Forms

Claims

Policy Administration

Premium Collection

MPF / ORSO / Macau Pension

Group Insurance

Accident Claim Form

Dismemberment Claim Form

Total & Permanent Disability Claim Form

Critical illness

Critical illness (applicable to AIA One Absolute only)

Critical Illness & Severity-based Health Protection Claim Form

Angioplasty and Other Invasive Treatments for Coronary Artery Disease

Cancer / Early Stage Malignancy

First Heart Attack / Less Severe Heart Disease

Acute Necrohemorrhagic Pancreatitis

AIDs due to Blood Transfusion

Alzheimer's Disease / Irreversible Organic Degenerative Brain Disorders

Angioplasty and Other Invasive Treatments for Coronary Artery Disease

Angioplasty or Endarterectomy for Carotid Arteries / Endovascular Treatment of Peripheral Arterial Disease

Apallic Syndrome

Aplastic Anaemia

Bacterial Meningitis

Benign Brain Tumour

Biliary Tract Reconstruction Surgery

Cancer, Early Stage Malignancy

Carcinoma-in-Situ of Breast, Cervix Uteri, Uterus, Ovary, Fallopian Tube and Vagina/Vulva

Cerebral Aneurysm Requiring Surgery

Cerebral Shunt Insertion

Chronic Adrenal Insufficiency (Addison's Disease)

Chronic Liver Disease/Liver Failure / Liver Surgery

Chronic Relapsing Pancreatitis

Cochlear Implant Surgery

Coronary Artery Surgery

Creutzfeld-Jacob Disease

Crohn's Disease

Dengue Haemorrhagic Fever (Severe Child Disease)

Diabetic Retinopathy

Down's Syndrome

Early Stage Dementia Including Early Stage Alzheimer's Disease

End Stage Lung Disease

Facial Reconstructive Surgery for Injury due to Accident

First Heart Attack / Less Severe Heart Disease

Fulminant Viral Hepatitis

Glomerulonephritis With Nephrotic Syndrome (Severe Child Disease)

Heart Valve Replacement

Infective Endocarditis

Insulin Dependent Diabetes Mellitus

Intellectual Impairment Due To Sickness or Injury

Kawasaki Disease with Heart Complications

Loss of Hearing

Loss of Independent Existence

Loss of One Limb and One Eye

Loss of Sight in One Eye

Loss of Two Limbs

Major Head Trauma

Major Organ Transplant

Medullary Cystic Disease

Mother & Child Benefits

Motor Neurone Disease

Multiple Sclerosis

Muscular Dystrophy

Necrotising Fasciitis

Occupational Acquired HIV

Osteogenesis Imperfecta - Type III

Other Serious Coronary Artery Disease

Parkinson's Disease

Pheochromocytoma

Progressive Supranuclear Palsy

Pulmonary Arterial Hypertension

Rheumatic Fever With Valvular Impairment (Severe Child Disease)

Rheumatoid Arthritis

Serious Infectious Disease

Severe Central or Mixed Sleep Apnea / Severe Obstructive Sleep Apnea

Severe Haemophilia (Severe Child Disease)

Severe Myasthenia Gravis

Severe Myocarditis

Severe Psychiatric Illness

Severe Rheumatoid Arthritis

Severe Ulcerative Colitis

Still's Disease

Surgery to Aorta

Surgical Removal of One Lung

System Lupus Erythematosus (S.L.E.) with Lupus Nephritis

Systemic Scleroderma

Terminal Illness

Tetralogy of Fallot

Type I Juvenile Spinal Amyotrophy (Severe Child Disease)

Urinary Incontinence Requiring Surgical Repair

Wilson's Disease (Severe Child Disease)

Confidential Medical Certificate: Severity-based Health Protection

Severity-Based Health Protection Supplementary Form

Application Form for Death Claim (Claimant's Statement)

Supplementary Information of Claimant

Application Form for Death Claim (Physician's Statement)

Network Surgery / Medical Claim Form

Medical Expense Pre-approval Form (for treatment in Hong Kong/Macau/Mainland China/Taiwan) - Traditional Chinese/English

Medical Expense Pre-approval Form (for treatment in Hong Kong/Macau/Mainland China/Taiwan) - Simplified Chinese

Medical Expense Pre-approval Form (for treatment overseas)

Cancer Genomics Test Supplementary Form

Travel Insurance Claim Form

Other claim types

Miscellany

Accident & Health Claim Form (Domestic Worker Insurance)

Property Damage and Loss Claim Form

Accidental Death Benefit Claim Form (AIA Dining Cover)

Individual Life & Group Claims Arrangement Form

Request for Return of Original Document(s) Form

Application for Transfer of Money by Wire Transfer

Letter of Consent / Authorization Form for Attending Physician's Statement / Medical Record

Financial Needs Analysis Form (For Macau Only)

Premium Repayment For Premium Holiday

Request for Investment-Linked / Universal Life Plan Services (Applicable to applications submitted by customers only)

Request For Premium Holiday Form

Request For Investment- Linked Assurance Scheme ("ILAS") Services (For Cheerful Life / U-Select / AIA 2-in-1 Protection Linked Plan (Single Premium)("2-in-1") only) (Applicable to applications submitted by customers only)

Risk Profile Questionnaire

IMPORTANT FACTS STATEMENT AND APPLICANT'S DECLARATIONS INVESTMENT LINKED ASSURANCE SCHEME ("ILAS") POLICY Name of the ILAS Policy: Staff Privilege – AIA 2-in-1 Protection Linked Plan (Single Premium) (FOR HONG KONG POLICIES ONLY) Request for Lump Sum Premium

Agreement And Assignment Of Policy As Collateral Security For Mortgage Loan

Agreement And Assignment Of Policy As Collateral Security For Overdraft Facility

Amendment / Supplementary To Financial Needs Analysis "FNA" Form

Annuity Request Form (Applicable to Leisure Years Retirement Savings Plan)

Annuity Request Form (Applicable to Wiz Kid Education Savings Plan /Better Tomorrow Investment Savings Plan / AIA 10-Year Interest Plus Annuity Account Plan /AIA Interest Safeguard Annuity Account)

Application Form for Standing Instructions

Collateral Security For Personal Loan

Customer Declaration for Policy Replacement (Chi)(Macau)

Customer Declaration for Policy Replacement (Eng)(Macau)

Critical Illness Product - Per Life Maximum Benefit Declaration Form (Macau)

Declaration of Customers Understanding on Premium Information (Macau)

Entity Classification Declaration Form Under The U.S. Foreign Account Tax Compliance Act (FATCA)

Financial Needs Analysis Form

Health Certificate (NOT Applicable for Wealth Series)

Health Certificate (Only Applicable for Wealth Series)

Important Facts Statement And Applicant's Declarations ILAS Policy (Macau) - Treasure Advantage 2 (CHI)

Important Facts Statement And Applicant's Declarations ILAS Policy (Macau) - Treasure Advantage 2 (ENG)

Important Facts Statement for Mainland Policyholders ("IFS-MP")

Important Facts Statement for Mainland Policyholders ("IFS-MP")-Macau

Important Notes and Risk Disclosure on Assignment of Life Insurance Policy

Notice Of Release Of Assignment

Policy Lost Declaration

POS Supplementary Form

Premium Offset Option Quotation Form

Request for AIA e-advice Service

Request For Application / Change Of FPS / e-BankIn (Applicable to Hong Kong Policy Only)

Request for Change Form / Subsequent Application for Personal Accident Contract

Request for Change Form for Personal Lines Products

Request for Change Form of Basic Plan / Supplementary Contract

Request for Change of Beneficiary and Appointment of Trustee of a Minor Beneficiary

Request for Change of Beneficiary / Signature / Ownership / Trustee

Request Form for Change of Address / Telephone Numbers / E-mail Address / Apply "AIA e-Advice"

Request for Change of Insured under Newborn Option Form [Only applicable for Simply Love Encore 3]

Request for Change of Insured Form

Request for application / Change Of e-BankIn (Applicable to Macau Policy Only)

Request for designation / Removal of contingent insured form

Request for Registration/Change/Termination of The Designated Person Form

Request For Return Of Original Document(s)

Self-Certification Form – Controlling Person (FOR HONG KONG)

Self-Certification Form – Controlling Person (FOR MACAU)

Self-Certification Form – Entity (FOR HONG KONG)

Self-Certification Form – Entity (FOR MACAU)

Self-Certification Form – Individual (FOR HONG KONG)

Self-Certification Form – Individual (FOR MACAU)

Severity-based Health Protection Product－Per Life Maximum Benefit Declaration Form (Macau)

Policy Loan Agreement with Assignment of Policy And Agreement As to Interest

Policy Account Value Request Form

Request For Cash Surrender Form

Policy Account Value Request Form

e-BankIn and Direct Debit Authorisation For Bank Account Application

Direct Debit Authorisation For Credit Card Account

Direct Debit Authorisation For Levy payment

OCBC Wing Hang Bank Limited (Applicable to Macau Policy Only)

HSBC (HKD Account) (Applicable to Macau Policy Only)

HSBC (MOP Account) (Applicable to Macau Policy Only)

Bank of China (Applicable to Macau Policy Only)

China Construction Bank (Applicable to Macau Policy Only)

Industrial and Commercial Bank of China (Applicable to Macau Policy Only)

Should you need assistance in filling out the form(s), please contact our AIA Representatives or call AIA Customer Hotline at (852) 2232 8888 / Macau Customer Hotline (853) 8988 1822.

Please submit your claim application to our AIA financial planner / your broker / IFA or send it to us at the following address:

HK: AIA Wealth Select Centre, 12/F AIA Tower, 183 Electric Road, North Point, Hong Kong
Macau: Unit 201, 2F, AIA Tower, Nos. 251A-301, Avenida Comercial de Macau, Macau