Insurance Brokers Requests Unified Digital Platforms for Streamlined Claims and Grievances

IBAI has urged the government to create a single, technology driven platform to streamline claim settlements and grievance reddressal accross insurers. The proposal was presented during a meeting with Finance Minister Ms Nirmala Sitharaman in New Delhi.

A unified digital platform improves speed, transparency, and data flow across the value chain, raising customer satisfaction, lowering operating costs, and enabling better fraud control and analytics. Already, India's regulator, along with several industry players, is moving in this direction.

Why it matters ?

• Faster, more consistent claim & grievance resolution

• Transparency & auditability (regulatory + customer trust) - A single transaction trail - tickets, documents, decision logs - makes compliance, reporting, and Ombudsman escalations easier, thereby reducing dispute costs and reputational risk. IRDAI already maintains grievance portals (Bima Bharosa / IGMS) that illustrate regulatory expectations.

• Better data for fraud-control & underwriting - Combined claims and grievance information enhances pattern detection, speeds fraud detection models, and informs product/price lifecycle decisions. This integrated data allows modern analytics and AI to reduce leakage.

• Improved channel efficiency & partner experience - Brokers will have a single pane to manage submissions, claim statuses, client communications, and regulatory escalations. This decreases time spent on multiple insurer portals, thereby improving productivity.

• Customer experience & retention - Faster settlements, real-time status updates, and clear escalation paths translate directly to higher NPS and lower lapses/complaints.

Key Challenges (and Practical Mitigations)

Legacy systems & poor interoperability

Challenge: Carriers and TPAs operate many different, aging backend systems that don't expose clean APIs.

Mitigation: Introduce lightweight middleware/adapter layer; apply API-first integrations for high-volume workflows (intake of claims, document upload, and statuses). Use phased rollouts: start with integrating the top 3 carriers and then expand.

Data privacy, security & consent management

Challenge: Consolidation of personal and medical data increases compliance and breach risk.

Mitigation: Implement robust encryption, role-based access, consent logs, audit trail for data shared with brokers/TPAs, and adherence to local data rules-Aadhaar/PAN linkage rules, wherever applicable. Insert least-privilege practices and routine pen-testing.

Standardization & master data issues

Challenge: There is no single industry standard among the players on claim statuses, complaint categories, and document types.

Mitigation: Define and publish a minimal common data model for claims/ grievances - status codes, SLA fields, document types. Regulator-backed standards, or a voluntary industry charter, accelerate adoption. IRDAI's platform work is relevant here.

Fraud & adversarial behaviour at scale

Challenge: Unified intake makes it easier to route legitimate claims — but also centralizes attack surface.

Mitigation: Combine rules-based checks, ML anomaly detection, document forensic checks, and stronger KYC at onboarding.

Digital divide / customer accessibility

Challenge: Not all policyholders are digital-native; they would prefer call centres or offline.

Mitigation: Provide multi-channel access - IVR, assisted digital at branches/agents, WhatsApp, and minimum UI mobile flows - and ensure easy escalation for non-digital users. IRDAI grievance call-centre models show multichannel approaches.

This Unified Platform could enhance speed, reduce cost, improve compliance, and create better actionable data. However, its success depends upon pragmatic standards, legacy integration strategy, strong security/consent controls, and carefully aligned incentives across insurers, brokers, and TPAs.