Summary of this article
• Digitization of Living Wills in Maharashtra puts them in everyone's retirement planning conversation.
• With ICU beds rapidly increasing in price, and inflation soaring in healthcare spending, planning ahead financially just makes sense.
• A Living Will gives peace of mind and helps prevent unpleasant spending.
Nobody likes thinking about the day they might not be able to speak for themselves. Most families avoid that conversation entirely until a crisis forces it. By then, decisions are made in panic, not in peace.
Maharashtra has taken a significant step toward changing that. The state has announced India's first digital registry for living wills, formerly known as Advance Medical Directives. A Living Will is simply a document where a person records, in advance, what medical treatment they want or do not want if they can no longer communicate. A prolonged illness, a coma, a terminal condition - none of us plans for these. Yet, all of us remain vulnerable to them.
“The financial reality hits harder than most families expect. ICU charges at private hospitals run between Rs 15,000 and Rs 30,000 per day. A patient on ventilator support for 2-3 weeks can accumulate a bill of Rs 3 lakh to Rs 7 lakh, before medicines and specialist fees are even counted. India's medical inflation sits at 14 per cent annually, and average hospitalisation costs jumped over 11 per cent in a single year between 2023 and 2024,” says Shraddha Nileshwar, Head – Will & Estate Planning at 1 Finance.
Health insurance, the safety net most people rely on, often does not stretch far enough given sum insured limits and ICU sub-limits. Studies show that more than 40 per cent of ICU families had to borrow money or sell assets to settle bills. That is not an outlier but a pattern that is quietly repeating across middle-class households every day.
“This is where a Living Will becomes as much a financial instrument as it is a medical one. Without one, doctors are legally and ethically bound to continue all possible treatment unless a family explicitly says otherwise, and most families, overwhelmed with grief and guilt, find it nearly impossible to make that call,” says Nileshwar.
The result is weeks of continued intervention that may go against what the patient would have wanted, at a cost the family carries long after the hospital is behind them. A Living Will removes that paralysis. It gives families a clear, legally-backed answer to an impossible question, and in doing so, it protects not just the patient's dignity but the family's financial stability as well.
“Living Wills have been legally recognised since the Supreme Court's landmark 2018 ruling, with the process further simplified in 2023. Yet most Indian families have never heard of one. Maharashtra's digital registry addresses this gap by allowing citizens to register their directive online, retrievable by hospitals instantly in an emergency,” informs Nileshwar.
For anyone building a financial plan, a Living Will deserves a place on the list. A traditional Will covers one’s assets. Health insurance covers hospitalisation. A Living Will covers the space in between, and it may turn out to be the most important document in the entire stack.
