Health
₹26,037 Cr
of health claims were rejected in FY24 — money patients paid out-of-pocket.
Moneylife · IRDAI govt data
Gooclaim OS
The operating system for India’s claims industry
Built for every claim.
Every channel. Every CMS. Every vertical.
IRDAI 3-hour TAT
DPDP consent gate
Immutable audit ledger
scroll
01 · One core
One agentic core. Any channel. Any CMS. Any source of truth.
50+ connectors out of the box — your stack, plugged in. A single multi-agent runtime reads every source and replies on every channel, without ever generating free text to a claimant.
WhatsApp
Slack
MS Teams
Gmail
Outlook
Intercom
Zoom
Facebook
ServiceNow
Salesforce
HubSpot
Zendesk
Freshdesk
Zoho CRM
Jira
Linear
Monday
Asana
Calendly
Stripe
SharePoint
Google Drive
Dropbox
Box
OneDrive
Notion
Confluence
Document360
Google Docs
Word
GitHub
Oracle
MySQL
Elastic
Mailchimp
Shopify
Channels
12+
WhatsApp · Slack · Teams · Gmail · Voice
CMS / Helpdesk
14+
ServiceNow · Salesforce · Zendesk · Jira
Knowledge
30+
SharePoint · GDrive · Notion · Confluence
Voice-ready
1×
ASR · TTS · IVR · WebRTC
and 50+ more sources via Connector Hub
inside the OS
Workflow Engine
Multi-agent reasoning per claim.
Truth Layer
Reads any CMS — read-only.
Knowledge Layer
Your policy library, searchable.
Policy Gate
Every reply pre-approved.
Outbound Engine
Templates-only on every channel.
02 · Problem
It’s not a health problem. It’s a communication problem.
Indian insurance has world-class actuaries and pricing — but stone-age communication and coordination. The same broken layer surfaces across seven verticals.
Hero stat · all-vertical
0
grievances on Bima Bharosa in FY25.
Health insurance alone is 75–80% of them — but the same broken layer repeats across every line of business.
IRDAI Annual Report 2024-25 · Bima Bharosa portal
Life
0.00%
of all life insurance complaints are mis-selling — agent promise vs. policy fine print.
Outlook Business · FY25
Motor
0.0%
of all general-insurance complaints are motor — surveyor lag + garage disputes.
Business Standard · IRDAI FY25
Crop (PMFBY)
ZERO
Kharif 2024 claims settled by Feb 2025 — 4.19 Cr farmers waiting in silence.
Ground Report · PIB
Travel
#1 reason
non-disclosure tops travel-claim rejections — IST hours + foreign hospitals + no agent reachable.
Upstox · eIndia Insurance
SME / MSME
0%
of 60M+ Indian MSMEs are insured — denial horror stories blocked the other 97%.
IRDAI · Tata AIA
The hidden bottleneck · TPA
6–8 months
hospital dues delayed by TPAs — yet IRDAI's new mandate is 1 hr admission · 3 hr discharge. Without automation, the penalty is bank rate + 2% daily.
Moneylife (TPA admission) · IRDAI Master Circular 29 May 2024 · PPHI Circular Sept 2024
Same root cause across all 7 verticals
World-class actuarial, policy, and pricing systems — sitting on top of stone-age communication and coordination infrastructure.
03 · Solution
An OS. Not a chatbot.
One agentic core, one audit ledger, one runtime — across every channel, every CMS, every workflow.
Gooclaim OS
v1.0 · multi-agent core
Any data · Any knowledge · Any channel · Any workflow · Any interaction — connected into a single audit-grade agent mesh.
Not a chatbotNot RPANot a CRMAn OS.
Pillar 01Truth Layer · L2
Any data source
REST · SOAP · SFTP · Webhook
Gooclaim
Per-tenant encrypted credentials, circuit-broken, audit on every call.
Hardcoded to 1-2 CMS via API.
Pillar 02Sources · L3
Any knowledge layer
50+ connectors built-in
Gooclaim
Notion, Drive, SharePoint, SQL, S3, Slack, Confluence, past cases, policy PDFs.
Single FAQ DB.
Pillar 03L0 + L5
Any channel
WhatsApp · Voice · SMS · Web · IVR
Gooclaim
Same conversation thread across channels. Hand-off without losing context.
WhatsApp only — or voice only.
Pillar 04L1 + registry.yml
Any workflow
Versioned, hot-swappable
Gooclaim
Versioned config per tenant — custom flows ship as YAML, not as a new build.
Fixed product flows. Custom = new build.
Pillar 05L0 + Voice agents
Any interaction
Text + Voice + Hybrid
Gooclaim
Bilingual by default — Hindi · English · Hinglish + regional. Same agent talks AND types.
Text-only chatbot — or voice-only IVR.
Every output L6-gated
Templates only — no free text
Immutable audit ledger · 7-yr
Multi-vertical by design
04 · Modules
Seven layers. One OS.
Each layer does one job well. Every layer is multi-tenant, audit-instrumented, and platform-agnostic. Add a new vertical without rewriting the platform.
- Layer L0multi-tenant · audit-instrumented
Channel Gateway
Every claimant message starts here.
One inbound layer for every channel a customer actually uses — secure, tenant-scoped, ready out of the box.
- Voice agents
- SMS · Email · Web
- Per-tenant routing
SolvesChannel fragmentation — customer on WhatsApp, agent on portal, no unified view.
Beside the 7 layers
Audit Ledger
Immutable event store. Every decision, every message, every consent.
If IRDAI asks what happened on claim X at time Y — you have the receipt. Append-only, SHA-256 chained, 7-year retention. DPDP-compliant.
Append-onlySHA-256 chained7-year retentionIRDAI exportDPDP-native
audit_event#0x9f3a…b842
type CLAIM_STATUS_FETCHED
tenant 4f9d2a1c-8b73-4e6f-9a02-1c5e7d8b3a91
claim_id sha256:8c4f…e21a
layer truth-layer
ts 2026-06-07T14:22:08.142Z
sealed · prev_hash 7c1f…
05 · Coverage
Coverage is a circle.
Watch what each path can actually cover. The closer the ring reaches the orbit, the more of your claims operation it owns.
DIY
2/7Point Solutions
4/7Gooclaim OS
7/7Everything in the circle — built in, not bolted on.
No vendor sprawl. No integration backlog. One operating system that already does the whole job.
Any channelAny CMSMulti-agentIRDAI + DPDPTemplates-onlyEvery vertical
T = 0%Coverage · auto-loop
- 01Multi-channel, day one
- 02Talks to any CMS
- 03Multi-agent reasoning
- 04IRDAI + DPDP compliance pack
- 05Templates-only output
- 06Time to production
- 07Health / Life / Motor