Many people got their policies when they are much older, hence high premiums. Some have older parents etc, their premium will easily touch atleast 50K without much cover also. Some people pay 2 or 3 year in one shot to lock in the premium as well.
Bhai HDFC Ergo Optima Secure medical insurance for a family of 4 will easily touch 40k especially if the eldest people are 40-50...if they are even older it will cross 50