Policybazaar introduces ‘Claimsetu’ for business: India’s first AI-LED Claim Group Insight Engine for Health Claim

While PBFB has already supported strong claims to corporate customers along with millions of employees, Clemcetu has taken the experience to the next level, which gives quantitative scoring such as Claim Insights Approval and Scoring that their claim is expected to be processed. Apart from this, it is the system, which also helps to claim faster up to 50% with less errors and more visibility to employees, HR teams, insurers and TPAS process.

It currently focuses on streamlining GHI reimbursement claims, a process delayed due to traditionally missing paperwork, and lacks real -time updates. Using state -of -the -art Artificial Intelligence (AI), Natural Language Processing (NLP), and optical character recovery (OCR), from document submissions to final claim approval, it becomes more accurate and more transparent, starting the entire journey.

“The claims of reimbursement remain one of the exhausting procedures of group health insurance. With Clemcetu, we are working on that friction is the most, in GHI reimbursement, and building a system that removes ambiguity and strengthens users with real -time updates,” Said Sajjja Praveen Chaudhary, Director, Policy Bazar for Business, “It is more than automation; it is about providing clarity and confidence in the most important moment of insurance experience.”

Refruiting GHI reimbursement for Indian enterprises

For Indian enterprises, Claimsets have been proud of India, addressing the unique operations and infrastructure challenges of the country’s corporate health insurance ecosystem. As India’s first homegron, the B2B insurance claim engine in space, the engine, it marks a jump in digital innovation that aligns with the National Vision for Tech-Interested Change.

Today, many GHI reimbursement claims include several emails, back and forth with TPA or insurer. AI-driven document checks it changes it with a check, automated verification, immediate alert, and live trekking via WhatsApp, brings forward speed and clarity to the process.

The platform identifies and extracts information from documents such as bills, prescriptions and discharge summary using AI-LED classification. It also mismatch against policy conditions and can detect potential fraud, reducing administrative burden on HR teams and insurers. Claims are presented through familiar channels such as mobile apps, emails or WhatsApp, with real -time alerts for missing or invalid documents, they cut the delay before starting.

Conducted by AI, OCR, and NLPClemcetu:

• Claims automate reading documents from forms, pharmacy bills, hospital bills, prescriptions, discharge summs, etc.
• Missing or wrong documents in real time
• Each phase of the claim process provides insparse approval to employees claiming the data and constant updates of the huge historical claims of the policyman.
• Intelligent claim routing: The document claims for suitable teams based on perfection, complexity and assistance estimated.

Safe, scalable and ready for future

Ensuring enterprise-grade safety, Claimsetu is made with strict adherence to data security criteria. The platform is also designed to basically integrate with customer relationship management (CRM) system, insurer backand system and HR tools.

In its beta version, while it currently supports GHI reimbursement workflows, Clemcetu’s modular architecture allows expansion in OPD claims and other categories in the future-this creates a future ready engine for insurance operations in various product lines.

By finishing manual work, reducing turnaround time, and by making a more sympathetic claims experience, Claimsetu is ready to set a new benchmark to handle the entrepreneurship claims in India’s rapidly changing workplace.

Pay attention to readers: This article is part of the paid consumer connect initiative of HT and is made independently by the brand. HT does not consider an editorial responsibility for the material, including its accuracy, perfection, or any error or omission. Readers are advised to verify all the information independently.

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