No doubt the medical insurance policies are subject to the conditions and exclusions. There are certain declarations by the assured to be made in the proposal to get covered, particularly in respect of major disease which is the self confirmation by the policy buyer. If that proposal is accepted then medical check up unless insisted before issuance of policy can not be cited as the reason to reject claims and consumer courts had rejected number of such cases.
A forensic audit needs to be done of Medical Insurers so that truth can come out that they make profits from their operations instead of losses as claimed regularly by them. Then rationalize rates to reflect the profile of insurance buyers. One taking treatment at KEM must also pay same as one taking treatment at Lilavati/Hinduja.
