What kind of deaths are covered or not covered in term life insurance?

A term insurance plan is the best way to secure your family’s financial condition after your demise. It pays the sum assured value as a death benefit to the nominee on the policyholder’s death during the policy term. In order to receive the term insurance cover amount, a claim request needs to be submitted by the nominee with necessary documents, based on which the insurer may approve or reject the claim.

Rajesh Sinha, a senior professional working with an IT firm, had purchased a term insurance policy 15 years ago worth Rs 2 crores. He had diabetes and had disclosed this condition while availing of the term plan. Rajesh was on a strict diet to keep his diabetes under control, but recently, he collapsed while working in his office. On taking him to the hospital, the doctors pronounced him dead, and the cause was a heart attack due to a sudden spike in his sugar levels. Since Rajesh had already disclosed his diabetes condition while buying the policy, his wife could get the death benefit from the insurance company without any trouble. If he had not mentioned his health condition earlier to the insurer, his claim would have been rejected.

Did you know that not all deaths are covered under term life insurance? Read on to find more on what types of deaths are covered and what kind of deaths are not covered in a term insurance plan.

Types of death covered in Term Insurance

The insurance company generally approves the claim request in case of the following death events:

• Does term insurance cover natural death? Yes, suppose the policyholder dies due to natural or due to any medical condition, critical illness, etc., within the policy term. In that case, they are usually covered by term insurance plans, and the insurance company shall pay the sum assured to the nominee.
• Does term insurance cover accidental death? Yes, term insurance plans cover deaths caused by accidents or death in the hospital after an accident. But the claim can get rejected if the policyholder was under the influence of any drug or alcohol while driving the vehicle or was involved in a crime, or was trying to escape after breaking the law, ultimately leading to the death by accident. In addition, there are accidental death benefit riders that can be added to the existing term plan, which offers an additional sum assured in case of death of policyholder due to accidents.
• Death due to pre-existing Illness: If the insured’s death is caused by pre-existing disease and if the condition is mentioned in the policy guidelines at the time of purchasing the term policy, then the death benefit would be paid to the nominee of the policyholder. But if the pre-existing illness wasn’t disclosed earlier, then the claim will get rejected.
• Death due to suicide: To answer a common question – is suicide covered in term insurance, the answer is yes, but there are certain conditions associated with it. For example, if the death of the policyholder happens due to suicide in the first 12 months of policy starting or revival, then the nominee will be entitled to receive 80% of the total premiums paid till the date of death in case of a non-linked plan and 100% in case of a linked plan. But, if the policyholder commits suicide after completion of 1 year of the policy term, the claim would not get rejected.
• Does term insurance cover pandemic deaths: Yes, if a policyholder dies due to the COVID-19 pandemic during the policy tenure, then the insurance company will settle the death benefit to the nominee since the death by COVID-19 is classified as ‘general death’.

Now, let’s know about the deaths that are not covered under a term insurance policy, and the claim request shall get rejected by the insurance company.

Types of death not covered in Term Insurance

• Death due to Natural calamities: Death of a policyholder in a natural calamity such as earthquakes, floods, cyclones, tsunami, etc., are not covered under term insurance plan unless any particular rider is availed for this purpose.
• Death due to HIV/ AIDS: The death of a policyholder due to HIV/ AIDS or any other STDs (Sexually Transmitted Diseases) during the policy term is not covered under a term insurance plan unless any specific riders are availed to provide coverage for these diseases.
• Death due to hazardous sports and activities: The term insurance plan does not cover the death of a policyholder who has participated in an adventure sport or hazardous activities such as car/ bike racing, bungee jumping, river rafting paragliding, hiking, etc. The insurance company will not approve a claim request in this regard.
• Death due to Substance abuse or Addiction: Death of the insured person due to alcohol abuse, drug overdose, or consumption of banned narcotics isn’t covered under the term insurance plan and will lead to claim rejection by the insurance company.
• Death due to Homicide: If the policyholder of a term insurance policy is murdered and investigations reveal that nominee is involved in the crime, the insurer will withhold the payout indefinitely till the case is resolved in the nominee’s favor. However, if the policyholder was involved in some criminal activity that led to death, no claim shall be paid by the insurance company.
• Death during childbirth: The term insurance policy does not cover any death that may occur to the policyholder during childbirth because of pregnancy complications. The insurer shall reject a claim request in this regard.

Hence, before buying a term insurance policy, it is essential to read through the terms and conditions of the policy, its inclusions, exclusions and then sign the agreement. Paying attention to these small details at the initial stage help save a lot of time for your family members while filing a claim request after your demise and getting the settlement amount on time, without any confusion.