Health Claims Investigation

A Prominent General Insurer in India was seeking to implement a Mobile App to enable investigation of claims emanating from Mass / State sponsored Health Insurance schemes. The customer had engaged multiple third party agencies all over the country to carryout investigation. Managing huge volumes of investigations across multiple investigation agencies was a challenge often leading to delays in claim processing. ​

iNube leveraged its flagship RMAD platform called Evidens which has built in capabilities to create a Mobile App for any on-field activity. An Android Mobile App was custom built to manage the Health Claims Investigations. A front-end integration with the Claims Processing application provided a mechanism to Create, Assign & Track Claim Investigation cases. ​

• Investigators digitally captured Claim Details, Hospital Details, Nurse Details, Patient Details
• Investigators captured evidence and important artefacts in the form of Images, Audio / Video clips with Geo Co-ordinates​
• Claim cases were assigned to specific investigation agencies that were mapped region-wise​
• Investigation reports were auto-compiled in customized formats

• Successfully conducted investigations in remote areas with no data connectivity (offline data capture)
• Improved Data Accuracy and Reliability – real-time digital tamper-proof evidences​​