Healthcare - Mediclaim Investigation

Curis24

Curis24 is our brand name for investigation service having an objective to provide quality services to our clients as per their business needs. Now our presence is in Delhi/NCR only but extending our services in all over India.

It is a private investigations company and our desire to obtain a specific goal. We take the time to listen client stories and come up with action of plan to help them through our investigation. We will be up front and honest with the client. After listening to their story and understanding what the client is looking for, we know that we cannot help this individual, we will simply turn the case down. We believe in work and inspect the case through to save the money and effort of the client.

Curis24 has professional assigned to the specific investigation based upon their own prior training and employment experience and keep updates regularly to track the status of investigation on daily basis. Many of our clients establish a very solid trust with our investigators, which makes them feel very comfortable and not like just another number. Our employees are constantly being trained to keep up with modern technology, laws and ethics and the continuous changes in the field of private investigations

Our team has more than 15 years of experience in investigation with different clients like TPA. When it comes to hiring an investigations company to handle your case, bigger is not always better. Give a chance to Curis24 and call us.

Why us ...

  • We have experienced and sincere professionals for investigation.
  • We deliver the claim investigation within the time bound period with quality.
  • Identified the red zone areas.
  • Protect all confidential reports and clients identity.
  • Database of major hospitals and their location, which help the investigation quickly, and within time period.
  • Dedicated team for document collection.
  • Curis24 offers services of Health Claim Investigation. We work for both Cashless and Reimbursement type claims.

Cashless Claim Investigation

  • Physical verification of patient.
  • Member job verification.
  • Physical verification of Hospital and provided facilities to the patient.
  • Physical verification of Pharmacies and Diagnostic centers/Laboratories and their accreditation.
  • Investigation of final reports of all health check-ups.
  • Investigation of Surgeries
  • Investigation of Billings (Hospital/doctors)
  • Investigation of Chronicity of the diseases
  • Investigation of the prescriptions(drugs/injections)
  • Collection of evidences.
  • Take photos and measurements
  • Obtained witness statement
  • Prepare the short investigation report with Evidences obtained during verification.
  • Rogue Hospitals are flagged and intimated to Insurer, Corporates & TPAs.

Why investigation needed?

  • Claims from suspected Hospitals
  • HIGH value RI claims from chain or network hospitals.
  • All RTA claims.
  • Close proximity claims.
  • All suspected claims of excluded ailments like infertility treatment, congenital external etc.
  • All suspected claims of alcohol related ailments.
  • Claims from Red flagged hospitals.
  • Repeated claims from the insured from the same hospital for the same ailment.
  • All chronic ailment claims from standard policies.
  • Claims of admissions documented for just 24 hrs.
  • Claims with high budget pharmacy bills and arrange in chronological order.
  • Claims with high budget with unrealistic diagnosis tests.
  • Claims with altered bills / documents without proper counter signatures.
  • Claims with highly inflated bills in comparison to the treatment provided.

Common Fraud

  • Pre existing disease
  • Altered/Highly Budget bills.
  • Fictitious Admission
  • Altered documents
  • Conversion of OPD treatment to IPD.
  • Presentation of suspicious facts.

What we do?

All of our work is documented and supported. We do not speculate or embellish. We know what you need to succeed in the insurance industry and that is what we deliver.

When you need results, we encourage you to call us today and speak with an investigator. We realize that too many insurance investigative agencies make far too many irresponsible promises about they can do which almost always leave you looking bad to your supervisors, claims team and the claimant. We understand that you have many choices when selecting an investigator and that most insurance investigators sound the same when pitching their services to you. we promise and deliver within time.

We have a different approach to investigate the cases. We only take cases in areas of our expertise, we cover regularly and reliably, we have a strict code of ethics we follow, all of our investigators are experienced and all of our investigators are well-paid professionals.

Reach us at 9625-281-968 for any query or Investigation. Thank You!