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What are Life Insurance Exclusions? 

Life insurance exclusions refer to the specific circumstances or situations in which the insurance company will not provide coverage or pay out benefits to the policyholder or their beneficiaries. These exclusions are typically listed in the policy contract and can vary depending on the insurer and type of policy. It is important for policyholders to understand these exclusions before buying a life insurance plan to make sure that they have sufficient coverage for their needs. 

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Most Common Exclusions in Life Insurance

Here is a list of all the most common exclusions in life insurance offered by Indian insurers:

  1. Suicide Claims

    Most life insurance companies in India do not cover death due to suicide within the 1st year of the policy issuance or revival. The exact period for which death due to suicide is not covered under the policy might differ from insurer to insurer, but the general range is between 12 months to 2 years. During this period, if the policyholder commits suicide, the insurer will not pay the sum assured on death, instead will return a percentage of the premiums paid. Usually, the insurers return 80% of the total premiums paid until the death of the policyholder. You should go through your policy documents to get a better understanding of the suicide exclusions in life insurance.

  2. Life-threatening Activities

    Life-threatening activities or hobbies are generally not covered under life insurance. This is because these activities put you at a higher risk of life and increase your mortality rate. These activities include adventure sports like skydiving, paragliding, rock climbing, racing, and hang gliding. 

  3. Maternity-related Deaths

    Deaths caused due to maternity-related reasons like complications during pregnancy are a part of the life insurance exclusions and are not covered under life insurance.

  4. War/War-related Acts

    These exclusions in life insurance might have been less common in the older days than it is now, but a life insurance policy will not payout the death benefit in case the policyholder participates in war or war-related acts. 

  5. Aviation-related Deaths

    Insurance companies in India only cover aviation-related deaths in commercial planes. In case the policyholder suffers an air crash and unfortunately dies, the insurer is not obligated to pay out the sum assured on death.

  6. Natural Calamities

    Deaths due to natural disasters or calamities like earthquakes, hurricanes, tsunamis, and floods are usually life insurance exclusions. Thus, in case the policyholder dies due to any of the natural calamities, the nominee will not be paid the life cover amount. However, in case you live in a calamity-prone area, you can opt for specific riders in your base life insurance plan to cover you against natural disasters as well.

  7. Murder

    Deaths due to homicide are also not covered under the life insurance policy. In case the nominee of the policy is revealed to have committed or have involvement in the murder of the policyholder, the insurance company will not pay the sum assured. If the allegations against the nominee are lifted after legal investigations, the insurer might pay out the life cover amount.

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Life Insurance Exclusions in Case of Accidental Death

Let us take a look at some of the exclusions in life insurance for which the insurance company might reject your accidental death claims:

  1. Pre-existing Diseases

    Life insurance policies in India do not provide coverage against pre-existing diseases and ailments. Only the critical illnesses diagnosed after the policy purchase that are included in the policy document are covered under the policy.

  2. Participating in Criminal and Illegal Activities

    All life insurance policies in India do not provide coverage in case the policyholder performs a criminal or illegal activity. These unlawful activities include driving under the influence of alcohol or drugs, consuming illegal drugs, injury or death due to a car accident where the driver not wearing a seatbelt or was speeding, participating in illegal protests, etc.

  3. Sexually Transmitted Diseases

    STDs like HIV, AIDs, or other diseases caused due to lifestyle choices are excluded from life insurance coverage. Thus, life insurance claims on deaths due to STDs might be rejected by the insurance company.

Other Reasons Why Life Insurance Claims Are Rejected

Here is a list of all the life insurance policy rejection reasons:

  • Providing Incorrect Information: Providing the insurer with incorrect information at the time of policy purchase can result in life insurance claim rejection. This includes the details provided regarding age, medical conditions, or smoking habits.

  • Contestability Period: As per the IRDAI, the insurer can cancel the life insurance policy within the first 2 years of policy purchase/renewal if there is a discrepancy found in the details provided by the customer. During this period, the insurer can investigate the death claims and even deny them.

Note: Since a term insurance plan is a type of life insurance, the list of term insurance exclusions is similar to the exclusions in life insurance.

Wrapping it Up!

As seen above, while life insurance is an important financial product that offers a variety of benefits to the policyholder and covers a range of deaths/eventualities, it still has some exclusions. Thus it is important to always take a thorough look at the policy documents to get a better understanding of all the inclusions and exclusions of life insurance in India.

Note: It is suggested to calculate the term plan premium on the term insurance premium calculator online tool by Policybazaar before buying.

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