ClaimBuddy: ESTA 2024: ClaimBuddy wins by easing the pain of insurance claims for everyone

This is part of a series of interviews with the winners of The Economic Times Startup Awards 2024.

it was during Khet Singh Rajpurohithis passage through a initiation of medical care who gained first-hand experience of the struggles of patients seeking to resolve insurance claims. The co-founder of Claim Buddy We saw numerous cases where people had to extend their hospital stay or endure more stress, simply due to delayed or denied claims.

During his second year at IIM Bangalore, Rajpurohit reached out to Ajit Patel, his former colleague who headed insurance operations at the healthcare startup, and the two delved into the complexities and inefficiencies in claims processing. Ultimately, they envisioned a solution that would simplify the claims process for both patients and healthcare providers. This is how the idea for ClaimBuddy, which won this year’s award, came about. Best on Campus Category at The Economic Times Startup Awardsfor trying to solve the important problem of making the health insurance claims process more transparent and efficient. Others in the Best on Campus category included aerospace and urban mobility startup Khageshvara Aviation Technology, fuel aggregation platform Nawgati, cleantech startup Yotuh Energy and Culture Circle, a luxury marketplace for sneakers, watches and clothing urban.

“ClaimBuddy is a commitment to ensuring patients receive the care they need without the added stress of navigating complex insurance processes. We are driven by the belief that healthcare should be compassionate, efficient and accessible to all,” said Rajpurohit.

Typically, the insurance industry includes third-party administrators (TPAs) who work with insurers to process claims. However, there is no such interface available for hospitals and patients.

Gurugram-based ClaimBuddy, whose competitors include ClaimTherapist and BimaGarage, is looking to address this gap in the insurance chain. Up to 91% of the total premiums collected from the sale of health insurance policies are recovered. While there are many companies selling insurance, almost none are solving the claims problem, even though both are equally large markets, Rajpurohit said.

“We have found numerous cases where patients had to spend extra nights in hospitals because approval was not obtained, or where people, despite paying premiums for years, were denied claims for thousands of dollars because of errors in relatively small presentation. While many players focus on selling insurance, we are on the other side, helping people have a seamless claims experience,” Patel said.

Post-Covid, there has been an increase in health insurance awareness and adoption, and ClaimBuddy’s goal is to ensure that patients and hospitals can work together effortlessly during the claims process.

The startup, which has around 130 employees, has processed claims worth over Rs 180 crore, works with over 125 hospitals and has treated over 15,000 patients so far. Valued at $23 million in April this year, its investors include Bharat Innovation Fund (BIF), Chiratae Ventures, Rebright Partners and Titan Capital.

In April, Claimbuddy raised $5 million in Series A funding round. The fundraising was led by BIF, with participation from Japan’s CAC Capital and existing investors including Chiratae Ventures and Rebright Partners.

“The recent investment will help us expand our operations, improve product offerings and expand our reach to more hospitals. We also plan to test a couple of new product offerings,” Patel said.

Meanwhile, Claimbuddy is looking to hire technology and product talent, as well as senior leaders to head product and strategy functions.