an Accredited Exercise Physiologist or Physiotherapist to assist in the development of fitness for everyday activities and preparation for return to work. The program is designed with wellness and return to work goals in mind and tailored to the needs of the individual.

WORKING WITH EMPLOYERS

AIA Rehabilitation also works closely with Corporate Employers to design early intervention and return to work programs focused on health and wellness.

For more information contact us at au.claims-rehabilitation@aia.com

*This information is current at the date of this document and may be subject to change. AIA Australia Ltd takes no responsibility for any incorrect information (by omission or otherwise) contained in this document. This provides general information only, without taking into account your objectives, financial situation, needs or personal circumstances. Please consult a financial adviser before making any decision in relation to any financial product. You should consider such factors and view the Product Disclosure Statement, available at aia.com.au, in deciding whether to acquire or continue to hold a financial product. This document is a summary of the circumstances in which AIA Australia Ltd pays claims under these policies. The payment of claims is subject to the terms and conditions of the relevant product as summarised in the relevant PDS. *249 working days in 2017 excluding Weekends and Public Holidays