TPA-agnostic comms
Run a single member-facing OS across every TPA you partner with — no per-TPA project.
Gooclaim OS
Use case · Insurers
For insurers. One layer atop every TPA and every channel.
Insurers carry the regulatory risk while TPAs handle the ops. Gooclaim OS gives the insurer a single, audited communication layer that works across every TPA, every channel, every vertical — without ripping out the CMS.
IRDAI + DPDP compliant by designMulti-vertical · same OSPer-TPA isolated audit ledger
The problem · in one number
₹26,037 Cr
of health claims rejected in FY24
Most rejections are not policy-related — they are communication failures: missed deadlines, wrong format, no proactive nudge. Each one becomes an ombudsman case the insurer has to defend.
Moneylife · IRDAI Annual Report 2024-25
What Gooclaim OS does for Insurers
Multi-vertical, one platform
Health today, Motor tomorrow, Life next. Same OS, swap workflows by tenant.
IRDAI Ombudsman ready
Immutable audit ledger with consent, content and decision history — ready for the new Internal Ombudsman Guidelines 2025.
Brand-safe outbound
Templates-only, 4-tier policy gate — free text never leaves on your letterhead.
Real-time SLA dashboards
Per-TPA, per-channel breach tracking against the 1hr / 3hr mandate.
DPDP-native
Consent gate at step zero, withdrawal honoured within one business day.
Who this is for
Three people own this in your org.
Gooclaim OS shows up first for these roles — but the platform serves the entire claim chain.
Head of Customer Operations
Owns CSAT, NPS, ombudsman volume and TAT.
Chief Risk / Compliance Officer
Owns IRDAI exposure, audit posture, DPDP readiness.
Chief Technology Officer
Owns CMS, channels and the never-ending integration backlog.
Same actuarial. Different mouth.
Your policies, pricing and underwriting are world-class. Replace the stone-age communication layer underneath — without touching the rest of the stack.