Health Insurance After Policyholder Dies
  • Understanding Policy Terms & Conditions
  • Health Insurance Death Clauses
  • Kinds of Health Insurance That Covers Death
Health Insurance After Policyholder Dies
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What Happens To Health Insurance After Policyholder Dies?

Have you ever wondered, what happens to health insurance after the policyholder’s death? India is witnessing a constant uprise in multiple lifestyle-related diseases such as heart attacks, strokes, diabetes, respiratory ailments, etc.

Treatments for life-threatening diseases result in hefty medical bills as the treatments are expensive and can drain you financially. Health Insurance plans are built to help you combat medical ailments without breaking the bank.

However, what happens to the health insurance after the policyholder’s demise? A question many ask when purchasing a health insurance plan. Most of you are not aware of the death benefit clause mentioned in health insurance plans.

What does that imply? Does health insurance cover death? Let us find out together.

Review Your Policy Documents For Death Benefit

To cross-check whether your health insurance consists of death benefits, understand that the terms and conditions may vary with different categories of health plans. You must ensure that your family members are also covered under the health insurance plan, after your demise.

Each health insurance plan provides different features which we will understand with an example:

Mr. Nishant and Mr. Gaurav purchased a family floater and an individual health plan respectively.

During the policy tenure, Mr. Nishant faced an accident that led to his unfortunate demise. Since he was a family floater health plan holder, his coverage continued and provided financial security to the other covered members of the family mentioned in the policy.

However, when Mr. Gaurav passed away due to an accident his health plan was terminated but the claim amount was provided to his beneficiary (his wife). The claim covered all the hospitalisation costs, and medical bills calculated during Mr. Gaurav’s treatment.

Now we understand how different health insurance plan categories provide different features. Now, let’s find the answer to the main question ‘Does health insurance cover death?’

Health Insurance Categories and Do They Cover Death?

Read below to understand the impact of the death of a policyholder on each category of health insurance plan available in the market.

  1. Individual Health Insurance

    An individual health insurance plan is liable to cover only one individual. Under an individual health plan, you are entitled to the full amount of the health insurance plan for hospitalisation, daycare, AYUSH, and many other healthcare features.

    Death benefit

    In case of the individual policyholder’s demise, the policy will be terminated. In such a scenario, the family members of the insured individual can raise a claim if the policyholder dies during hospitalisation.

    However, if the policyholder opts for a second insured member under the individual plan, the second insurance member continues to receive health insurance benefits even after the policyholder’s demise.

  2. Family Floater Health Insurance

    A family floater health insurance covers multiple family members under a single sum insured which is shared by all family members till exhaustion within a policy term.

    Death benefit

    In case the primary policyholder passes away, other family members will be covered under the health insurance plan. However, if the primary policyholder paid premiums, the health insurance provider must be intimated immediately.

    This allows the health insurer to update the policy details of the primary policyholder.

  3. Group Health Insurance

    Group health insurance is a health cover provided to you by your employer. The health insurance plan benefits and features are decided by the employer as per the overall requirements of its employees.

    The group health insurance is similar to a family floater health plan, with the employer having major control over the health plan.

    Death benefit

    In case of the employee’s demise, the group health insurance policy will be terminated for the insured individual. The dependants do not receive any coverage unless mentioned in the health insurance policy.

    If the health insurance plan compensates for the death of the employee, it will be provided to the nominee.

  4. Critical Illness Health Insurance

    Critical illness health insurance covers you against the listed health ailments in a policy schedule. The health ailments can range from cancer, strokes, neurological disorders, heart ailments, etc. This category of health insurance will offer you a lump sum amount on diagnosis of any critical ailment covered under the policy.

    Critical illness health insurance requires you to survive for a particular amount of time before the coverage is activated. This period is known as the ‘survival period’.

    Death benefit

    In case of the unfortunate demise of the policyholder within the survival period, there is no death benefit or coverage sum insured paid to the nominee and the policy is terminated.

  5. Senior Citizen Health Insurance

    A senior citizen health insurance plan covers you if you are above 60 years old. This category of health insurance is similar to an individual health insurance plan.

    Death benefit

    In case of the unfortunate demise of the policyholder, a senior citizen's health insurance plan is terminated automatically. The health insurance provider covers you only for the treatments availed but not for a death benefit.

Summing It Up

It is necessary to understand the death clause in your health insurance plan to figure out what happens to health insurance after the policyholder dies. This information is crucial for you and your family members, regardless of the category of health plan you have opted for.

It is also unfair to assume that all health insurance plans come with a death clause or will provide continued coverage after the policyholder’s demise. Make an informed decision by reading all the terms and conditions carefully or connect with our insurance experts at PolicyX.

What Happens To Health Insurance After Policyholder Dies: FAQ's

1. Does a health insurance plan cover death?

A health insurance plan typically only covers policyholders for treatments availed or in case of an emergency or planned hospitalisation. However, there is a death clause mentioned in selected health insurance plans. In a family floater plan, in case of a policyholder’s demise, the coverage continues with updated details of the primary policyholder.

2. Can you change the health insurance policy details in case the policyholder is no longer around?

If you want to update the health insurance policy features like sum insured, addition or removal of family members you will have to wait till policy renewal. However, you are required to inform your health insurance provider in case of the primary policyholder’s demise.

3. How to claim health insurance in case the spouse passes away?

In case of the unfortunate demise of your spouse, you can claim expenses for medical treatments availed by your spouse if he/she was covered under your health insurance policy.

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Simran Kaur Vij

Written By: Simran Kaur Vij

Simran is an insurance expert with more than 3 years of experience in the industry. She may have all the answers to your insurance queries. With a background in Banking, she proactively helps her readers to stay on par with all the latest Insurance industry developments.