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WorkflowHow it worksWhy Pramaan
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Stronger claim decisions. Fewer surprise denials.

Pramaan, a caretaker for your claims — before they're denied.

It flags, fixes, and follows up on every claim you file.

Documents come in. Pramaan reads the fine print. Agents surface the risk and chase the insurer when a denial shouldn't stand — so billing isn't left filing blind.

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Pramaan · claim decisions
Pre-file risk queue
SAMPLE
ClaimPayerAmountWinStatus
CLM-4821
Waiting period check
Insurer A₹2.4L0%Hold
CLM-4819
Exclusion review
Insurer B₹95K0%Review
CLM-4814
Documentation gap
Insurer C₹1.1L0%Risk
Pramaan flags what will likely be rejected before you file, so billing teams decide with the appeal engine behind them.
26 lakh

health claims denied last year, after the insurer reviewed them

₹30,000 Cr

the value of those denials in FY25 — up from ₹21,861 Cr in FY23

15 days

the insurer's deadline to settle your claim, or pay interest

Source: IRDAI Annual Report 2024-25

Workflow

From documents to a fightable case.

Upload. Parse the fine print. Structure the claim. Get a straight report. The same Pramaan pipeline that powers pre-file decisions for your billing team.

System view

Documents to report

document ingestIRDAI matchagent runtime
Policy
Rejection
Pre-existing · denied
2 documents in
Parsing
47
clauses
IRDAIOmbudsmanfine print
Claim structureDrafted

Waiting period served · exclusion misapplied · prior rulings attached

ReportDone
Winnable · 78% confidence
Grievance path ready · chase insurer
pramaan.pipeline · sample run
parse 1.2s
14:02:11UPLOADPolicy.pdf + Rejection.pdf received
14:02:14PARSE47 clauses · waiting period served
14:02:16MATCHIRDAI + 8 Ombudsman rulings linked
14:02:17CLAIMCase structure built · grounds drafted
14:02:19REPORTWinnable · confidence 0.78 · ready to fight

The fine print is the case

We read every clause against IRDAI rules and past Ombudsman rulings — not a checklist.

Honesty before the fight

If you don't have a case, we say so. A rejection isn't automatically a battle worth fighting.

We don't stop at the report

Agents chase grievance officers, IRDAI, and the Ombudsman — so a denial isn't the end.

Product

How it works

Automate claim decision support with the Pramaan engine that challenges insurers — so you recover more with fewer blind filings.

Step 01

See risk in the queue

Every claim ranked by denial likelihood and financial impact — so billing focuses on what matters first.

Priority · value · urgency
Step 02

Pramaan reads the case

Policy clauses, IRDAI rules, and Ombudsman patterns against the documents you already have — before submission.

Policy · rules · history
Step 03

Decide: file, fix, or hold

A straight recommendation with grounds. Fix weak docs, hold a doomed claim, or file with confidence.

Decision support
Step 04

Learn from every fight

The appeals Pramaan wins feed back into pre-file flags — so the next denial is cheaper than the last.

Appeal loop
Why Pramaan

Decision support from the appeal side of the table.

Claims software sees the denial and stops. We live in the fight after — and bring that signal back to filing.

Intelligent denial prioritization

Rank claims by overturn likelihood and rupees at risk — not first-in, first-out.

Policy-aware decisions

Pramaan checks clauses, waiting periods, and exclusions against IRDAI and Ombudsman precedent.

Pre-file rejection flags

Know what will be denied before you submit — fix the packet or hold the claim.

Appeal-trained intelligence

Every fight we win teaches the next decision. Claims software never sees that side.

Early access

We're shaping this with a small set of hospitals.

Help your team take better claim decisions before revenue walks out the door. We're building this with hospitals who feel the denial problem every week.

READY WHEN YOU ARE

Stop filing blind.
Decide with Pramaan.

Pre-file flags, policy-aware grounds, and appeal-trained intelligence — so denials don't surprise your billing team.

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cluwise

Cluwise Health Pvt Ltd. Pramaan helps hospitals make stronger claim decisions before filing — and challenge denials that shouldn't stand.

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Privacy. If you share policy documents or rejection letters with us, we use them only to evaluate your claim and provide decision support. We do not sell that data.

Disclaimer. Pramaan is not an IRDAI-registered insurer, TPA, or legal practice. Sample screens on this site are illustrative. Outcomes depend on policy terms, documentation, and applicable regulation.

© 2026 Cluwise Health Pvt Ltd