Complete Guide to Survival Period in Critical Illness Health Insurance

Even though the medical field has made exceptional advancements, people continue to succumb to severe illnesses. Conditions of the heart, kidneys, and brain and life-threatening diseases like cancer and neurodegenerative disorders are more prevalent now than before. This is due to changes in environmental conditions, lack of physical activities, poor dietary habits, and so on. Therefore, insuring your health with medical insurance is vital. As a potential policyholder, being familiar with health insurance jargon can allow for a smooth policy-buying experience. If you are looking to buy a critical illness health insurance plan, you should know what the survival period in health insurance means. Keep reading to know more about the survival period.

What Is The Survival Period In Health Insurance?

Survival period is a term indigenous to critical health insurance plans. It is defined as the duration of time a policyholder must survive after being diagnosed with a critical illness. As the policyholder, you can claim the lumpsum insured amount after riding out the designated survival period per your policy terms. 

Critical illness health insurance plans come with a survival period of 14 to 30 days. Let’s say an individual is covered under a critical illness health insurance plan with a sum insured amount of ₹50 lakh. The survival period he must ride out after the diagnoses of the illness is 30 days. Now, assume the individual gets diagnosed with cancer on 1st December 2022. The insurer will pay the individual the sum insured amount of ₹50 Lakh on or after 30th December 2022, when the survival period ends.

Cancers of specific severity, neurodegenerative diseases like Alzheimer’s or Parkinson’s, auto-immune diseases like Multiple Sclerosis (MS), Primary Pulmonary Hypertension, etc., are a few critical illnesses for which the survival period clause exists.

Major surgeries such as open chest coronary artery bypass graft (CABG), major organ transplant, heart valve replacement, etc., come under the ambit of critical illnesses. Your insurance provider may take at least two weeks to assess your diagnosis and treatments. Once the insurer is satisfied with your case and the supporting documents, they will release the lumpsum insured amount, provided you survive the survival period. Individuals diagnosed with motor neuron disorders, paralysis and total blindness, among other conditions, must also outlive the survival period. 

The Need For Survival Period In Health Insurance 

Critical illness medical insurance is a type of fixed-benefit health insurance plan. In this case, the insurance provider pays the policyholder the entire sum insured at once. The amount can cover expenses associated with various critical illnesses and ailments, be it hospitalisation, diagnoses, consultation, medication, etc. Moreover, a critical illness may often lead to job loss or permanent disability. As an insured person, you can use the sum insured to finance your everyday expenses, pay off existing debts, and live independently despite losing the steady income sources as a result of the illness. 

Critical illness health insurance plans usually come with a higher sum insured amount. This increases the insurance provider’s liability substantially. It thus becomes necessary for the insurer to ascertain whether an individual’s illness is genuine, due to the rising cases of insurance fraud. This verification typically takes time, which is why insurers add the clause of the survival period.

How Does Survival Period in Health Insurance Differ From Waiting Period?

Waiting periods and survival periods are important medical insurance terms. While the survival period applies to critical illness health plans, the waiting period applies to all health insurance policies in general, whether they are indemnity plans or fixed-benefit plans. 

What Is Waiting Period?

The waiting period in health insurance is the period of time you must wait until you can file insurance claims. Health insurance policies typically have a waiting period ranging from one month to six months. Let’s say you bought a health insurance policy today with a 30-day initial waiting period. Your insurer will reject claims made during this period (except in the case of accidental hospitalisation). After 30 days, you can enjoy your insurance benefits. The waiting period for pre-existing conditions can range from three months to four years. Maternity covers may have a higher waiting period of two to four years. 

Critical illness medical insurance policies come with both a waiting period and a survival period. You need to ride out both the waiting period and the surviving period, which may last from two to four years. However, the survival period clause kicks in only when you are diagnosed with a critical illness. All medical insurance policies have waiting periods, but not all of them come with survival periods. 

What Happens When The Insured Person Doesn’t Survive The Survival Period

If the insured person does not survive the survival period, the insurer does not pay the sum insured amount. It is also important to note that there’s no option of ‘return on premium’ on critical illness health insurance plans. The ‘return on premium’ feature is available under life insurance policies only, wherein the insurer refunds the total premium paid for the policy.

How to Waive off the Survival Period In Health Insurance?

Insurers typically do not waive off the survival period in health insurance. As the policyholder, you have to honour this period and ride it out before filing your claim. In certain extreme cases, the insurer may reduce the survival period. Some insurers also allow you to purchase add-on riders to reduce the waiting and survival periods. 

Final Note: Critical illness health insurance can be beneficial due to its lumpsum pay-outs and no end-use restrictions. However, the survival period is a necessary clause you should be aware of before purchasing the policy. Note that if a policyholder does not make it through the survival period, the insurer is not liable to pay anything to their nominees or heirs. Also, it helps to select medical insurance policies with shorter waiting and survival periods, but the costs for the same may be higher. Ensure you compare policies and make prudent decisions to secure your health.