A medical emergency is hard enough without confusion over who receives your insurance claim. If you are hospitalised and unable to file the claim yourself, your family should not have to struggle through paperwork to get the support they need. Naming a nominee solves this problem and protects the people who depend on you.
Who Is a Nominee in Health Insurance?
A nominee is the person you choose to receive your health insurance claim if you are unable to receive it yourself, most often because you have passed away during treatment or before a pending claim is settled. You name your nominee in the proposal form when you buy the policy, and you can change this choice at any time during the policy period.
Nomination is a long-standing right in Indian insurance law, first set out for life insurance under Section 39 of the Insurance Act, 1938. The Insurance Regulatory and Development Authority of India (IRDAI) also requires general and health insurers to record your nominee's details when you buy or renew a policy.
Why Does Your Health Insurance Need a Nominee?
Naming a nominee gives your family quick, clear access to your claim amount when they need it most, and helps your coverage work the way you intended.
Faster claim settlement: your insurer can release the funds directly to your nominee, without waiting to identify your legal heirs.
Fewer legal hurdles: without a nominee, your family may need a legal heir certificate or succession certificate from a court before they can claim the amount.
Financial support when it matters: your nominee can use the funds for hospital bills, outstanding dues, or other urgent family needs.
Fewer disputes: a clearly named nominee reduces the scope for disagreement among family members over who should receive the claim.
Nominee vs Legal Heir vs Beneficiary: What Is the Difference?
These three terms are often used interchangeably, but they mean different things under Indian law.
Your nominee is the person named in your policy to receive the claim amount on your behalf. In most cases, your nominee holds this amount as a custodian and is expected to pass it on to your legal heirs.
Your legal heirs are the people entitled to your assets under a will or personal succession law, such as your spouse, children, or parents.
If your nominee is also your spouse, child, or parent, an amendment to the Insurance Act allows them to be treated as a beneficial nominee, meaning they may be entitled to keep the payout rather than pass it on. However, courts have clarified that this right is not absolute. If other legal heirs come forward with a valid claim, the nominee's right to keep the funds must give way to personal succession law. Naming a nominee who is also your intended legal heir helps you avoid this kind of dispute.
Types of Nominees in Health Insurance
You can choose from a few different types of nominees, depending on your family's situation.
Single nominee: one person, such as your spouse or a parent, who receives the full claim amount.
Multiple nominees: two or more people who share the claim amount in percentages you decide, such as 60% to your spouse and 40% to your child.
Minor nominee: a nominee below 18 years of age. If you nominate a minor, you must also appoint an adult appointee who will receive and manage the funds on the minor's behalf until they turn 18.
Beneficial nominee: your spouse, child, or parent, who may be entitled to keep the claim amount under the 2015 amendment to the Insurance Act, subject to the legal position explained above.
How to Add or Change a Nominee in Your Health Insurance
You can name or update your nominee at several points during your policy.
At the time of purchase: add your nominee's details in the proposal form when you buy your policy.
During the policy term: send a written request or email to your insurer with the updated nominee details.
At renewal: most insurers let you review and edit nominee details when you renew your policy online.
To add or update a nominee, you will usually need to share their full name, date of birth or age, relationship to you, and a valid identity proof, such as an Aadhaar card or PAN card.
How to Choose the Right Nominee
Your nominee should be a trusted person who will act in your family's best interests.
Choose someone financially dependent on you, such as a spouse, child, or parent, so the funds reach the person who needs them most.
Consider naming someone who is also your legal heir to avoid disputes between your nominee and other family members.
Check that they can manage the paperwork, since your nominee will need to handle documents and coordinate with your insurer.
Keep their contact details and identity proof updated in your policy records to avoid delays during a claim.
Review your choice after major life events, such as marriage, the birth of a child, separation, or the death of your existing nominee.
Common Challenges Nominees Face and How to Resolve Them
Incorrect or outdated details. If the name on your policy does not match your nominee's identity proof, the claim can be delayed. Check the spelling against their Aadhaar card or PAN card, and update your policy if anything changes.
Nominee passes away before the claim. If your nominee dies before you, your nomination becomes invalid. Update your policy with a new nominee as soon as possible to avoid this gap in cover.
Nominee is a minor. A minor cannot receive or manage the claim amount directly. Always name an adult appointee alongside a minor nominee so the funds are managed responsibly until they turn 18.
Conclusion
A nominee is one of the simplest ways to help secure your family during an already difficult time. Take a few minutes to review your health insurance policy today, confirm that your nominee's details are accurate, and update them whenever your family circumstances change. It is a small step that can offer your loved ones real peace of mind.
Explore Zurich Kotak General Insurance Company (India) Limited's health insurance plans, and reach out to our assistance team any time you need help updating your nominee: Explore Health Insurance
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Frequently Asked Questions
Is It Compulsory to Name a Nominee in Health Insurance?
IRDAI requires insurers to record a nominee's details when you buy or renew a health insurance policy. Naming one is a standard part of buying cover, and it helps your family receive the claim amount without delay.
Can I Add More Than One Nominee?
Yes. You can name multiple nominees and decide the percentage of the claim amount each one will receive.
Can a Policyholder Nominate a Non-Family Member?
Yes. You can nominate a friend or a distant relative, though your insurer may ask for additional details to confirm the relationship.
Can I Change My Nominee After Buying the Policy?
Yes. You can update your nominee at any time during the policy period by informing your insurer in writing.
What Happens if I Do Not Name a Nominee?
Your family can still claim the benefit, but they may need to submit a legal heir certificate or succession certificate to establish their right to the funds, which can extend the settlement process.
Is a Nominee Always the Final Owner of the Claim Amount?
Not always. In most cases, your nominee receives the amount on behalf of your legal heirs. Only a beneficial nominee, being your spouse, child, or parent, may be entitled to keep it, and even then, this right can be affected by a valid claim from another legal heir.
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