Terminal Illness & End-of-Life Administration in India: 5-Step Official Checklist

1. 1

   Coordinate Specialist Palliative Care, Home Care, and Hospice Services

   Ask the treating specialist or oncology/internal medicine team for a referral to a dedicated pain and palliative medicine unit. Under the National Programme for Palliative Care overseen by the Ministry of Health and Family Welfare (implemented through the National Health Mission and Ayushman Arogya Mandirs / district hospitals), public district and tertiary hospitals provide outpatient and home-based palliative support and essential pain medications [1][2].

   To locate accredited specialist centres, inpatient hospices, and home-care teams across Indian states, consult the national directory maintained by the Indian Association of Palliative Care [3]. Established nonprofit and hospital services (such as Pallium India in Thiruvananthapuram, Karunashraya in Bengaluru, Cipla Palliative Care and Training Centre in Pune, or CanSupport in Delhi NCR, listed as public-source examples for orientation; Clarvia does not endorse, recommend, or rank them) coordinate home nursing, symptom management, and family caregiver training [3][4].

2. 2

   Prepare and Attest a Written Advance Medical Directive (Living Will)

   While your family member is of sound mind and retains full decision-making capacity, they can execute a written Advance Medical Directive (Living Will) under the Supreme Court of India judgment in Common Cause v. Union of India (2018), as simplified by the Supreme Court's Constitution Bench order of 24 January 2023 (MA 1699 of 2019) [5]. The directive sets out when artificial life-sustaining treatment (such as mechanical ventilation, cardiopulmonary resuscitation, or artificial nutrition) should be withheld or withdrawn in the event of an irreversible terminal condition, and names a guardian or close relative to be consulted by clinicians [5].

   Under the 2023 Supreme Court rules, countersignature by a Judicial Magistrate First Class is no longer required [5]. Instead:

   • The person signs the Advance Medical Directive voluntarily in the presence of two independent witnesses [5].
   • The document is attested before a Notary Public or a Gazetted Officer [5].
   • Give copies to the appointed guardian/surrogate, the family physician, the treating hospital (to be incorporated into the medical record), and the competent local government officer (municipal corporation, municipality, or panchayat custodian) [5]. If the person later loses capacity in a terminal phase, withdrawal of life support is reviewed by the hospital's Primary Medical Board and corroborated by a Secondary Medical Board including a nominee of the Chief Medical Officer [5].
3. 3

   Execute a Registered Power of Attorney and Record Bank and Demat Nominations

   While your family member has full legal capacity, execute a General Power of Attorney or Special Power of Attorney on the required state non-judicial stamp paper and register it before the jurisdictional Sub-Registrar of Assurances (under the Registration Act, 1908) so an authorised representative can manage property, tax filings, and banking affairs [10]. If the person or the appointed representative resides outside India, a Power of Attorney executed abroad must be attested by the Indian Embassy or Consulate (or apostilled under the guidelines of the Ministry of External Affairs) and adjudicated/stamped in India within 3 months of receipt [10].

   Note that under Section 201 of the Indian Contract Act, 1872, an ordinary Power of Attorney is subject to termination if the principal becomes of unsound mind, and expires immediately upon death. Therefore, alongside a Power of Attorney, ensure your family member registers statutory nominations while competent across all financial accounts: Form DA-1 for bank accounts and fixed deposits (under the Banking Regulation Act), Form SH-13 for company shares, and NSDL/CDSL nominations for demat and mutual fund holdings, so funds can be released directly to nominees without waiting for lengthy court probate.

4. 4

   Access Medical Advances, ESIC Sickness Benefits, and Health Coverage

   Depending on your family member's employment and insurance coverage, activate immediate financial and medical support:

   • EPFO Medical Advance: Salaried members covered by the Employees' Provident Fund Organisation can apply online via the Unified Member Portal using the Composite Claim Form (Form 31 under Paragraph 68-J of the EPF Scheme) to withdraw a non-refundable advance for treatment of severe or terminal illness; a self-declaration suffices without requiring hospital proformas [6].
   • ESIC Sickness and Extended Sickness Benefits: Workers insured under the Employees' State Insurance Corporation can claim cash Sickness Benefit (Form 9, up to 91 days) and Extended Sickness Benefit (for specified malignant or long-term diseases, up to 308 days at an enhanced daily rate) through their local branch office and dispensary [7].
   • Ayushman Bharat PM-JAY and Private Insurance: Eligible families under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana administered by the National Health Authority can access cashless secondary and tertiary hospital care (including oncology and palliative packages) up to INR 5 lakh per family per year at empanelled hospitals [8]. Central and state government employees can combine Earned Leave, Half Pay Leave, and Commuted Leave for caregiving or medical treatment.
5. 5

   Organise the Will, EPFO/ESIC/PBBY Nominations, Vital Documents, and Estate Records

   While your family member has testamentary capacity, review or execute a written Will under the Indian Succession Act, 1925: it must be signed by the testator in the presence of at least two attesting witnesses (optional registration before the Sub-Registrar of Assurances helps prevent later authenticity disputes). Assemble a master folder containing the person's Aadhaar card, PAN card, passport, marriage certificate, property title deeds, and written funeral or cremation preferences.

   Verify and update survivor nominations across statutory schemes to prevent post-death bottlenecks:

   • EPFO Survivor Claims: Ensure e-Nomination is completed on the UAN portal so survivors can file the Employees' Provident Fund Organisation Composite Claim Form in Death Cases (integrating Form 20 for PF final settlement, Form 10-D for Employees' Pension Scheme monthly survivor pension, and Form 5-IF for Employees' Deposit Linked Insurance lump-sum payout) [6].
   • ESIC Funeral and Dependants' Benefits: Ensure family particulars are updated with the Employees' State Insurance Corporation (Form 22 for funeral expenses and Form 15/Form 24 for Dependants' Benefit where applicable) [7].
   • Overseas Indian Workers (PBBY): If your family member is an Indian emigrant worker covered under the Pravasi Bharatiya Bima Yojana managed by the Ministry of External Affairs on the eMigrate portal, keep policy and employment records ready for medical, repatriation, or survivor claims [9].
   • Post-Death Estate Certificates: Clarify whether the state and asset types will require a Legal Heir Certificate (from the Tehsildar/Talukdar for service benefits), a Succession Certificate from the Civil Court for movable debts and securities where no valid nomination exists, or High Court/District Court Probate (mandatory under Sections 57 and 213 of the Indian Succession Act for applicable Wills in Mumbai, Kolkata, and Chennai) alongside registration of the death within 21 days under the Registration of Births and Deaths Act, 1969.

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   National Programme for Palliative Care (NPPC) Operational Framework — Ministry of Health and Family Welfare
2. [2]
   Guidelines for Palliative Care at Health and Wellness Centres — National Health Systems Resource Centre (NHSRC)
3. [3]
   Indian Association of Palliative Care (IAPC) Directory and Resources — Indian Association of Palliative Care
4. [4]
   Palliative Care Access and Policy in India — Pallium India
5. [5]
   End-of-Life Care and Advance Directives in India — Indian Journal of Medical Research
6. [6]
   EPFO Composite Claim Form and Illness Advance Rules — Press Information Bureau, Government of India
7. [7]
   ESIC Sickness and Dependants' Benefit Claim Procedure — National Portal of India (india.gov.in)
8. [8]
   Employees' Provident Fund Scheme Claim Portal — National Portal of India (myScheme)
9. [9]
   Pravasi Bharatiya Bima Yojana (PBBY) — Ministry of External Affairs, Government of India
10. [10]
    Apostille and Consular Attestation of Power of Attorney Documents — Ministry of External Affairs, Government of India