Petitioner was the complainant before the District Forum.  Briefly stated, the facts are that the petitioner obtained Mediclaim Policy from the respondent insurance company for the year 2004-05 for himself and his wife for an amount of Rs.10 lakh and extended to his son and four daughters for Rs.50,000/- each.  On 15.4.2006, wife of the complainant got admitted in Flex Medical Centre for hysterectomy (removal of uterus) and incurred an expense of Rs.32,636/-.  Petitioner filed a claim with the respondent, which was repudiated on the ground that for the first two years, the petitioner was not entitled to the reimbursement of the amount spent in connection with hysterectomy.  Aggrieved by this, petitioner filed a complaint before the District Forum.

          District Forum allowed the complaint and directed the respondent to reimburse the petitioner of the expenses incurred by him in the operation of his wife.  Rs.10,000/- were awarded by way of compensation and Rs.2,000/- as costs.

          Aggrieved against the order passed by the District Forum, respondents filed an appeal before the State Commission.  State Commission accepted the contention raised by the respondent that in view of Sub-clause C of Clause 12 of the insurance policy, the insurance company was not liable to reimburse the claimed amount for hysterectomy in the first two years of the taking of the policy.  In spite of this finding, the State Commission directed the respondent to pay 50% of the claimed amount.  Relevant Exclusion Clause is reproduced below :

“C.          What we will not pay

1)                ………………………………..

2)                Without derogation from C(1) above, any Medical Expenses incurred during the first two consecutive annual periods during which you have the benefit of a Health Guard Policy with us in connection with cataracts, benign prostatic hypertrophy, hysterectomy, menorrhagia, fibromyoma, endometriosis, hernia of all types, hydrocele, fistulae, haemorrhoids, fissure in ano, stones in the urinary and biliary systems, surgery on tonsils, adenoids, sinuses, ears, skin and all internal tumors/cysts/nodules/polyps of any kind including breast lumps, gastric or duodenal ulcer.  This Exclusion period shall apply for a continuous period of a full 4 years from the date of your first Health Guard Policy with us if the above referred illness were present at the time of commencement of the policy and if you had declared such illness at the time of proposing the policy for the first time.”

          The insurance company has not challenged the order passed by the State Commission.  Counsel for the petitioner contends that the policy document was not supplied to him.  The cover note, which was supplied to the petitioner – Annexure B, which is at paged 19 of the paperbook, states “Scope of cover as per policy wordings attached”.  From this, we will presume that the terms and conditions of the policy were attached with the cover note.  Contention of the counsel for the petitioner that the same was not attached, cannot be accepted and has rightly been rejected by the State Commission.

          We find no merit in this Revision Petition.  Dismissed.