The challenge
Anand did a lot of insurance and corporate work, and tracked all of it in spreadsheets maintained alongside the billing software. Claims were entered when raised and updated when someone remembered.
The result was that nobody could answer the basic question of what was outstanding. Claims that had been short-paid were not identified as short-paid; they were simply recorded as paid. Claims never submitted looked identical to claims submitted and awaiting settlement.
Monthly corporate invoicing took the better part of four days, because it meant reconciling the billing system against the spreadsheets before anything could be sent.
What we did
Claim tracking moved into the billing record itself. Every insurance bill carries its TPA, policy number and claim reference from the moment it is raised, and its status moves through submitted, in process, settled or short-paid.
Settlement reconciliation matches payments received against amounts claimed, so a short-payment is flagged rather than absorbed.
Corporate tie-ups were set up with their own rate lists and consolidated monthly invoicing, which removed the reconciliation step entirely.
The outcome
The first aged outstanding report identified about seven point one lakh rupees in claims more than ninety days old, a significant portion of which had never been submitted at all.
Average settlement time fell by sixty-eight days, mostly because claims now get submitted promptly and chased on a schedule rather than when someone notices.
Monthly corporate invoicing went from four days to one, since the invoice is generated from the same records that produced the bills.
The first outstanding report was uncomfortable reading. It was also the most valuable thing the software has done for us — we were carrying seven lakh rupees we had stopped counting on.