Health Insurance
CRP partners leading players in the
Insurance Industry in their endeavor to create a fact-based claims
investigation environment. It has expert personnel and cutting edge
technology. The company helps its customers serve their clients through
better and quicker claim reimbursements. CRP provides outsourcing
solutions for the three major types of Insurance - Health Insurance,
Life Insurance and General Insurance.
CRP handles health insurance claims investigation for its clients
through its Health Insurance Verification and Outsourcing Solutions
vertical. CRP's health insurance claims processing team consists of
people who have experience in various claims issues like nature of
health problems, disease management lifecycle and claims scenario
resolution. This guarantees accurate judging of each claim and prevents
losses arising from false or misjudged claims. CRP's robust technology
system, back up arrangements and data security practices ensure quick,
safe and unhindered service.
As claims investigation and processing is mainly dependent on the
information provided by the claimant, CRP ensures that the claimant
provides necessary and complete information.

The information collected as below is then processed by the team.. |
- Proposal form
- Age proof
- Claim forms
- Case - Sheets
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On the basis of this information and CRP's claims investigation
standards, the CRP team investigates various facts related to the health
of the assured. Analyzing the assured's history and records with
hospitals, pharmacies and general practitioner or specialists helps in
verifying the claim in an objective manner.
Certain key areas of investigation are:
Occupational Hazards:
Whether the assured has had any extraordinary occupational hazards
while at work. Based on its experience and research, CRP has earmarked
professions and workplaces that pose more occupational and health
hazards as compared to other professions.
Salaries:
CRP collects the assured's salary information and relevant documents
like Employer certificates, leave records and medical certificates
furnished to the employer. CRP looks into the financial records of the
assured if there is no fixed income.
Medical History:
CRP investigates and collects information about the medical history
of the individual. It collects detailed information on whether the
individual was under any hospital or doctor. It also looks into the
authenticity of the medical cause and claims. Any information about
chronic diseases and illnesses is collected.
The claims made by the assured are verified against the data
collected through investigation. The collected information is analysed
using data from past records. CRP's database, built over a decade's
experience and records is used to check past claims and create
predictive analytical scenarios. The final report is then submitted to
the Insurance Company in an agreed time frame thus compressing the total
time for the entire claims processing.
CRP's value proposition is its expertise in providing independent and
thorough investigation and accurate data. This ensures that the claim
and the amount of claim are rightly judged, thus safeguarding the
profits of the insurer. CRP personnel's keen understanding of medicine,
disease management, hospitalization and patient treatment procedures,
give the company an edge in judging health insurance claims.
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