Star Health Insurance partners with Medi Assist to introduce AI in claims processing

Health insurance provider Star Health and Allied Insurance Company has announced a partnership with healthcare and insurtech company Medi Assist to adopt an Artificial Intelligence (AI)-based claims processing platform known as MAtrix. The collaboration aims to streamline and modernise the company's claims management system using digital tools and automation.

The introduction of the MAtrix platform is intended to speed up claim settlements, reduce manual processes, and improve accuracy in processing. By leveraging AI and machine learning, the system is also expected to assist in identifying fraudulent claims and cutting down on unnecessary costs.

This move comes as part of Star Health's broader effort to upgrade its digital capabilities in response to increasing demands from customers, hospitals, and regulatory bodies. The platform will help manage growing volumes of claims while maintaining consistency and transparency in the process.

“Claims are at the heart of the insurance experience, and with Medi Assist’s platform, we are enhancing speed, accuracy, and consistency, while keeping a keen eye on fraud, waste and abuse. By reducing manual interventions and standardising processes, we aim to strengthen efficiency and reinforce trust with our policyholders,” said Anand Roy, Managing Director and CEO of Star Health.

Medi Assist’s CEO, Satish Gidugu, also welcomed the collaboration, stating that the platform would help raise industry benchmarks for technology-based insurance services.

Among the features offered by the MAtrix platform are standardised rules for claims adjudication, co-working tools supported by AI, and automation that assists in reducing subjectivity in decisions. The system also supports fraud detection and provides digital support to policyholders through chatbots and virtual assistants, including integration with WhatsApp and mobile applications.

The partnership is further supported by a unified API framework that allows secure and real-time data sharing among insurance companies, hospitals, and the National Health Claims Exchange (NHCX), aiming to improve coordination across the sector.