Financial Hardship Form

We're here to help

If you're experiencing financial difficulty, please submit the form below and we'll be in touch shortly to discuss your options.

First name *

Last name *

Email Address *

Phone number *

Policy number (if known)

Are you currently in paid employment? *

Yes

Do you have another life insurance policy with AIA? *

Yes

Other

If you are currently unemployed / not receiving income how long has this been the case? *

0-3 months

3-6 months

6 months+

I have read and understood AIA Australia’s privacy policy. I acknowledge and consent to the collection, use and disclosure of my personal information as detailed in the privacy policy.

Please agree with above statements

Thank you ,Thank you

We will contact you soon.,We will contact you soon.