🇮🇳 India's First AI Health Claim Appeal Tool

Your insurance company said no.
Fight back in 3 minutes.

Upload your documents. Our AI reads IRDAI regulations, finds every gap in the rejection, and writes your professional appeal — with your estimated recovery amount and win probability.

Start My Appeal — Free → See How It Works ↓

Free during beta · Works in your browser · No lawyer needed

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Insurance PolicyBest analysis
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Hospital BillsStrengthens case
✉️
Rejection / Approval LetterMinimum required

The system is stacked against you.
We level the playing field.

Insurance companies have legal teams. Until now, you didn't.

3 minutes vs 2 weeks

Traditional services take 1–2 weeks. ClaimBack delivers your appeal letter and full analysis in under 3 minutes.

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Gaps, not guesses

We identify specific legal gaps in the insurer's reasoning — citing the exact IRDAI regulation that applies to your case, not a generic template.

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Know before you fight

Estimated recovery amount (min–max) and win probability calculated upfront — so you go in with eyes open, not blind faith.

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Your data stays protected

Documents encrypted, stored in India (Mumbai), processed solely for your analysis. Compliant with India's DPDP Act 2023. We never sell your data.

₹26,037 crore in health claims were rejected last year.
Most claimants give up. You don't have to.

Total claims filed
₹1.10L Cr
FY2023-24 · IRDAI Annual Report
Approved & settled
82%
₹90,200 Cr paid out · IRDAI 2024
Rejected / disallowed
12.9%
₹26,037 Cr · Business Standard Dec 2024
Win rate on appeal
~58%
Insurance Ombudsman data 2023-24
31%Pre-existing disease exclusion
24%Policy exclusion / sub-limit breach
18%Incomplete / incorrect documentation
15%Non-disclosure at policy issuance
12%Waiting period not completed
Average cost — traditional services
₹5,502
₹999 fee + 15% of claim · Insurance Samadhan 2024
ClaimBack flat fee
₹999
All 4 escalation levels · No success cut

From rejection to appeal letter in under 3 minutes

No legal jargon. No appointments. No waiting. Upload all documents before you pay — re-running analysis requires a fresh payment.

STEP 01
📤

Upload your documents

More documents = higher confidence + more accurate estimate. Upload everything you have before proceeding.

📋 Policy ✉️ Rejection Letter 🏥 Hospital Bills
STEP 02
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AI reads IRDAI regulations

Cross-references your documents against IRDAI Health Insurance Regulations 2016 and Insurance Ombudsman Rules 2017 to find every gap in the rejection.

STEP 03
⚖️

Get estimate + appeal letter

Win probability score, estimated recovery amount (min–max), gap analysis with regulation citations, and a professionally drafted appeal letter.

STEP 04
📬

Send. Escalate if needed.

4 escalation paths with ready-to-send emails: Grievance Officer → IRDAI Bima Bharosa → Ombudsman → Consumer Court docket.

Estimated recovery + win probability,
from AI analysis of your documents benchmarked against IRDAI regulations

Your output — and its confidence level — depends on which documents you upload. The app will always tell you how to improve your analysis before you pay.

74WIN SCORE

Good Appeal Case · Confidence: High

Your rejection cites a pre-existing condition exclusion, but IRDAI Regulation 8(6) limits this to conditions disclosed at policy issuance. Our analysis found 3 gaps in the insurer's reasoning.

Est. Recovery (Min)
₹1.8L
Conservative scenario
Est. Recovery (Max)
₹2.4L
If Level 1 succeeds
Win Probability
74%
Confidence: High ✓
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Upload hospital bills to reach Confidence: Very High You've provided your policy + rejection letter. Adding itemised hospital bills lets us verify the exact billed amount vs. claimed — improving your recovery range accuracy. Act before paying: once the analysis runs, a re-run requires a fresh payment.
Why does a re-run cost again? Each analysis reads your documents end-to-end using AI — there's no cached "partial result." Adding new documents means running the full analysis afresh. The fee reflects that real cost honestly. We surface this upfront so you upload everything before you proceed. That's just being fair.

Transparent pricing. No cuts from your recovery.

Average claim value is ₹31,086. Spending ₹499–₹999 to fight for it is a straightforward decision — and still 5.5× cheaper than traditional services.

Essential
Appeal Starter
₹499 /case
Good for clear-cut cases
Upgrade to Full Package anytime: pay ₹799 more (total out-of-pocket: ₹1,298). A fresh analysis runs with your complete document set.
  • Full AI analysis + gap identification
  • Win probability score
  • Estimated recovery (min–max)
  • Level 1 — Grievance Officer appeal letter
  • Level 2 — IRDAI Bima Bharosa email
  • Level 3 — Ombudsman complaint
  • Level 4 — Consumer Court docket

Upgrade anytime for ₹799 — not ₹500. Fresh analysis runs in full.

🎉 Beta is completely free. Sign up free on the web and use ClaimBack at no cost during beta.

For HR teams managing group health claims

Your HR department spends hours helping employees fight rejected claims. ClaimBack cuts that to minutes — per case — at a fraction of traditional service costs.

Small teams
(50–250 people)

Your HR person is drowning in claim disputes on top of their regular duties. They need a tool that turns hours of research into a polished appeal letter in 3 minutes.

Discuss your plan →

Mid-market
(250–1,000 people)

Rejected claims are bleeding your benefits budget. Your HR team knows the patterns but doesn't have time to fight each one individually. ClaimBack scales their advocacy.

Discuss your plan →

Enterprises
(1,000+ people)

At scale, claim rejections cost you millions annually. You need a standardised, auditable process your HR can deploy across the entire employee base — and we can customise it.

Discuss your plan →

Custom pricing based on your company's needs

We'll review your group health policy, case volume, and team size to design a plan that works.

Get Pricing →

ClaimBack vs the alternatives

Feature ClaimBack Insurance Samadhan Do It Yourself
Time to appeal letter3 minutes1–2 weeksDays to weeks
Cost₹499–₹999 flat₹999 + 15% of claimFree (complex)
Estimated recovery amount Yes No No
Gap analysis with IRDAI citation Specific regulation Yes Unlikely
4-level escalation plan Yes You manage You manage
Win probability score AI-calculated No No

Tell us what happened.
Earn ₹200–₹300 in shopping vouchers.

Once you've sent your appeal, come back and update your outcome. Your real-world result helps us improve accuracy for every claimant who comes after you — and we reward you for it.

🛒 Amazon / Flipkart Voucher
₹200

Any outcome update + supporting document

Update your case status (won, lost, pending, escalated) and upload any supporting document — insurer response, TPA letter, Ombudsman acknowledgement, or any correspondence.

✓ Even a loss counts — all outcomes are valuable
🎉 Amazon / Flipkart Voucher
₹300

Proof of settlement or approval

Upload your settlement letter, final approval from the insurer, or payment confirmation showing the claim was resolved in your favour (full or partial).

✓ Highest tier — verified win proof

How it works

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Send your appeal letter from ClaimBack
Wait for insurer response (15–30 days typically)
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Open ClaimBack app → update your outcome → upload document
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AI verifies document (48–72 hrs)
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Voucher code emailed to you

Vouchers are issued as Amazon or Flipkart gift codes via email. One voucher per case. Verification is automated — documents are checked for authenticity by our AI. Fraudulent uploads will result in disqualification. Programme is active during beta and subject to change. No cash alternative. Not a cashback or financial service.

Join the ClaimBack beta

Invite-only. Completely free. Works right in your browser.

Start Free on the Web

No app download needed. Sign up with your email, upload your documents, and get your appeal — right from your browser.

💻 Works on any device Phone or computer Free in beta 3 mins to appeal
Create Free Account →

iOS app in beta · Android coming soon · support@claimback.co.in

Common questions

Which documents should I upload for the best analysis?

Upload all three for the most accurate result: (1) Insurance policy document — lets us cross-reference your actual coverage terms. (2) Rejection or partial approval letter — minimum required to run any analysis. (3) Itemised hospital bills — helps us verify the billed vs. claimed amount and sharpen your recovery estimate. More documents = higher confidence level and a more precise win probability. Important: upload everything before you pay. Re-running analysis requires a fresh payment because the full AI analysis must be re-executed — there is no "top-up" option.

Why do I have to pay again if I want to add more documents later?

Every analysis — including a re-run — reads your documents end-to-end using AI. There is no cached "partial" result we can build on. Adding new documents means running the full process again from scratch: re-reading every page, re-cross-referencing every IRDAI regulation, and regenerating your appeal letter. That costs real compute and AI processing — and we pass it on honestly rather than baking it into a higher initial price. We surface this prominently before you pay so you have every opportunity to upload all documents first. That's just being fair to you.

What does the win probability and estimated recovery amount mean?

The win probability (0–100%) is an AI assessment of how likely your appeal is to succeed, based on your rejection reason, policy terms, and applicable IRDAI regulations. The estimated recovery (min–max range) is derived from your claimed amount, the identified gaps, and patterns from similar appeal outcomes. Important disclaimer: these are AI-generated estimates for informational guidance only. They are not a guarantee or prediction of outcome, and do not constitute legal advice. Actual results depend on the insurer's response, the Ombudsman's discretion, and facts not visible in your documents. Confidence level (Low / Medium / High / Very High) tells you how complete your document set is for the analysis.

What are the "gaps" ClaimBack identifies?

Gaps are points where the insurer's rejection reasoning does not align with IRDAI Health Insurance Regulations 2016, your specific policy terms, or Insurance Ombudsman Rules 2017. For example: a pre-existing disease exclusion applied beyond IRDAI's permitted waiting period limits, or a sub-limit enforced without clear disclosure at policy issuance. Each gap is cited with the specific regulation number — not generic language.

Is ClaimBack a legal service? Is it regulated?

No. ClaimBack is an AI-powered document analysis and drafting tool — a software product, not a law firm and not an insurance intermediary. We are not regulated by IRDAI (which regulates insurance companies and licensed intermediaries). We are not regulated by the Bar Council (which regulates lawyers). Our service is informational — we help you understand your position and draft appeal documents. For complex legal proceedings, we recommend consulting a licensed insurance lawyer, particularly for Consumer Court matters.

How is my data protected under India's DPDP Act?

ClaimBack is committed to compliance with India's Digital Personal Data Protection Act 2023 (DPDP Act). Your documents are: (1) processed solely for generating your analysis and appeal letter; (2) stored encrypted in India (AWS Mumbai, ap-south-1); (3) never sold, shared, or used for any other purpose; (4) retained for 12 months then deleted automatically. You may request access, correction, or erasure of your data at any time by emailing support@claimback.co.in. See our full Privacy Policy for details.

How do I earn the ₹200–₹300 voucher?

After sending your appeal, come back to the ClaimBack app and update your outcome — won, lost, pending, or escalated. Upload any document related to the outcome (insurer response, TPA letter, settlement letter, approval email, etc.). Our AI verifies the document within 48–72 hours. If it passes, we email you an Amazon or Flipkart gift voucher: ₹200 for any valid outcome document, ₹300 for a settlement letter or formal approval confirming your claim was resolved. Even if you lost, update your outcome — we value all data and still send ₹200. One voucher per case. No cash alternative. See the Close the Loop section above for full details.

What if my appeal fails at all four levels?

ClaimBack provides you with all tools and documents to pursue every available statutory remedy. If all four levels are exhausted without resolution, the Consumer Court docket we provide (Level 4) is your final formal option and requires a lawyer to represent you in proceedings. We do not provide legal representation. At that stage, we recommend engaging a licensed insurance lawyer — and we plan to partner with legal referral services to help you find one.

⚠️ AI Disclaimer — Estimates & Probability The win probability score and estimated recovery amount generated by ClaimBack are AI-derived estimates based on your uploaded documents and IRDAI regulations. They are for informational guidance only. They are not a guarantee, prediction, or legal opinion regarding your case outcome. Actual results depend on insurer discretion, Ombudsman findings, and facts that may not be present in your documents. ClaimBack accepts no liability for decisions made based on these estimates.
ℹ️ Not Legal Advice ClaimBack is an AI-powered document drafting tool. It does not constitute legal advice, and ClaimBack is not a law firm. The appeal letters, escalation emails, and analysis generated are starting points for your own action — review all content before sending. For legal representation in Consumer Court or complex insurance disputes, consult a licensed advocate.