Star Health to Outsource Claims Processing to Medi Assist's AI Platform
MUMBAI: In a first for India's largest retail health insurer, Star Health has decided to outsource a significant part of its claims operations to a third-party administrator. The insurer will adopt Medi Assist's AI-driven MAtrix platform to expedite claims processing and enhance fraud detection capabilities.
The move is part of Star Health's broader effort to modernize its claims ecosystem. The platform, which uses intelligent automation and real-time data integration, will eventually handle the full volume of Star Health's in-house claims portfolio. According to Medi Assist, the AI tools embedded in MAtrix will help cut down on waste, eliminate manual intervention, and streamline workflows to deliver quicker settlements and better customer experience, the partners said.
Anand Roy, MD & CEO, Star Health, said the shift reflects the insurer's intent to build a technology-led, agile claims infrastructure. 'This partnership is a key milestone in our journey to strengthen claims management. By improving speed, accuracy, and consistency, we aim to deliver a transparent and reliable claims service while addressing fraud, waste, and abuse,' he said.
Medi Assist CEO Satish Gidugu said the collaboration will modernize claims adjudication and reshape how insurers interact with stakeholders.
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'We are redefining industry standards in technology-driven operations,' he said.
The MAtrix platform provides Star Health with a rules-based adjudication engine that improves accuracy and consistency. AI co-pilot features support claims teams in making quicker decisions, while machine learning tools enhance fraud detection. The system's integration with Star Health's internal architecture ensures scale, real-time exchange, and compliance with the National Health Claims Exchange framework.
The partnership also brings in AI-powered customer engagement tools such as chatbots and virtual assistants, with omnichannel availability via mobile apps and WhatsApp. These upgrades are expected to improve responsiveness and policyholder satisfaction.
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