We will
help through
every step

Overview

  • 29 States
  • 100% Retention of all stakeholders
  • 97% Settlement Ratio
  • Claim TAT 5 Days - Retails 2 Days - Corporate
  • Card TAT 5 Days - Retails 2 Days - Corporate
  • 100% Retention of all stakeholders
  • 100% Retention of all stakeholders

Benefit

DIGITAL & PLASTIC CARDS

  • Online Policy Download via SFTP.
  • 14-Seater dedicated Data Entry Cell.
  • Online/Mobile enabled E-cards.
  • Online IT/Enrolment support,Smartphone Claim App.
  • 7 Days Physical Card Issuance TAT.
  • Capacity: 2500-3000 Cards per day.
  • TPA Dedicated Card Helpline number and WhatsApp Support -
  • +91—9599286872,011—47222131,136

IT & MIS SYSTEM

  • Efficient and defined team of Software engineers and Data analysts with minimum 4 years of experience
  • All data analysis and MIS available as per IRDA and underwriters
  • Daily intimation reports, timely software and database upgrades, Live claim view
  • LAMP Technology-Linux,Apache,MySQL and PHP
  • Insurer DO, BO, RO, HO - Login System Access
  • Customizable real-time claim and MIS dashboards

CLAIMS PROCESSING SERVICE (Insurer Benefits)

Increased benefits to Insurers
  • Meaningful product differentiator
  • Increased customer retention
  • Increased sales - Higher Close Ratio
  • Reduction in Loss Ratio
  • Speedy settlement of claim


Reduced Claims / TAT’s for Insurers
  • Cost containment for insurers
  • Reduction in Claims - Lower Claim Ratio

CLAIMS PROCESSING SERVICE (Consumer Benefits)

Reduced Claims / TAT’s for Insurers
  • Increased benefits for Customers
  • Proactive & Responsive TPA
  • Hassle free cashless service
  • Peace of Mind
  • 24 Hours Emergency Assistance
  • Focused & Personalised Service
  • Optimal level of medical care

Investigation, Fraud &
Abuse Management

MAIN TRIGGER POINTS

POLICY & CLAIM TRIGGER
DIAGNOSIS OR SURGERY SPECIFIC TRIGGER
PROVIDER LOCATION OR PROFILE TRIGGER
BILLING AND TARIFF BASED TRIGGERS
  • Claim Trigger
  • Investigate
  • data & analytics
  • Study Pattern
  • Report
  • Red Flag/Caution list/ Book the case
  • Share with All stakeholders