Does your term insurance cover coma and its aftermath?

Individuals should prioritise pure-term life insurance as their first line of defence to secure their overall financial plan. This plan will ensure that in the event of the policyholder’s demise during the term, their nominee gets the sum assured from the insurance company. 

However, what happens if the policyholder goes into a coma during the policy term? Basically, term plans don’t pay any maturity benefits if the policyholder survives during the policy term. 

Rakesh Goyal, Probus Insurance Broker Director, said that Individuals in a coma experience a protracted loss of awareness. This can occur for various reasons, including a head injury, stroke, brain tumour, etc. “People in a coma are conscious but unable to move, be aware of, or respond to their surroundings. They lose their cognitive capacities while maintaining non-cognitive processes and normal sleep patterns. Now, one can predict how long they will remain in such a position. However, if the policyholder has a critical illness rider (which covers coma), he can get the benefits during the policy period. Riders are optional and add-on covers offered by the insurance companies over and above the base term life insurance coverage.” 

While buying the critical illness rider, policyholders need to pay a certain amount (which varies from one insurer to another) apart from their term insurance premiums. This will ensure that, in any diagnosis of the critical illness rider, the insurer will pay the policyholder a lump sum amount. 

However, before purchasing any rider or add-on protection, reviewing the exclusions and inclusions is important. Riders for critical sickness provide financial assistance for medical expenditures and lost income. However, one must review all the terms and circumstances before zeroing the rider for the base term plan. 

“If the policyholder has no riders for critical illness coverage and is in a coma, the policy will continue as long as premiums are paid on time. Nothing will be paid to them if the policyholder survives the policy term. But if the policyholder passes away in between, the family will get the sum assured. However, the claim process is simple if you have the rider and are in a coma. As with any other claim, the policyholder's family member or agent must alert the insurance company of the sickness. Later, they must also provide all essential documents to expedite the claim process,” Goyal explained. 

The insurer will offer the insured a lump sum or make periodic payments based on the rider- option. However, remember that the claim will most likely be denied if the coma was caused by pre-existing diseases that the policyholder failed to notify the insurance company. 

So, suppose the policyholders are worried about other illnesses while buying the term cover. In that case, they should buy the rider of critical illness, which will cover major diseases and get tax benefits on the premiums.