India has a quiet legal crisis hiding inside its hospitals.
Over 1.5 million inheritance-related cases are pending in Indian courts as of 2025, according to the National Judicial Data Grid (NJDG). Legal analysts often point to ambiguous wills, disputed property, and gender bias as the root causes. But the trigger is usually earlier—and far less examined: the weeks or months families spend at hospital bedsides, making high-stakes financial decisions under pressure, without any guiding document. In many cases, the inheritance battle begins not after death, but during dying.
Maharashtra’s decision to build government-backed digital infrastructure for living wills on its MahaULB portal is therefore far more consequential for family finances than it appears.
The Chain Nobody Maps
A familiar pattern plays out in thousands of Indian families each year. A parent is incapacitated—by a stroke, cancer, or organ failure—without an advance medical directive in place. The family, suddenly forced into collective decision-making, fractures quickly.
One sibling insists on aggressive treatment while another, bearing the costs, pushes back and the third, settled abroad, has opinions but no liability. Without a living will, the family is left with the torment of guessing what the patient would have wanted, triggering needless suffering and a crushing financial and emotional toll.
The consequences extend well beyond hospital bills. Who paid more? Who visited less? Who decided to switch hospitals—or to withdraw life support? These questions do not end with the death certificate.
According to NJDG data, about 50% of inheritance disputes in India involve gender-based claims, while roughly 25% of property cases in 2025 hinge on whether assets are ancestral or self-acquired. Many of these conflicts are seeded much earlier—in ICU waiting rooms, not probate courts.
When a patient has documented their wishes, the family’s role shifts. They move from conflicted decision-makers to executors of a stated preference. Decisions about continuing or withdrawing treatment are no longer personal judgments, but compliance with a legal directive.
This is not a unilateral patient decision that gets blindly enforced. Under the Supreme Court’s revised 2023 guidelines, implementation requires certification by two independent medical boards, a primary board constituted by the treating hospital and a secondary board set up by the district medical officer. Both must independently confirm that the patient’s condition is terminal and irreversible before the directive is given effect to.
What Maharashtra Actually Fixed
The Maharashtra government has launched a dedicated module on the MahaULB portal allowing citizens to upload advance directives, with municipal commissioners appointed as custodians for secure storage and management. The significance is institutional permanence.
A document inside a government system cannot easily be disputed by a family member claiming it was made under pressure. Its timestamp and digital trail make it far harder to weaponise in estate battles later.
This matters because a living will stored in a drawer is only marginally better than no living will at all. Retrievability during a medical emergency is everything and that requires state infrastructure, not just personal initiative.
What other states can learn
Following the Supreme Court’s 2023 simplified guidelines, a living will must be signed before two independent witnesses and attested before a notary or gazetted officer, with a copy submitted to the local magistrate.
States like Karnataka, Delhi and Tamil Nadu, with large ageing urban populations and high private hospital density, must build retrieval infrastructure urgently. The argument is fiscal as much as moral. Tamil Nadu alone recorded 27 lakh pending cases in 2024, with 30% pertaining to divorce and inheritance issues, per NJDG data.
The data also points to a demographic urgency that cannot be deferred. About 81% of older adults in India have no health insurance coverage, according to the 75th round of the National Sample Survey. For this cohort, which is the very population most likely to need a Living Will, the absence of documented medical wishes leaves families not just emotionally rudderless but financially exposed at the most vulnerable moment of their lives.
Maharashtra’s digital living will framework may seem like a small administrative step. But for families that use it, it does something estate planning often cannot: it removes ambiguity from the most emotionally volatile phase of financial decision-making.
Instead of leaving behind a conflict to resolve, it leaves behind clarity to follow.
Shraddha Nileshwar, is head – will & estate planning at 1 Finance. Views are personal.
