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  • Glossary

    Health Insurance Terms Made Easy To Understand.

Third Party Administrator (TPA)

Third party administrators or TPAs are companies and entities licensed by the Insurance Regulatory Development Authority of India (IRDAI) and authorised/engaged by insurance companies to conduct business on their behalf. TPAs collect premiums, process and settle cashless and reimbursement claims, and offer administrative services on behalf of the insurance provider.

Top-up Plans

A Top-Up Plan is an insurance rider that policyholders can purchase over and above their existing health insurance plan. Top-up plans typically increase the policyholder’s sum insured limit, enabling them to enhance their coverage substantially. Policyholders can opt for top-up and super top-up plans at the time of policy renewal only and can file multiple claims in a policy year by adding this rider.

Terminal Illness

Illnesses or diseases that do not have a permanent cure or those that can only treat certain but not all symptoms of an illness, despite extensive medical care are known as terminal illnesses. Terminal illnesses usually result in death or indefinite unconsciousness (coma) from which a patient is unlikely to recover. Advanced-stage cancer, heart diseases, neurological diseases, etc., are examples of terminal illnesses.

Time Deductible

Time deductible is the duration the policyholder has to wait before receiving health insurance benefits. Typically, time deductibles include a specific number of hours and have no impact on the sum insured.


Treatment is defined as a process under which medical professionals employ various procedures to nurse a patient back to good health. Under health insurance plans, notable forms of treatments include medication, surgery, physical therapies, etc. Health insurance providers generally cover the treatment costs of various medical conditions, which they list in detail in their policy documents.

Territorial Limit

Territorial limit is a term indigenous to most health insurance plans. Under the territorial limit clause, the insurance provider only pays for the medical expenses associated with treatments within the territorial border of the country in which the policy is issued. For insurance policies in India, insured parties can file claims only for treatments sought within the territorial limit of India. Insurance providers can reject claims for treatment sought overseas.