Terms & Conditions of Service

Effective Date: June 1, 2025 | Last Updated: June 1, 2025

A Product of INDIEM TECH • ISO 9001 • ISO 27001 • ISO 20000

These Terms and Conditions of Service ("Terms") constitute a legally binding agreement between you ("User", "you", or "your") and ClaimTrue, a product of INDIEM TECH ("ClaimTrue", "we", "us", or "our"), governing your access to and use of our website www.claimtrue.in and all associated services including claim advocacy, policy decode, pre-submission audit, hospital bill verification, rejection defence, and hospital empanelment support (collectively, the "Services").

Please read these Terms carefully before registering or using our Services. By accessing our website, creating an account, or subscribing to any plan, you acknowledge that you have read, understood, and agree to be bound by these Terms and our Privacy Policy. If you do not agree, you must discontinue use immediately.

1. About ClaimTrue

ClaimTrue is an independent health insurance claim advocacy and documentation support platform. We are not an insurance company, insurance broker, or IRDAI-licensed intermediary. We do not sell insurance, underwrite risk, or act as an agent for any insurer or TPA. Our Services are limited to advisory, documentation assistance, claim preparation, submission support, and rejection handling on behalf of our subscribers. ClaimTrue is operated by INDIEM TECH, registered and operating from Noida, Uttar Pradesh, India.

2. Eligibility

To use our Services, you must:

Be at least 18 years of age
Be a resident of India or hold a valid Indian health insurance policy
Have the legal authority to enter into this agreement on your own behalf or on behalf of the person or entity you represent
Provide accurate, complete, and current information during registration

By using our Services, you represent and warrant that you meet all eligibility requirements. We reserve the right to suspend or terminate accounts that do not meet these criteria.

3. Services Offered

3.1 Personal Protection Plan (Individuals & Families) — ₹699 / year

The Personal Protection Plan includes the following services for the subscription year:

→Policy Decode: A plain-language summary of your health insurance policy, delivered within 24 hours of subscription activation, covering exclusions, sub-limits, waiting periods, and room-rent guidance
→Pre-Submission Claim Audit: Unlimited 15-point compliance checks on claim documentation before submission to the TPA or insurer
→Hospital Bill Verification: Line-by-line review of hospital bills against IRDAI non-payable lists and insurer tariffs
→Digital Document Vault: Encrypted, 24/7-accessible storage for policy, KYC, medical, and claim documents
→Claim Filing Guidance: Support in completing and submitting claim forms correctly
→Senior Citizen Assistance: Phone-based walkthroughs, doorstep document collection (major cities), and coordination with hospital TPA desks
→Discounted Claim Processing: 7% of claim value (vs. standard 10% for non-subscribers)

3.2 Rejection Handling & Resubmission Defence

Rejection handling is available to both subscribers and non-subscribers. The service includes full rejection analysis, documentation rectification, representation drafting, resubmission, and escalation to the insurer's Grievance Officer or IRDAI Ombudsman where necessary.

Fee: 20% of the recovered claim amount plus applicable GST. This fee is charged only upon successful recovery. No recovery, no fee.

3.3 Hospital Plans (B2B)

Starter Plan — ₹1,499 per month: For small clinics and diagnostic centres. Includes pre-submission audit, compliance verification, claim tracking, and proactive rejection correction for up to 10 patient claims per month. Additional patients billed at ₹169 each.

Enterprise Plan — ₹3,999 per month: For hospitals and multi-specialty facilities. Includes everything in Starter plus complete file management, digital patient documentation, an online patient portal, dedicated technical support, and free empanelment support (₹9,999 per approved insurer). Up to 25 patients per month. Additional patients billed at ₹169 each.

3.4 Empanelment Support (Enterprise)

ClaimTrue provides end-to-end hospital empanelment support, including application preparation, documentation, and direct insurer liaison. The empanelment support fee of ₹9,999 per insurer is charged only upon confirmed approval. Estimated timelines are indicative and subject to insurer processing schedules, which are outside ClaimTrue's control.

4. Subscription, Billing & Cancellation

4.1 Subscription Activation

The Personal Protection Plan subscription is activated upon receipt of payment. Services commence immediately upon activation, including delivery of the initial policy decode report within 24 hours.

4.2 Billing Cycles

Personal Protection Plan: Billed annually at ₹699 per year, inclusive of all applicable taxes
Hospital Starter and Enterprise Plans: Billed monthly
Per-claim processing fees: Charged separately per claim as per the applicable rate
Rejection handling fees: Charged only on successful recovery, upon completion of settlement

4.3 Payment Methods

We accept UPI, major credit and debit cards, net banking, and wallets. Payments are processed through secure, PCI-DSS compliant third-party payment gateways. Card details are not stored on our servers.

4.4 Refund & Cancellation Policy

Personal Protection Plan: The annual subscription fee is non-refundable once the subscription is activated, as service delivery (including policy decode) commences immediately. The subscription will not auto-renew; you must actively renew at year-end.

Hospital Plans: Monthly plans may be cancelled at any time. Cancellation takes effect at the end of the current billing month. No refunds are issued for partial months.

Rejection Handling: As this service is success-contingent, no upfront fee is charged and the question of refund does not arise until recovery is confirmed.

4.5 Price Changes

ClaimTrue reserves the right to revise subscription pricing. Existing subscribers will be notified at least 30 days in advance of any pricing change. Continued subscription after the effective date constitutes acceptance of the new price.

5. User Obligations

As a user of our Services, you agree to:

Provide accurate, complete, and truthful information about yourself, your health insurance policy, and your claim details
Ensure that all documents uploaded to our platform are authentic and unaltered
Disclose pre-existing conditions accurately, as per your insurance policy obligations — ClaimTrue is not liable for consequences arising from non-disclosure
Respond to queries and requests from ClaimTrue specialists promptly to avoid delays in claim processing
Keep your account credentials confidential and notify us immediately at info@claimtrue.in if you suspect unauthorised access
Use our Services only for lawful purposes and not to commit fraud or misrepresent any claim
Not attempt to reverse-engineer, scrape, or disrupt our platform or underlying technology

Violation of these obligations may result in immediate suspension or termination of your account, without refund, and may be reported to relevant authorities.

6. Limitations of Our Services

ClaimTrue provides documentation, advisory, and advocacy services. You acknowledge and agree that:

ClaimTrue is not a licensed insurance intermediary and does not guarantee claim approval or any specific settlement outcome
Claim decisions are ultimately made by insurers and TPAs in accordance with your policy terms and IRDAI regulations. ClaimTrue has no control over these decisions
Policy decode and audit reports are advisory in nature and are based on the documents you provide to us. Accuracy of our analysis is contingent on the completeness and authenticity of documents shared
Timelines for claim settlement, TPA processing, and empanelment approvals are subject to the insurer's and TPA's own procedures, which are outside our control
Our rejection handling service improves the probability of recovery but cannot guarantee it in all cases
ClaimTrue does not provide legal advice. For legal proceedings, you should engage a qualified advocate

7. Fees & Charges Summary

All fees are in Indian Rupees (INR) and are inclusive of applicable taxes unless otherwise stated:

Personal Protection Plan ₹699 per year (all-inclusive)

Reimbursement Claim Processing — Subscriber 7% of the approved claim amount

Reimbursement Claim Processing — Non-Subscriber 10% of the approved claim amount

Cashless / Reimbursement — Subscribed Hospital 5% of the claim

Rejection Handling (all customers) 20% of the recovered amount + GST, payable only on recovery

Empanelment Support Fee ₹9,999 per approved insurer (Enterprise plan), payable on confirmed approval only

Hospital Starter Plan ₹1,499 per month; additional patients at ₹169 each

Hospital Enterprise Plan ₹3,999 per month; additional patients at ₹169 each

No hidden fees. No commission from insurers. Full fee schedule available at www.claimtrue.in/pricing.

8. Intellectual Property

All content on www.claimtrue.in — including text, graphics, logos, icons, software, algorithms, documentation templates, and claim audit frameworks — is the intellectual property of ClaimTrue / INDIEM TECH and is protected under Indian copyright and intellectual property laws.

You are granted a limited, non-exclusive, non-transferable licence to access and use our platform solely for your personal or internal business purposes. You may not reproduce, distribute, reverse-engineer, or create derivative works from any part of our platform without prior written consent.

9. Confidentiality

You agree to treat all non-public information shared with you by ClaimTrue in the course of service delivery (including audit templates, internal workflows, and claim strategies) as confidential and not to disclose it to third parties. This obligation survives termination of your subscription.

Similarly, ClaimTrue treats all your personal, medical, and financial information as strictly confidential, in accordance with our Privacy Policy and ISO 27001 certified information security protocols.

10. Disclaimers & Limitation of Liability

To the maximum extent permitted by applicable Indian law:

Our Services are provided on an "as is" and "as available" basis. We make no warranty that Services will be uninterrupted, error-free, or meet your specific expectations
ClaimTrue shall not be liable for any indirect, incidental, consequential, or punitive damages arising from your use of our Services, including loss of insurance proceeds attributable to insurer or TPA decisions outside our control
Our aggregate liability to you for any claim arising out of these Terms shall not exceed the total subscription fees paid by you in the 12 months preceding the claim
We are not responsible for the accuracy or completeness of information provided by insurers, TPAs, or hospitals to us on your behalf

Nothing in these Terms limits liability for fraud, gross negligence, or willful misconduct by ClaimTrue.

13. Governing Law & Dispute Resolution

These Terms shall be governed by and construed in accordance with the laws of India, without regard to conflict of law principles.

In the event of any dispute arising out of or in connection with these Terms or our Services, you agree to first attempt resolution through our Grievance Officer (see below). If the dispute is not resolved within 30 days, it shall be referred to arbitration in accordance with the Arbitration and Conciliation Act, 1996. The seat of arbitration shall be Noida, Uttar Pradesh. The language of arbitration shall be English. The award shall be final and binding.

14. Grievance Officer

Name Grievance Officer, ClaimTrue / INDIEM TECH

Address Office No. 101, First Floor, Plot No. A-61, Sector-16, Seven Wonder Business Center, Noida, Uttar Pradesh – 201301

Email info@claimtrue.in

Phone +91 9205862303

Hours Monday – Saturday, 9:00 AM – 6:00 PM IST

Grievances will be acknowledged within 48 hours and resolved within 30 days of receipt.

19. Contact Us

ClaimTrue — A Product of INDIEM TECH

Office No. 101, First Floor, Plot No. A-61, Sector-16
Seven Wonder Business Center, Sector-16, Noida, UP – 201301

Website: www.claimtrue.in

Email: info@claimtrue.in

Phone: +91 9205862303

Support Hours: Monday – Saturday, 9:00 AM – 6:00 PM IST