Read-only to your claims system
Gooclaim reads your record to answer — it never writes back to it. Your system stays the source of truth.
Gooclaim OS
Security & compliance
Health data, handled like health data.
Claims data is health data. Gooclaim OS is designed around what IRDAI and the DPDP Act expect — consent, verification, encryption, masking and an audit trail on every claim.
01 · Security & data
Built for regulated data. From the first message.
Claims data is health data. Every layer of the OS is designed around what IRDAI and the DPDP Act expect — not bolted on after.
One tenant can never reach another
Your tenant is taken from the signed-in session alone — never from a header, a body or a setting. A cross-tenant request is refused, written to the ledger, and the session ends on the spot.
Personal numbers masked
Aadhaar, PAN, card and bank numbers are masked before anything is stored, and contact details never reach a log. What has to be recoverable is encrypted at rest with a key held in a managed vault — the service refuses to start without one.
Consent, then verification
DPDP consent before any claim detail. On WhatsApp the registered number proves who is writing; on email, a one-time code to it does.
Access by role
Sign-in supports multi-factor with an authenticator app. Roles decide what each person sees, and the role is checked on every request — never assumed from the screen they are on.
Every action on the record
Every message, decision and consent in an append-only, tamper-evident ledger — kept for as long as the regulator requires.
02 · On every claim
Every answer, on the record. Every clock, running.
What the OS does on every claim today — for the member who asked, and for the compliance team that has to answer for it.
Every answer
Names its source and date.
A member never gets a bare status. Each answer says whose record it read and when that record was last updated — and every value in it is checked against that record before it leaves.
“The latest status of your claim CLM-24817 (as per your insurer’s records, updated 3 Oct 2026): Under review.”
Whose record · as of when · checked before it is sent
IRDAI clocks
1 h · 3 h · 15 d
On every claim.
Pre-auth, discharge, reimbursement. Slide to see the reimbursement clock run out.
Past 15 days · 2 days late₹361 interest on a ₹1,00,000 claim (est.)
Reimbursement · RBI bank rate 5.75% + 2% · illustrative
Pending documents
Asked, collected, checked.
A secure upload link that can’t be forwarded, every file scanned and checked, reminders on day 7 and 14, a final notice and a ticket on day 21. Cashless members are never asked.
Complaints
Each with its own clock.
Acknowledged within 3 working days, resolved within 14 — and the decision goes back to the member, in their language.
NL-48 TAT report
Built from the record.
The quarterly turnaround report insurers publish — hour bands, month bands, ageing, complaints — straight from your claims. File it once and the copy is frozen with its SHA-256.
Consent & audit
Before a word. After every word.
DPDP consent before any claim detail, identity checked before anything personal, and every decision in an append-only, SHA-256-chained ledger.
See Gooclaim OS on a real claim.
A 30-minute walkthrough — real workflows on real channels, wired to a sample claims system. No slides.