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Addressing Claim Disputes With Insurance Samadhan

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Ravi Mathur, 

Co-founder and CTO, Insurance Samadhan
age: 33
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Always getting what he aimed, Ravi Mathur, co-founder and chief technology officer (CTO), Insurance Samadhan, had a tough time tasting failure for the first time in 2016 as the co-founder of an ed-tech start-up. His first brush with entrepreneurship didn’t work out post his stints with companies such as MapsofIndia, IIMJOBS and Cars24. He went back to a full-time job but with one foot out the door.
Coincidentally, the HR head who had hired Mathur referred him to Insurance Samadhan co-founder and CEO Deepak Bhuvneshwari Uniyal. “I didn’t know much about the insurance industry, but I was keen to use the power of technology for a noble cause,” says Mathur. He joined the grievance redressal start-up as the CTO in 2019, and within two years, got promoted as the co-founder.
“There are patterns you can identify in insurance policies,” says Mathur. For example, Covid-19 claims can be rejected for n-number of reasons. “N is a value. You can have a response to ‘n’ reasons based on data points from insurance policies and documentation aiding the claim and summarised bills. We extract those data points, make decisions and let you know whether we can accept your complaint.”
Once the complaint is accepted, the system sends an email to notify the customer regarding uploading of documents. “The system then creates an email on behalf of the policyholder to communicate with the insurer or ombudsman, as the case may be,” says Mathur. “Not only do we send it via email, but also the physical copy. This is because the customer only gets 90-120 seconds to present the case before the ombudsman.” The company currently resolves 60-70% life, 40% health and 20% general insurance complaints automatically.
Insurance Samadhan charges a ‘success fee’ of 12% of the claim amount once the case is resolved. Customers have to a pay a one-time registration fee of `500. On an average, the company registers 400 customers month-on-month, and is looking to raise the number to 5,000 by December 2022.
The start-up is looking to launch an app by April. It will tell customers how much insurance they need and which product will suit them the best. Services will be available on a subscription basis of `600 per annum.

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