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What is a Nominee in Health Insurance?

Source: dnaindia.com

By now, you should know the importance of having a health insurance plan to protect you financially in case of a health-related crisis. But to ensure that your family members or dependents don’t miss out on all the benefits of your health insurance policy, it is important that you select a nominee for your health insurance policy.

Role of a Nominee in Health Insurance

A nominee is a person (or people) who are chosen by the policyholder. In normal situations, when you make a health claim for hospitalization or medical treatment, you get that amount back yourself.

But, in the unfortunate event of your death during hospitalization, or as a result of an accident, the health insurance company will pay the claim amount to this nominee.

While this is mandatory in life insurance, it is also possible to appoint a nominee for a health insurance, or even personal accident insurance plan.

NOTE: This is not applicable in the case of a cashless health insurance claim, where the amount is settled directly with the network hospital.

Benefits of Nominees in Health Insurance

It is important that you inform your health insurer about who you have nominated for your policy. As, in case something goes wrong with your health, you can ensure that your loved ones are protected financially.

  • Financial Support for Your Family – In the event of a death, the entire family of the deceased suffers, and in the case of large hospital fees, they may have an added financial burden. But by selecting someone as a nominee, you ensure that there are no financial difficulties.
  • Safeguard Your Dependents – It is important that you financially safeguard those who are dependent on you. And you can ensure this by nominating them in your health insurance policy, so they will have help to overcome financial hurdles in the future.
  • Equally Shared Benefits – In case you have selected multiple nominees, the claim benefit can be equally shared among them.
  • Avoid Legal Complications – If you die without identifying a nominee, your health insurance, the insurer will have to identify your legal heir to receive the claim amount. Since this may include multiple individuals, it can involve court arbitration and other complications for your family.

Essentially, appointing a nominee for your health insurance policy will ensure that there are fewer hassles in case the worst happens. Thus, it can make a very hard situation a little bit easier for your loved ones.

Who to Select as Nominees for Your Health Insurance Plan?

There are no real restrictions on whom you can select as a nominee for your health insurance plan. It is possible to nominate immediate family members such as

  • Parents
  • Spouse
  • Children
  • Or distant relatives
  • Or even your friends

It is also possible to nominate a minor (someone who is below 18 years of age). In this case, you will also need to mention a guardian or appointee, as the minor cannot legally handle the claim amount until they are an adult.

Additionally, remember that if a nominee dies before the policyholder, the claim amount will go to your legal heirs. This is decided either as per your will, or is decided by the courts.

In general, it is advisable to name immediate adult families as your nominees, especially as the claim amount can provide essential financial support at a difficult time.

How to Add or Change a Nominee in Health Insurance?

You can add in the nominee details when you purchase your health insurance policy, whether you buy it online or offline. However, it is possible to appoint a new nominee at any time, by informing your insurer.

It is also possible to change or remove individuals as nominees at the time of renewal, or during the policy period. Once again, you can do this by contacting your insurer.

What Details are Required for Nominees?

It is necessary to provide correct information of the nominee to make sure there are no problems when raising a claim. This includes:

  • Personal Details: full name, date of birth, age, address
  • ID Proof: a valid identity proof, such as a driver’s license copy
  • Proof of Relationship: details of the relationship the nominee shares with you, especially in case of a distant relative

What is the Process for Nominee Claims?

When the worst happens, and you (the policy holder) die during hospitalization, it is up to the nominee to claim reimbursement. They can do this as follows in the case of a reimbursement claim:

  • Step 1: The nominee needs to inform the insurer of the death, providing a valid succession certificate and the death certificate and in the case of accidental death, a copy of the FIR and postmortem report as required. 
  • Step 2: Then the nominee needs to send any required documents to the insurer within 30 days. This might include medical bills, health records, and any doctor’s reports, as well as the deceased’s death certificate, and the nominee’s identity card, relationship proof, and bank details.
  • Step 3: The insurer will inform them of any additional requirements.
  • Step 4: Once the insurer verifies the documents, they will transfer the claim amount to the account of the nominee.

 

Nominees play a very important role in health insurance. In case of death, it provides a financial safeguard for one’s dependents and can also prevent any disputes from arising. It is possible to choose anyone as your nominee, even minors. Thus, when choosing a health insurance plan, it is very important to make the right choice and select a nominee.

Frequently asked questions

What happens if there is no nominee under your health insurance?

If you have not named a nominee in your health insurance plan, then in the case of a reimbursement claim, the insurance company will need to identify the legal heir to receive the compensation. In case this heir is not mentioned in a will or other document, they will require a succession certificate from a court of law to release the claim amount.

What is the difference between a legal heir and a nominee?

A person’s legal heir is the person who is entitled to succeed or inherit their properties. This could be the closest living relative, or any individual mentioned in their will. However, a nominee is someone who is named by a policyholder to receive their claim amount after their demise.

Is it mandatory to have a nominee for a health insurance policy?

No, it is not mandatory. However, it is recommended that you do so to avoid complications in reimbursement after the death of the policyholder.

Is it possible to have more than one nominee for your health insurance?

Yes, it is possible to name multiple people as their health insurance nominees, including family members or friends.

Can you appoint a minor as your nominee?

Yes, you can name a minor as your nominee. However, in such cases, you will also need to name a guardian or appointee along with this person. This is because the minor individual can’t legally handle the claim amount until they are an adult. Thus, either the amount will be paid to the guardian/ appointee to use in the name of the child, or they will get the amount once they turn 18.

Can you name a non-family member as a nominee?

Yes, you can name a non-family member, such as a close friend, as your health insurance nominee.

What about the nominee if you have a family health insurance policy?

In case you and your immediate family share a family health insurance policy, and you haven’t named a nominee, after the death of any member, the insurer will transfer the claim amount to another member, and the legal heir can apply to them for the amount.