One agentic core. Every channel. Every CMS.
Gooclaim OS is a Claim OS — a multi-agent system that reads any claims system, answers on any channel, and checks every word against your record before it leaves. Everything it does is on the record.
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.
An OS. Not a chatbot.
One agentic core, one audit ledger, one runtime — across every channel, every CMS, every workflow.
Any data · Any knowledge · Any channel · Any workflow · Any interaction — connected into a single audit-grade agent mesh.
One message, on a Sunday. Five things happen before it is answered.
Switch the language the member writes in. Gooclaim OS answers in English, Hindi and Hinglish today, and nine more are next in line — already read, waiting only on a customer who needs them. Tap one to tell us it is yours.
Any data source
Opens the claim in your own claims system and reads where it actually stands — read-only, with its own encrypted credentials, and the call itself on the record.
A chatbot answers from a FAQ. It has never seen this claim.
Any knowledge layer
Finds what the answer has to rest on — the policy wording, the query letter already sent, the way this was handled last time.
One FAQ database, written once, already behind the policy.
Any workflow
Runs the workflow your team switched on in the Console. It is declared once and versioned — not rebuilt for each customer, and not edited in a hurry on a Friday.
Fixed product flows. Anything different is a new build.
Every word checked
Every value in the draft is matched back to the record it came from, and the wording is one your team approved. No match, nothing leaves.
A chatbot writes a sentence and sends it.
Any channel, any interaction
Leaves on the channel it arrived on, in the language it arrived in. If the member calls next, it is the same thread and the same agent — nothing is explained twice.
WhatsApp only, or voice only. Two bots, two threads.
“What is happening with CLM-2487? It has been 9 days.”
- Read from your claims system · read-only
- Query letter sent on day 6 · one document still open
- Claim status · your switched-on workflow
- 4 of 4 values matched to the record
- Sent on WhatsApp · in English
Your claim CLM-2487 is with the medical team. We are still waiting on the discharge summary — please send it using this link.
Each of those five lines is a row in the audit ledger, with the claim it belongs to and the time it happened.
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.
- Channel layermulti-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.
- Per-tenant routing
- Voice · SMS · Web — next
SolvesChannel fragmentation — customer on WhatsApp, agent on portal, no unified view.
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, 10-year retention. DPDP-compliant.
Five systems hold a piece of the answer. None of them holds the answer.
“Has my claim moved?” is one question. Answering it today means a person opening five things, none of which can tell the member anything on its own — and none of which records what the member was finally told.
“Thanks, we will get back to you.”
Query raised on day 6
Query letter sent on day 6
Chased? Someone thinks so
15 days from submission
- Day 6Query raisedread from your claims system
- Day 6Query letter senton the claim, not in an inbox
- Day 9Member told, in their languageWhatsApp · approved wording
- Day 11Document receivedupload link · checked on arrival
- Now4 days left of 15IRDAI clock, from submission
Five places. No single record of what the member was told, or when.
The same five facts. One place to read them, and one place they are kept.
Built around the claim. Started with health.
Every claim — health, motor or life — has the same moments: a status to tell, documents to collect, a reason to explain and a clock to beat. This is what they look like in health, where the IRDAI clock is strictest.
- Who it waits onThe hospital, the TPA and the insurer
- A status to tellPre-auth, query, approval, settlement
- Documents to collectDischarge summary, final bill, investigation reports
- A reason to explainEach deduction, and the policy clause behind a rejection
- A clock to beat1 hour for pre-auth · 3 hours for discharge · 15 days to settle
cut from approved health claims in FY24.
Motor and life have the same moments — a surveyor or a nominee’s papers instead of a hospital, and a regulator clock on every claim.
The questions TPAs ask. Answered plainly.
No. Gooclaim OS reads from the claims system you already run — by API, a secure file drop or a batch upload — and never writes back to it. Your system stays the source of truth.
See Gooclaim OS on a real claim.
A 30-minute walkthrough — real workflows on real channels, wired to a sample claims system. No slides.