Insurance claim services
Practical help at each stage of a claim, from the hospital desk to the Insurance Ombudsman.
Health insurance claim assistance
For planned and emergency admissions: what to tell the TPA, which documents to collect before discharge, and how to file a complete reimbursement claim so it is not returned for missing papers.
Rejected claim review
We compare the insurer’s reason (pre-existing disease, waiting period, non-disclosure, ‘not medically necessary’, excluded provider) with your policy wording and the applicable regulations, and give you a written view on whether and how to contest it.
Short settlement and deductions
Room-rent proportionate deductions, non-payable items, co-pay and package-rate cuts: we check the calculation line by line and prepare a representation where the deduction is not supported.
Cashless denial at the hospital
When pre-authorisation is denied or only partly approved, we help you respond to the TPA’s queries quickly and keep the reimbursement route open.
Grievance and Insurance Ombudsman
Drafting the complaint to the insurer’s grievance officer, and preparing the complaint and documents for the Insurance Ombudsman if the insurer does not resolve it.
Motor insurance claims
Own-damage and theft claims: survey stage, depreciation and settlement disputes, and documents for total-loss claims.
Policy review before buying or renewing
A plain-language read of exclusions, waiting periods, sub-limits, room-rent caps and network hospitals for your city, before you commit.
For employers and HR: disputed group health claims
Help for HR teams and employees with rejected or short-settled group mediclaim claims, including representations to the insurer or TPA.
For employers and HR: hospital network review
A review of the cashless and PPN hospitals available to your employees in the cities where they work, with gaps flagged before renewal.
For employers and HR: claims process review
A practical check of how claims are intimated, documented and followed up in your organisation, so fewer claims are delayed or rejected for avoidable reasons.
United States: health insurance claims support
For US patient advocates, healthcare attorneys and medical billing firms: appeal drafts, medical-record summaries, claim timelines and plan analysis, prepared for their review and signature. See US health claims support.
How it works
- Share your policy, the claim papers and the insurer’s letter.
- We review them and explain your position and options in plain language.
- If you go ahead, we prepare the representation, complaint or claim file with you and follow it through.
What we are not. We are not an insurer, broker or TPA and do not sell policies. Outcomes depend on your policy terms and the facts; no result can be guaranteed.