Your claim was denied. Upload Your Denial Letter.
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No. ClaimRights is a document preparation service powered by AI. We generate appeal letters, IRDAI complaints, and Ombudsman petitions based on your uploaded denial letter and answers. We do not provide legal advice, medical advice, or represent you before any insurer, regulatory body, or court. For complex litigation or high-value disputes, we recommend consulting a licensed advocate. Our system flags cases that genuinely need a lawyer and tells you why.

Templates are static fill-in-the-blank documents with no legal intelligence, no insurer-specific arguments, no denial code parsing, and no quality assurance. They do not know that a "pre-existing disease" denial requires different regulatory citations than a "room rent sub-limit" denial under a group Mediclaim plan. Our 5-agent pipeline knows the difference and generates accordingly. Unlike a single chatbot prompt, our Red-Team agent attacks its own draft the way the insurer will, so you fix vulnerabilities before they see your appeal.

After our Drafter agent writes your appeal, a separate Red-Team agent reads it as if it were the insurer's claim review committee. It hunts for weak arguments, missing IRDAI circular references, ambiguous medical necessity language, and procedural gaps the insurer could use to uphold the denial. The Attack Report lists every vulnerability with specific fixes. No template or generic AI does this. It is the single most important step that turns a "hopeful letter" into a defensible appeal.

No. Upload your denial letter, claim settlement letter, or rejection email (PDF, photo, or scan). Our Document Parser agent extracts the denial reason, policy number, claim amount, insurer name, and regulatory deadline automatically. If the document is unclear, we ask you three to five targeted questions. Most users upload a phone photo of their insurer's rejection letter and the system handles the rest.

Under IRDAI guidelines, insurers must resolve grievances within 14 days. If you have missed the insurer's internal appeal window, you still have options: escalate via IRDAI's Bima Bharosa portal, approach the Insurance Ombudsman (within one year of the insurer's final rejection), or file under the Consumer Protection Act, 2019. Our Escalation Roadmap agent maps your exact next step based on how much time has passed and the value of your dispute. If there is truly no path forward, we tell you that honestly.

Bima Bharosa (bimabharosa.irdai.gov.in) is IRDAI's official online grievance portal. Filing a complaint here creates regulatory pressure on your insurer because IRDAI tracks resolution timelines and can impose penalties for non-compliance. Every appeal package we generate includes a Bima Bharosa complaint pre-filled with your case details. It is a standard tactic that patient advocates and insurance experts use, but most Indian policyholders do not know it exists. It is included in every package at no extra charge.

The Case Strength Rating rates how strongly the applicable IRDAI regulation or court precedent generally favours a policyholder for your type of denial — for example, IRDAI's strict cashless timelines make a cashless-delay denial a strong case, while an exclusion-wording dispute depends heavily on your specific policy. It is a plain-language rating, not a percentage or a prediction of your case, based on the regulator. It breaks down the estimate by your specific denial reason, insurer, and policy type. The prediction is informational and based on aggregate data, it is not a guarantee of any outcome.

Yes. Your rejection letter is read inside your own browser using client-side technology — the file itself is never uploaded to a ClaimRights server. The text from it is checked by an AI service (OpenAI) to verify it's genuine and read its details; OpenAI doesn't use this text to train its models and deletes it within 30 days. Your account details (name, email, mobile) are stored securely in our database (via Supabase), protected so that other users cannot see your records. When you generate a document, a copy is emailed to you through our email provider. We do not sell or share your health or policy information with third parties. We design our systems with the sensitivity of health information in mind.

That's a different situation from a rejection, and we handle it differently — upload the letter the same way, and the AI will recognize it as a "low settlement" rather than a rejection. The IRDAI Master Circular on Health Insurance Business (2024) requires insurers to give a specific, itemized reason — tied to an actual policy clause — for any partial deduction. A vague reason like "other deductions" or "miscellaneous charges" doesn't meet that bar, and a partial settlement has the same right to escalate as a full rejection. We'll generate a Deduction Challenge Letter for this instead of a standard appeal.

Yes — every document, including the full analysis and all downloads, is free during our public pilot. There's no catch and no card details are ever asked for. We're doing this to learn how useful ClaimRights actually is, directly from the people using it.

We can't promise that forever — this is a public pilot, and we may introduce pricing for some features later based on what we learn. If that happens, we'll announce it clearly in advance; nothing will change without notice. See our Terms of Service for the current position.