Terminal Illness Vs Critical Illness - What Is The Difference?

by SMCIB on Monday, 27 May 2024

Terminal Illness Vs Critical Illness - What Is The Difference?

In recent years, there has been an increase in illnesses across India. A recent health report highlights a surge in non-communicable diseases (NCDs), with cancer cases growing rapidly. The 4th edition of Apollo Hospitals' Health of Nation Report on World Health Day 2024 revealed alarming statistics: 1 in 3 Indians is pre-diabetic, 2 in 3 are pre-hypertensive, and 1 in 10 suffers from depression.

Among these chronic diseases, there is often confusion between terminal illness and critical illness. Terminal illness refers to a disease with no known cure and eventually leads to the death of the patient. On the other hand, critical illness means severe health conditions that may be life-threatening but could potentially be treated or managed. In this article, we aim to clarify these two distinctions for your better understanding. Let's delve in!

What Is Terminal Illness?

A terminal illness, also known as end-stage disease, refers to a medical condition or illness, as determined by a medical professional, that cannot be cured or effectively treated. Such illnesses are expected to lead to the eventual death of the patient in around 6 months. Examples include advanced stages of cancer, late-stage heart failure, etc.

What Is Critical Illness?

Critical illness refers to any severe sickness or disease that seriously affects a person's health and requires urgent medical attention. Unlike common ailments, critical illnesses demand immediate treatment and typically involve higher medical expenses. If left untreated, a critical illness can progress to become a terminal illness. Examples include heart attacks, strokes, major organ transplants, severe trauma, etc.

Now, let’s differentiate terminal illness and critical illness to get a better understanding -

Terminal Illness Vs Critical Illness

Below is a table showing how terminal illness and critical illness differ in terms of various aspects -


Terminal Illness

 Critical Illness


A terminal illness is when a disease or condition reaches an advanced stage with no known cure and is expected to result in the patient's death within six months.

Critical illness refers to a serious health condition that poses a significant threat to a person's life and often requires intensive medical intervention. These conditions are typically acute and can lead to severe complications if not promptly treated.


Conditions like advanced cancer, heart disease, lung disease, liver disease, motor neuron disease, neurological disease, dementia, stroke, and HIV/AIDS fall into this category.

Examples include heart attacks, strokes, cancer, organ failure, severe burns, coma, paralysis, multiple sclerosis, and liver transplant.


Treatment aims to manage symptoms, enhance quality of life, and provide supportive care rather than seeking a cure.

While critical illnesses may not always result in death, timely diagnosis and management are crucial to mitigate their impact on health. However, ongoing medical care may be necessary.


Terminal illness typically carries a below average prognosis, offering no hope of recovery.

Although critical illness can have a below average prognosis, there remains a chance of recovery with appropriate treatment.

As we discussed before, there are certain types of coverage designed to help with these illnesses and the two common options are the terminal illness rider and critical illness insurance policies. Let's take a closer look at what they offer.

What Is A Terminal Illness Rider In A Term Insurance Plan?

A rider is an optional benefit you can choose to add to your base term insurance policy for an additional cost. These riders come into play during specific situations, giving you extra financial support when you are facing certain risks.  A term insurance plan offers various riders like critical illness rider, accidental disability rider, hospital care rider, etc., and a terminal illness rider is one of them.

The terminal illness rider lets you get the term insurance payout before you pass away prematurely. This means that if you are diagnosed with a terminal illness, you can receive a part of the death benefit while you're still alive.

How Does Terminal Illness Benefit Work In Term Insurance?

If you are worried about your family's financial well-being after your passing and want to safeguard their finances, considering terminal illness coverage is advisable.

Terminal illnesses, such as paralysis, brain tumours, organ failure, and others, are frequently incurable, and patient survival chances significantly decrease during such circumstances. Hence, securing terminal illness medical coverage is a prudent step to ensure your family's financial stability.

When you have this benefit, if you get diagnosed with a listed terminal illness, you can get a part of the total term insurance coverage before you pass away. This amount is given to you while you are still alive, and it is deducted from the overall death benefit you chose for your policy.

Then, when you do pass away, the remaining part of the term insurance money goes to your family or beneficiaries. The insurance company decides how much of your death benefit you can get in advance, but usually, it is a portion of the total death benefit. The idea behind this benefit is to help you cover medical expenses and other associated costs while you are still around.

What Is A Critical Illness Insurance Plan?

Individuals with a family history of critical illness should consider investing in critical illness coverage to protect themselves financially.

In today's world, the prevalence of diseases such as heart attacks, kidney failure, organ transplant, strokes, etc. are increasing. Therefore, obtaining critical illness medical coverage is a wise decision.

A critical illness rider is like an extra coverage you can include with your life insurance plan in India. It kicks in if you get diagnosed with certain serious illnesses or conditions listed in the policy. If you get diagnosed with one of these illnesses while the rider is active, you will receive a lump sum of money. This payout is different from the death benefit that your life insurance provides to your loved ones when you pass away.

What Is Not Covered By The Critical Illness Insurance Cover?

Listed below are some of the situations that are not covered under the critical illness insurance policy –

  • Adventure Sport Injuries
    Enjoying adventure sports can be thrilling, but accidents during these activities can be risky. The policy will not cover any accidents that happen while you are participating in adventure sports.
  • Self-Inflicted Injuries
    The policy does not cover injuries that you intentionally inflict on yourself.
  • War
    Wars bring devastation, but unfortunately, the policy does not cover any claims arising from war-related incidents.
  • Participation In Defence Operations
    If you are involved in military operations (Army/Navy/Air Force), the policy will not cover accidents resulting from them.
  • Sexually Transmitted Diseases
    Unfortunately, the policy does not provide coverage for illnesses transmitted through sexual contact.
  • Obesity Or Cosmetic Surgery Treatment
    Procedures related to obesity or cosmetic surgery are not covered under a critical illness insurance policy.

Note: The terms and conditions for both terminal and critical illness covers can vary across insurance companies.

To Conclude,

Both terminal illness and critical illness insurance plans serve important roles in providing financial protection during tough times. Terminal illness coverage offers support when facing a life-limiting condition, ensuring financial help for medical expenses and peace of mind for loved ones. On the other hand, critical illness coverage provides a safety net for severe health conditions, offering financial assistance for treatment and recovery. Understanding the differences between these two types of coverage helps individuals make informed decisions to safeguard their health and financial well-being.

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