Does Health Insurance Cover Coma?

Last Updated : March 14, 2022, 4:22 p.m.

Coma is a long unconscious state during which you’re unresponsive to your environment. It is a critical illness that can last for one day or even years based on the case. The Insurance Regulatory and Development Authority of India (IRDAI) defines a coma as a state of unconsciousness without reaction to external stimuli. You can be diagnosed with a coma in the following cases:

• If you don’t respond to external stimuli for a continuous 96 hours
• When the medical practitioner advice o put you on life support for your survival
• If you undergo a permanent neurological deficit. This is diagnosed after 30 days of the onset of coma
• The medical practitioner should confirm Coma in writing before the insurer will cover you for the same.

Read this page and know more about the health insurance cover for Coma.

Companies That Offer Health Insurance Cover for Coma

Bajaj Finserv offers Accidental Coma Cash from Manipal Cigna Health Insurance under its FlexiCare Group Insurance Policy. For the rider cover, your age should be between 18 and 65 years. The tenure for this cover is one year. INR 5,000 per week shall be payable for seventy days during the policy year in case you suffer an injury caused solely and directly due to an accident resulting in Coma. The cash benefit will be payable up to the specified limit as shown in the policy schedule, provided the diagnosis of coma is supported by –

• No response to external stimuli for 96 hours
• Life support measures become necessary
• Permanent neurological deficit after the onset of Coma
• A specialist medical practitioner confirming Coma
• It is not caused due to alcohol or drug abuse or due to an illness

Manipal Cigna provides Coma Benefit in its accidental health insurance policies wherein, you will get 25% of the sum insured as a lump sum when you’re in Coma due to an accident.

Star Criticare Plus Insurance provides coverage for an established irreversible coma. The insurer will cover this under major illnesses. Under this health insurance policy, people aged 18 years and above will be covered.

ICICI Lombard also covers Coma in its critical illness insurance plan. In this, the insurer will pay a lump sum amount for the treatment. Coma of specified severity will be covered under this. So, read the policy brochure carefully while buying a health insurance plan.

What are the Causes of Coma?

You can suffer from Coma due to the following –

• Traumatic brain injuries caused due to an accident
• Heart attack can reduce blood supply to the brain that can result in a burst of blood vessels or blocked arteries
• Too high or too low sugar levels
• Brain tumors
• In case you’re suffering from a lack of oxygen in the brain
• Seizures
• Brain swelling due to meningitis and encephalitis
• Exposure to toxins such as lead, carbon monoxide, etc.
• Overdose of drugs or alcohol

What are the Symptoms of Coma?

Some of the common signs and symptoms of coma are –

• Breathing issues
• Closed eyes
• Paralysis of limbs
• Pupils non-response to light
• No response of the body to painful stimuli, except for reflex movements

Treatment of Coma in India

This is a serious medical emergency, and its treatment depends on the extent of the illness/injury. If you’re diagnosed with an illness/injury, you should rush to the hospital because any delay can make matters worse. After examining your airway, the doctor can help regulate the ventilation to circulation, provide blood transfusions, breathing assistance, and other supportive care to the patient. The treatment of Coma includes –

• Intravenous injection of glucose for Hypoglycemia,
• For an overdose case, intravenous injection of naloxone
• For a blood clot between the brain and its lining, surgical treatment
• Antibiotics in case of the infection