Under the medical benefit of this plan, we will not cover any of the following events or conditions that result from any of the following events:

• any treatment, investigation, service or supplies which is not medically necessary
• any pre-existing condition unless such condition, illness or disease was (1) fully and truly disclosed in the application for insurance or health statement and (2) the Company did not impose any exclusions on such condition, illness or disease in the Exclusion Endorsement
  
• self-destruction, intentional self-inflicted injury or drug abuse
  
• war or warlike operations, strikes, riots and civil commotion, any violation or attempted violation of the law or resisting arrest
  
• pregnancy, miscarriage, child  birth,  voluntary  termination  of pregnancy, or complications of them, mental or nervous disorder, except for the Mental or Nervous Disorder Benefit (see benefits schedule, item 14 for details)
  
• cosmetic or plastic surgery, dental care or surgery, corrective aids and treatments of refractive errors unless necessitated by injury caused by an accident, body checkup, gradual recovery of health or rest care
  

Under the critical illness protection of this plan, we will not cover any of the following events or conditions that result from any of the following events:

• any illnesses with signs / symptoms or surgeries triggered by the illnesses before the application of the policy unless such condition, illness or disease was (1) fully and truly disclosed   in the application for insurance or health statement and (2) the Company did not impose any exclusions on such condition, illness or disease in the Exclusion Endorsement;
• any illnesses with signs / symptoms or surgeries triggered by the illnesses within 90 days after the policy is issued;
  
• cancer of the  person protected under the policy was due to AIDS or HIV Infection; and
  
• a self-inflicted injury.
  
  

The above list is for reference only. Please refer to the policy contract of this plan for the complete list and details of exclusions.

1. Premium Adjustment
   In order to provide you with continuous protection, we will annually review and adjust the premium of your plan accordingly at the end of policy year if necessary. During the review, we may consider factors including but not limited to the following:
   1. claim costs incurred from all policies under this plan and the expected claim outgo in the coming year which reflects
      
      • applicable to the medical benefit: the impact of medical trend, medical cost inflation and product feature revisions
        
      • applicable to the critical illnessand life protection: the impact of change in the incidence rate of deaths, covered illnesses and covered surgeries
        
   2. historical investment returns and the future outlook of the product's backing asset
      
   3. policy surrenders and lapses
      
   4. expenses directly related to the policy and indirect expenses allocated to this product
      


2. Product Features Revision
   We reserve the right to revise the benefit structure, terms and conditions and / or product features of the medical benefits, so as to keep pace with the times for medical advancement and to provide you with continuous protection. We will give you a written notice of any revision before the end of policy year or upon renewal.
    

We will give you a written notice of any revision before the end of policy year or upon renewal.

The below limitations are applicable to the medical benefit:

1. Cover for specific items will be effective on the following dates (after the policy commences):
   1. Accidental injury: Immediately
   2. Illness: 30 days
   3. Investigation / treatment / surgery for tonsils, adenoids, hernias or a disease particular to female generative organs: 120 days


2. We only cover the charges and / or expenses of the person protected under the policy on medically necessary and reasonable and customary basis.
   
   “Medically necessary” means that the medical services, diagnosis and / or treatments are::
   1. delivered according to standards of good medical practice;
   2. necessary; and
   3. cannot be safely delivered in a lower level of medical care.
      
   
   Experimental, screening, and preventive services or supplies are not considered medically necessary.
   
   “Reasonable and customary” means:
   1. the medical services, diagnosis and / or treatments are medically necessary and delivered according to standards of good medical practice;
   2. the costs of your medical services and the duration of your hospital stay are not more expensive or longer than the usual level of charges or duration for similar treatment in the locality of such services delivered; and
   3. does not include charges that would not have been made if no insurance existed.
   
   We may adjust any and all benefits payable in relation to any hospital / medical charges which is not a reasonable and customary charge.
       
   
3. Except for the “Emergency out-patient treatment benefits (Accident only)” (benefits schedule, item 10) and “Long term treatment benefit” (benefits schedule, item 15), unless otherwise stated, benefit limits apply to each of the same confinement and same surgical procedure.
   


“Same Confinement” refers to two or more admissions that are due to the same or related Covered Injury or Covered Illness, or to any complications arising therefrom. Such Confinements shall be regarded as one and the same Confinement if each of them is not separated by more than 90 days from the paid or payable Confinement, which immediately precedes it. Limits for Confinement benefits shall be determined based on the aforesaid terms.

“Same surgical procedure” refers to two or more surgical procedures which are due to the same or related Covered Injury or Covered Illness, or to any complications arising therefrom. Such surgical procedures shall be regarded as one and the same surgical procedure if each of them is not separated by more than 90 days from the paid or payable surgical procedure, which immediately precedes it.

4. The person protected under the policy will be covered for any room type in which he stays at hospital, but there will be a reduction in his benefit pay-out amount in case the person protected under the policy stays in a room type which is at a higher level than the room type corresponding to the plan level chosen. In such a case, the benefit pay-out amount will be adjusted by multiplying the following factor:
   
   = Daily room charge of the room type in the hospital corresponding to the plan level chosen / Daily room charge of the room the person protected under the policy stays


5. The Personal Medical Case Management is not contractual services but the administrative arrangements offered in our absolute discretion. It is subject to termination at any time without prior notice.
   

If you wish to make a medical claim under this plan, you must notify us in writing within 20 days of the date the covered event happened, and send us the appropriate forms and relevant proof within 90 days of the same date. You can get the appropriate claim forms from your financial planner, or by calling the AIA Customer Hotline (852) 2232 8888 in Hong Kong, or (853) 8988 1822 in Macau, or by visiting any AIA Customer Service Centre.

If the person protected under the policy commits suicide within one year from the date on which the policy takes effect, our liability will be limited to the refund of premiums paid towards critical illness and life protection (without interest) less any outstanding debt.

Except for fraud or non-payment of premiums, we will not contest the validity of the critical illness and life protection of this plan after it has been in force during the lifetime of the person protected under the policy for a continuous period of two years from the date on which the policy takes effect. This provision does not apply to any add-on plan providing accident, hospitalisation or disability benefits.

• You have the right to cancel and obtain a refund of any premiums and any levy paid by giving written notice to us.
• Such notice must be signed by you and submitted to the Customer Service Centre of AIA International Limited at 12/F, AIA Tower, 183 Electric Road, North Point, Hong Kong or the Customer Service Centre of AIA International Limited at Unit 1903, 19/F, AIA Tower, 251A-301 Avenida Comercial de Macau, Macau within 21 calendar days immediately following either the day of delivery of the policy or the Cooling-off Notice to you or your nominated representative , whichever is the earlier.