Product updates: Simplifying group health insurance at scale

Product Updates: Simplifying Group Health Insurance at Scale

Over the last six months, our product focus at Pazcare has been very clear:
Remove friction, reduce dependency on broken workflows, and deliver a truly uniform experience across group health insurance at scale.

This post is a summary of what we’ve shipped recently and why it matters for HR, finance teams, and employees.

The Problem We Set Out to Solve

Group health insurance today suffers from deep fragmentation:

• Multiple portals, manual follow-ups, unclear statuses
• Every insurer and TPA works differently
• Poor user experience driven by legacy systems and delayed updates
  

The outcome is predictable:

• High admin overhead
  
• Claims stuck for avoidable reasons
  
• Low trust in the system
  
  

Our work over the last six months has been about fixing this experience layer, not patching around it.

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1. Admin & Finance: Removing Manual Work

We launched several features to make insurance administration predictable and self-serve:

• CD statement generation directly from the platform
  
• Auto CD proforma invoice creation, reducing finance follow-ups
  
• Endorsement copies and tax invoices easily accessible anytime
  
• Real-time tracking of endorsements until completion
  
  

These changes significantly reduce back-and-forth between HR teams, the Pazcare team, insurers, and finance teams, eliminating dependency on manual follow-ups and fragmented communication.

2. Deep HRMS Integrations

Insurance workflows should move automatically with employee data—not require rework.

We built native integrations with leading HRMS platforms like Darwinbox, KekaHR, HROne and similar systems, enabling:

• Seamless employee additions and exits
  
• Fewer endorsement errors
  
• Faster turnaround without manual intervention
  
  

3. Claims: Addressing the Biggest Pain Point

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Claims are where experience breaks most often.

Our data showed that ~40% of claims get stuck due to queries.
Many of these queries are:

• Redundant
  
• Repetitive
  
• Poorly articulated
  
• Non-actionable for employees
  
  

This leads to delays, confusion, and frustration—despite the claim being otherwise valid.

4. APIs with Insurers & TPAs: Creating a Uniform Experience

Instead of relying on insurer or TPA portals which often suffer from legacy UX and delayed updates, we built direct APIs with multiple insurers and TPAs.

This allows us to:

• Deliver a single, uniform, real-time experience, irrespective of the insurer or TPA
  
• Track claim status live rather than via emails and follow-ups
  
• Reduce dependency on fragmented backend systems
  
  

As a result, the experience no longer breaks simply because a different insurer or TPA is involved.

5. Claims AI: Reducing Queries, Not Just Tracking Them

On top of API integrations, we introduced Claims AI to improve claim outcomes.

Claims AI helps by:

• Identifying and reducing redundant queries
  
• Guiding employees with clear next steps
  
• Minimising unnecessary back-and-forth
  
• Speeding up claim progression
  
  

We are now progressing towards:

• Auto claim submission
  
• Auto claim settlement
  
• Real-time claim status integration across major insurers and TPAs

6. Measuring Insurer & TPA Performance

A key by-product of routing everything through our platform is visibility.

This benefits HR teams and employees alike, while also strengthening the overall ecosystem. The data enables us to advise clients on the best options based on real performance, and helps our insurer and TPA partners clearly understand where they stand against benchmarks especially in areas impacted by legacy UX and delayed updates.

We can now:

• Track insurer and TPA turnaround times
  
• Measure query frequency and resolution speed
  
• Identify bottlenecks precisely
  
• Drive accountability using data instead of anecdotes
  
  

Where We’re Headed

Our core belief remains unchanged:

• Insurance should be a feature
  
• Healthcare experience should be the product
  
• Trust should be the default outcome
  
  

The last six months were about laying the foundation.
What comes next is deeper automation, faster resolution, and an even more invisible insurance experience.

More updates soon.

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