SCOPE OF SERVICES

Fraud Detection & Claim Integrity Services

Identification, investigation, and substantiation of fraudulent insurance claims. Submission of evidence-backed reports.

Reduction of Fraudulent Death Claim Ratio

Verification of cause, timing, and circumstances of death. Authentication of hospital and local authority records.

Pre-Policy Risk Assessment

Video call and field verification. Verification of occupation, income, and lifestyle.

Private Forensic & Pathology Laboratory Support

Full utilization in pre-policy check-ups to detect sample substitution or fabricated reports.

Post-Insurance Policy Checks

Post-issuance verification of insured’s existence and address. Policy audits to detect moral hazard.

Legal & Regulatory Support

Assistance in lodging FIRs, expert testimony, and death certificate cancellation assistance.

Control & Reduction of Medical Bill Inflation

Medical audit of hospitalization. Identification of inflated bills and unnecessary treatments.

Employee checks, TPA Mystery Shopping.

Forensic Services

In-depth scientific analysis of physical and digital evidence for claim substantiation.

Forensic Consultation

Professional advisory services on forensic findings and medico-legal complexities.

Mystery Shopping

Covert audit of TPA operations and hospital network protocols to ensure integrity.

We proudly offer comprehensive and reliable services across a wide geographic footprint. Currently, our operations extend across Maharashtra, Madhya Pradesh, Chhattisgarh, and Uttar Pradesh, covering all major districts, cities, and key locations within these states. Our wide coverage enables us to deliver timely, accurate, and consistent services.

Maharashtra Madhya Pradesh Chhattisgarh Uttar Pradesh
Our Operational States - MH, MP, CG, UP

Direct operational presence in highlighted regions

Services and their overview

Claim Investigations (Death, Critical Illness & Health)

End-to-end investigation of insurance claims to assess authenticity and compliance. Field investigations, hospital visits, and evidence collection.

Claim Assistance

Support to insurers/TPAs in claim processing activities. Coordination with claimants, hospitals, and employers.

Document Procurement

Collection of required documents from hospitals, employers, and authorities. Ensuring completeness and authenticity.

Profile Checks

Background verification of insured including address, occupation, income, and lifestyle profiling.

Document Verification (Each)

Authentication of submitted medical, financial, and identity records with issuing institutions. Identification of discrepancies.

Live Verification & Pre-Claim Verification

Real-time verification through video calls. Confirmation of health condition or hospitalization prior to claim registration.

Skip Tracking of Lapse Policies

Tracing and locating policyholders of lapsed policies. Providing updated contact details and existence confirmation.

Forensic Document & Signature Examination

Scientific examination to detect forgery or alterations. Analysis of ink, handwriting, and printing using forensic techniques.

Forensic Services

Advanced scientific analysis and physical evidence processing to support litigation and claim integrity.

Forensic Consultation

Providing strategic consultation on complex cases involving forensic data and medico-legal opinions.

Mystery Shopping

Conducting simulated interactions to audit TPA efficiency and hospital billing integrity.

Professional Competency

Our field operations are driven by a high level of professional competency, supported by robust technology and strict compliance protocols. All field explorers are fully equipped with smartphones and essential digital gadgets, enabling real-time data collection and seamless communication. The transfer, storage, and monitoring of data are carried out exclusively through secure, authorized tools, ensuring that all collected information and documents remain within controlled systems at all times. Data safety and confidentiality are treated as top priorities, with zero tolerance for breaches. Regular data purging is conducted in accordance with security protocols to prevent unauthorized retention or misuse of information. Additionally, surprise audits, random checks, and systematic searches are carried out at different operational stages to safeguard the interests of our clients and maintain the highest standards of integrity, accuracy, and trust.