SureClaim: Improving the healthcare and health insurance experience for LMI users

The InsurTech startup SureClaim works with individuals and organizations to simplify the experience of dealing with hospitalization expenses when needed, assist them with timely processing of insurance claims, and minimize their out-of-pocket spending. SureClaim’s objective is to extend its offerings to low- and moderate-income (LMI) customers in India and improve their experience around accessing suitable healthcare services and claiming health insurance. This blog explores the journey of this startup and the positive impact it hopes to create for this segment in India.

This blog is about a FinTech startup from the Financial Inclusion Lab accelerator program, which receives support from some of the largest philanthropic organizations across the world—the Bill & Melinda Gates Foundation, J.P. Morgan, Michael & Susan Dell Foundation, MetLife Foundation, and Omidyar Network.

Since SureClaim participated in the first cohort of the FI Lab, it has created a streamlined communication plan for reaching out to a broad audience. It formed strategic partnerships with health and wellness aggregators, such as Apollo Life, CNH, and Truworth Wellness. SureClaim assists the low-and moderate-income (LMI) customers of these aggregators with hospitalization and insurance claims.

The premiums for health insurance in India increased by 41% in March, 2021. The increase was driven by rising demand for health insurance products amid the surge of COVID-19 in India. However, LMI customers find it challenging to choose the right insurance policy. They cannot process their claims smoothly due to lengthy and complex terms and conditions from insurance providers. SureClaim’s vision is to become the single-window solution for any patient seeking affordable hospitalization. It will guide them to the most appropriate treatment centers based on their healthcare requirements and insurance plan and assist them with the claim process.

SureClaim’s unique pitch and the FI Lab support

SureClaim seeks a holistic understanding of the experience of LMI customers throughout their journey as they use healthcare and insurance. People from the LMI segments face several challenges and respond uniquely through this journey—from searching for a primary healthcare provider, selecting an appropriate hospital, using health insurance, to claiming the settlement successfully.

Through CIIE.CO and MSC, the FI Lab helped SureClaim build this understanding by conducting market research with urban LMI respondents (Figure 1).

We segmented LMI users into different persona groups and uncovered critical factors that influence their choices at each stage of their journey as they seek healthcare. This segmentation exercise will help SureClaim approach them based on their specific characteristics. The startup can design appropriate nudges to sensitize users on the intricacies of hospitalization and help them avail the most of their eligible amount in the claims settlement process. MSC also recommended various B2B2C and B2C partnership strategies for the startup to increase its customer outreach.

We also developed a hospital navigator prototype that SureClaim can offer to their customers to guide them through their entire healthcare journey. With this prototype, the startup’s users will have a hassle-free healthcare experience. This prototype covers researching doctors, finding suitable hospitals for procedures, and retrieving details of their insurance policy coverage to ensure that the insurance covers their treatment or visit.

Creating opportunities from crises

During India’s second wave of the pandemic, SureClaim helped more than a thousand patients find hospital beds, access life-saving treatments, and assisted in their insurance claim processes. The startup thus played an impactful role in instilling the importance of health insurance coverage in the LMI community in its own small yet significant way.

The path ahead

SureClaim plans to scale up its current user volumes tenfold through corporate networks under B2B2C business models. SureClaim believes it can reach out to a diverse range of end customers through such tie-ups, ranging from small business owners to microfinance institutions, small finance bank customers, to white-collar workers in semi-urban areas. Building on its goal of becoming a single-window healthcare solution, SureClaim will assist these users in improving their experience of health insurance and trust in it.

This blog post is part of a series that covers promising FinTechs that make a difference to underserved communities. These startups receive support from the Financial Inclusion Lab accelerator program. The FI Lab is a part of CIIE.CO’s Bharat Inclusion Initiative and is co-powered by MSC. #TechForAll, #BuildingForBharat

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