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Digitizing Claims Management from the Inside Out

‘Digital Claims Management & Fraud Detection’ solution powered by ClaimsLive, a new age state-of-the-art technology platform from iNube, provides end-to-end health and motor claims management

Overview

ClaimsLive is a comprehensive and modular platform that aids collaboration among various stakeholders throughout the claims handling process. It ensures transparency and compliance for quick claims settlement with streamlined workflows.
This robust platform comes with mobility extensions for customers, investigators, auditors etc., to ensure greater accessibility.

Who are the users of this solution?

  • Insurance Claims Team
  • Providers
  • Members (Corporate & Individuals)
  • TPAs
  • Corporate HR
  • Claim Investigators
  • Regulators

Features

Explore the distinctive features of ClaimsLive platform, that helps in delivering value in terms of fraud detection, operational agility and process digitization

Enterprise Level Integration – API driven microservices based architecture

Configurable Modules – Robust and elaborate benefits administration module

Enable Auto Adjudication – Rule-based triggers for straight through processing of claims and flagging non-compliant claims

Configurable Business Rule Engine – Identify and generate alerts for fraud/ suspicious claims with smart validation

Stakeholder Collaboration – Individual self-service portals for each stakeholder for specific functionality

Mobility Solutions – Investigate fraudulent and suspect claims using mobile apps developed by iNube’s proprietary Evidens mobility platform

Variants

Accident & Health Insurance

ClaimsLive Health, a state-of-the-art and customizable technology platform for end-to-end digital claims management and fraud detection for health insurance Know More

Motor Insurance

ClaimsLive Motor, a versatile and customizable claims management system for efficient motor insurance claims processing Know More

Core Building Blocks – A Modular Approach

ClaimsLive platform comprising core functional blocks in a modular setup. Each of the functional blocks or a group of functional blocks, may be leveraged independently to fit into the existing IT ecosystem of the insurance company

  • User Management

    Manages users across the applications

  • Master Data Management

    Manage and configure master values

  • Service Provider Management

    End to end empanelment of various service providers

  • Product Setup

    Configuration of product parameters

  • Claims Management

    Workflow driven processing of claims

  • Payments & Settlements

    Calculation of net liability and generation of settlement reports

  • Business Rules Management

    Configuration of business rules to enable automation of claim processing

  • Business Intelligence & Analytics

    Generation of insights by studying historical data

  • Grievance Management

    Capture and track status of complaints

  • Communication Management

    Configurable notifications to all stakeholders, on defined trigger events

Value Proposition

ClaimsLive technology platform comes with a host of benefits, designed to meet your business objectives

  • Reduce Turnaround Time (TAT)

    Enables straight through processing of Pre-auth/Claims with real time claims data

  • Reduce Fraud

    Auto flagging of claims, assigning suspect cases for investigation, capturing suspect claims details along with audio video evidence using mobile app

  • Reduce Claims Leakage

    Eliminate inconsistencies in the claims management process such as over payment of claims due to erroneous billing, human errors, provider over servicing etc. and streamline operations

  • Enhance Customer Engagement

    Readily integrates with iNube’s B2B mobile apps for real-time flow of data from the field, thus helping in faster claims processing

  • Build your Network

    Network with health and motor service providers to build brand awareness and provide timely service to your customers, in the advent of an eventuality

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Live Streaming

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