
Pre-Existing Disease Exclusion | Insurer Must Prove Knowing Concealment & Recent Hospitalisation Near Policy Inception : Delhi SCDRC
The Delhi State Consumer Commission upheld a ₹2.7 lakh health insurance claim, holding that a mere history of diabetes and cerebrovascular accident - without recent hospitalisation proximate to policy inception - cannot trigger the pre-existing disease exclusion. The insurer bears the burden of proving the policyholder's knowing concealment, and failure to physically supply policy terms and conditions constitutes a deficiency in service.













