Claims verification and processing is a critical function for insurance companies in terms of customer retention, service quality, operations costs and profitability. Long processing cycles, poor service quality and faulty claims processing can damage business and reputation for insurance companies.

UNIMAX offers an end-to-end claims service protocol to clients, which is tailor-made to reduce processing time, lower costs and increase efficiency in Claims Processing. Our end-to-end services enable clients to have a single window for all their factual data needs. We provide:

• End To End Service
• PAN India Presence
• Experienced Professionals
• elevant Liaison Support.

UNIMAX's claims professionals have good experience in the Indian Insurance Industry. Our Pan India presence provides us excellent logistical and service advantages along with necessary liaison support in various organizations related to the Insurance Industry.

With the opening up of the insurance sector, the Indian insurance market has become severely competitive. Product differentiation by itself will no longer give companies an edge, it will have to be matched by superior claims servicing for customer delight and efficient processing to reduce costs. UNIMAX is geared to provide clients with the best in-class managed service that will ensure a factual-data environment for the Insurance Industry.

Claim verification- Health Insurance

UNIMAX is ready to be partners leading players in the Insurance Industry in their endeavour to create a fact-based claims investigation environment. It has expert personnel and cutting edge technology. The company want to help its customers serve their clients through better and quicker claim reimbursements. UNIMAX provides outsourcing solutions for the three major types of Insurance - Health Insurance, Life Insurance and General Insurance.

UNIMAX handles health insurance claims investigation for its clients through its Health Insurance Verification and Outsourcing Solutions vertical. UNIMAX's health insurance claims processing team consists of people who have experience in various claims issues like nature of health problems, disease management lifecycle and claims scenario resolution. This guarantees accurate judging of each claim and prevents losses arising from false or misjudged claims.

As claims investigation and processing is mainly dependent on the information provided by the claimant, UNIMAX ensures that the claimant provides necessary and complete information.

Life Insurance

UNIMAX offers end-to-end verification and outsourcing processing solutions to the Life Insurance sector. Its services help Life Insurance companies ascertain the right amount of claim and also, expedite the process because of UNIMAX's reach, network and past expertise in this area. UNIMAX provides outsourcing solutions for the three major types of Insurance - Health, Life and General.

UNIMAX has a wide national branch network and well-cultivated relationships with local bodies like hospitals, doctors and law and order machinery. A team of qualified professionals form a central team which analyses the legal and medical reports of the claimants to ensure correctness and detect any fraud or purposeful misrepresentation.

One of the key risk areas Insurance Companies face globally is the threat of false claims; in case of Life Insurance, the size if often substantial. UNIMAX's Life Insurance Verification and Process Outsourcing Solutions Services protect Life Insurers' interests by advising them about the correctness of each and every claim. The vertical deploys professional knowledge, screening, IT & analysis and local level network to provide full-proof claims verification service.

UNIMAX's verification process begins with collecting the necessary information from the immediate family of the assured. The various documents collected are:

• Proposal form
• Age proof
• Death Certificate
• Claim forms
• Case – Sheets

UNIMAX team then collects the necessary background information about the assured and the family. Medical history of the assured and the family is collected with special focus on any untimely deaths in the family.

Certain key issues addressed are

Cause of Death / Accident:

One of the key points the UNIMAX team establishes is the cause of death or accident; globally, most insurance claim frauds misinterpret the real cause of death. UNIMAX uses its examination of the documents of the case and also field visits to ensure that the cause of death is ascertained in clear terms.
Bonafide Person:

UNIMAX team ascertains that the person against whom the claim has been exercised is bonafide and genuine; the team examines all records of the person and also personally meets the immediate relatives of the deceased to establish genuineness. This establishes the age, health and other personal details of the assured. The teams' checks whether the claimant is bonafide.

Legal and Medical:

UNIMAX's team of claims professionals have in depth knowledge about legal and medical requirements. The team ensures that all required papers and supporting documents have been submitted along with the claim. Incomplete reports like absence of doctors' report etc. if overlooked can cause monetary or time loss to the insurer. All legal and medical documents submitted are examined for authenticity to avoid any manipulation or fraud.
The key challenges in Life Insurance Claims are authenticity of the claim and the claimants. False claims or multiple/fake claimants can lead to legal battles, time and cost inefficiencies and revenue losses. UNIMAX's full-proof verification of the claim and claimants through document examination and physical verification help in eliminating any frauds or mistakes.

UNIMAX's USP is it's near to two decades' experience in this vertical and its strong local level network that is supported by a central team of legal and medical experts. Today, several Indian and few global Life Insurance players have benefited from UNIMAX's Life Insurance Claims Verification and Process Outsourcing services. Clients derive cost and time efficiencies due to outsourcing and revenue benefits due to right claims settlement with UNIMAX's services.

General Insurance

UNIMAX offers verification and outsourcing processing solutions to the General Insurance sector. The company's comprehensive General Insurance Verification and Processing Outsourcing solutions help General Insurance companies arrive at the right amount of claim for assets and in the process create cost and time efficiencies. UNIMAX provides outsourcing solutions for the three major types of Insurance - Health, Life and General.
Today with the ever growing threat perception and mandatory insurance requirements for assets like motor vehicles, travel, mortgage house loan etc, more assets are being insured. In this scenario, it is imperative for General Insurance Companies to ensure that claims verification and processing is accurate, quick and cost effective.

Key areas of investigation and inquiry are based on the information submitted by the claimant. The information collected as below is then processed by the team.

• Proposal form
• Asset ownership proof
• First information report / Police diary or event note
• Claim forms
• Case – Sheets

UNIMAX's areas of assurance in the General Insurance Verification and Processing Outsourcing Services are developed on the basis of the following steps:

Asset / Site verification:

UNIMAX offers asset inspection or site verification service for a claim lodged. The distinct advantage of UNIMAX is its all India branch network which facilitates quick inspection of a site or asset irrespective of its location. Asset or site verification is one of the determining factors that lead to substantiating of the claims.

Documents and Records for the asset:

UNIMAX's verification team comprises experts from investigative, forensic and legal backgrounds. The team thoroughly screens all relevant documents like invoices, registration papers and insurance policy to arrive at a proper valuation of the asset.

Purpose and Intent:

One of the key challenges faced by general insurers is establishing a bonafide purpose and intent of each claim; often, general insurance claims are misused to claim money from the insurance company or maybe a higher value than actual. UNIMAX's team ensures a physical visit to the spot, meeting the claimant and also inquiring about the incident with other witnesses. This ensures a strict verification of the purpose and intent of the claimant.

Ownership and parties involved:

A key focus of the UNIMAX team is to ensure the right ownership of the asset and identify all parties involved, like third party incase of motor accident claims. This is a critical aspect in General Insurance claim, as multiple ownership of a single asset to claim inflated insurance claims needs to be eliminated.

UNIMAX's advantage in the General Insurance Verification and Processing Outsourcing services is its deep understanding of documentation norms and regulations in different Indian states. It has a self-owned all-India network of documentation and site verification experts. Today, UNIMAX is helping General Insurance companies with a faster Turnaround Time (TAT) in claims processing through its extensive branch network, domain expertise, IT and analytical capabilities.

For more details & quotation please contact us.