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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

    • > Download pdf > Download pdf

           

    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

    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

    Claims by gender
    - +

    46.1%

    Female

    Gender graph

    53.9%

    Male

           


    Claims by age

    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

    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

    Claims by gender
    - +

    39.5%

    Female

    Gender graph

    60.5%

    Male

           


    Claims by age

    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

    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

    Claims by gender
    - +

    53.8%

    Female

    Gender graph

    46.2%

    Male

           


    Claims by age

    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

    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

    Claims by gender
    - +

    38.3%

    Female

    Gender graph

    61.7%

    Male

           


    Claims by age

    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
      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
      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
      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       

    Contact AIA

    1800 333 613

    PO Box 6111
    Melbourne VIC 3004

    infohub@aia.com

    AIA Global aia.com

    Contact AIA

    1800 333 613

    PO Box 6111
    Melbourne VIC 3004

    enquiries@aia.com.au

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    Copyright © 2021. AIA Group Limited and its subsidiaries or affiliates. All rights reserved. Priority Protection and Priority Protection for Platform Investors products are issued by AIA Australia Limited (ABN 79 004 837 861, AFSL 230043). AIA Vitality, a personalised, science-backed program that supports members every day to make healthier choices, is available with eligible products issued by AIA Australia. AIA Health with AIA Vitality is issued by AIA Health Insurance Pty Ltd ABN 32 611 323 034, a registered private health insurer governed by the Private Health Insurance Act 2207, Private Health Insurance Rules 2007 and the AIA Health Insurance Pty Ltd Fund Rules. The information on this website is current as at 14 January 2021 and may be subject to change. It is general information only and is not intended in any way to be financial, legal, tax, health, medical, nutritional or other advice. You should consider your own personal circumstances and needs and view the relevant product documents, fact sheets, fund rules and terms and conditions before making a decision to acquire such products. If necessary you should obtain professional advice from a financial, tax, medical or health professional. Unless expressly stated, any views or expressions of opinion (including any video content) do not represent the opinion of AIA.
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