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Does Health Insurance Cover Coma?

Learn how health insurance handles coma coverage, including the role of critical illness riders and policy terms. Understand your coverage options and the importance of timely premiums.

  • 10 Sep 2024
  • 3 min read
  • 41 views

During a coma, a person is unresponsive to his/her surroundings for an extended period. Some causes of comas include diabetes, a lack of oxygen, seizures, strokes, and traumatic brain injuries. Depending on its severity, the condition may last for a single day or even several years. Hence, the question, "Does health insurance cover coma?" comes to the fore. Let's look at the factors that define the answer to this common query.

Is Coma covered by Health Insurance?

  • An optional supplement to a health insurance policy is a critical illness rider. It offers coverage for specified critical illnesses or medical conditions when added to an insurance policy. If one of these conditions gets diagnosed while the policy is in effect, the policyholder may be eligible for a lump sum payment that will help with any associated medical costs or other needs.
  • In the absence of a critical illness rider, the insurance policy will continue to be in effect if the policyholder slips into a coma as long as the premiums get paid on time. As long as the premiums are up to date, the policy remains in effect even if the policyholder remains unconscious.
  • Usually, no benefit is paid out if the policyholder lives through the policy term (that is, he/she is still alive when the policy term expires). But if the insured person passes away during the tenure of the policy, the beneficiary receives the sum assured. If the insured person lives past the term of the policy, there will be no payout or return of premiums.

Conclusion

A coma is a serious medical emergency whose treatment depends on the extent of the illness. A person who has been diagnosed with the illness should be rushed to the hospital as soon as possible, as a delay may worsen the situation. It is always advisable to have an insurance policy for such emergencies.

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Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

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