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Request for a new feature

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30 Apr, 2021 by  Maze Runner

Hi Beshak team,

One feature I wish as a customer and where I would be happy to pay:

Once we raise a claim, whatever the amount insurance policy grants us, we take it for granted. Many times there are mistakes and we should be receiving more. If there is a service that can revalidate our claims and then we can raise it back to insurance providers and get the additional amount. As a user, we can pay a percentage for the service. I remember some company in the US used to do a similar thing for refunds on airline tickets and they charge prorata basis

(The same service can be offered to insurance providers to where in they pay extra to clients). I have experienced both in my case in last one year out of more than 15+ claims raised last and this year due to many issues.. Not many go into details what is deducted and why.. it will be a fantastic service to have.

Example of what I experienced

  1. 1. claim-1,2: Raised for covid, got reimbursement without co-pay deduction as there is no co-pay applicable for my policy
  2. 2. claim-3 issues faced
  3. Claim was processed and money given.. but a co-pay was deducted
  4. They are not able to identify ICU bed charges and some more which they have deducted
  5. When I have raised the issues, 1&2..they agreed to both, but when the amount is disbursed only for 2... I had to raise the issue again for 1 for the balance co-pay which is again going round and round

This is the similar service for airlines I was pointing at.

Health Insurance

2 Answer

Regional Director, Amicus Insurance Broking

As a customer you are entitled to receive a settlement advice of the claim from the insurer giving the calculation details as to what is being paid and what’s not. If you haven’t been extended that courtesy by the insurer, then that is a deficiency of service in accordance with Policyholders Protection Guidelines of IRDA. You can approach Insurance Ombudsman for necessary relief.

If you have obtained the policy thru an authorised intermediary such as an agent or a broker, it is the job of the intermediary to get this input for you and ensure that unfair deductions are not applied to your claim. In fact, this is an important purpose of engaging an intermediary.

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03 May, 2021
Co-founder, SureClaim

Hey there,

You are looking for a solution such as SureClaim, a company I started in 2017. Beshak is not a platform for self-promotion, so I won't delve into it much.

Primarily, SureClaim is focused on helping policyholders make good decisions while doing admission at hospital, helping patients understand all expenses claimable under their policy and preparing claims for patients using technology and systematic process so that the quality of claim is such in which insurer cannot find faults. Lastly, if there are any queries or denials or unfair deductions in the claim, our experts dispute the same to get maximum recovery for patients.


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04 May, 2021
Maze Runner
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