Petitioner/complainant took a health insurance policy from respondent on 8.8.2007, which was got renewed on 8.8.2008.  In the renewed policy, name of the petitioner’s daughter was also included in the policy.  On 18.10.2008, petitioner’s daughter was admitted in the hospital in serious illness of fever.  She was discharged on 20.8.2008 but was again admitted in the hospital when she became seriously ill.  Petitioner applied for reimbursement, which was repudiated by the respondent on the ground that as per Exclusion Clause 4.2 of the terms and conditions of the policy, the petitioner was not entitled to any reimbursement for the medical treatment in the first 30 days of the taking of the policy. 

Aggrieved by this, petitioner filed a complaint before the District Forum, which was dismissed.  Not satisfied with the order passed by the District Forum, petitioner filed an appeal before the State Commission, which has also been dismissed.

It is not disputed that the complainant’s daughter was admitted in the hospital on 18.8.2008, as she was suffering from fever for the last 8-10 days.  She was discharged on 20.8.2008 and was re-admitted on 23.8.2008.  The period fell within 30 days from 8.8.2008, i.e. the date of obtaining the policy.  As per Exclusion Clause 4.2, petitioner was not entitled to any reimbursement for the medical treatment in the first 30 days from the date of taking of the policy.  Insured as well as the insurer are bound by the terms of the policy.  As per terms and conditions of the policy, insured could not claim reimbursement for medical treatment in the first 30 days of the taking of the policy.  The parties are bound by the terms of agreement.

Hence, we do not find any infirmity in the orders passed by the fora below.  Dismissed.