Medi Assist Launches AI Platforms to Enhance Health Benefits
Filing Summary
Medi Assist Healthcare Services Limited has introduced AI-driven platforms to improve health benefits administration. The company reported that 15% of discharges now occur before final billing, and 70% of claims are processed cashless. Two new platforms, MAven Guard and MAgnum, aim to enhance transaction integrity and hospital enablement. A report with Boston Consulting Group highlights ₹8,000–10,000 crore in annual claim payouts lost to fraud. The report suggests a framework for reducing fraud and supporting the government’s Insurance for All vision. Medi Assist continues to focus on technology-led health benefits administration.
Medi Assist Healthcare Services Limited has announced the launch of new AI-driven platforms aimed at enhancing the health benefits ecosystem. The company, recognized as India’s largest technology-led health benefits administrator, introduced these platforms to facilitate seamless member interactions and improve transparency and sustainability in health benefits. The announcement was made on November 21, 2025, and highlights the company’s ongoing efforts to streamline cashless healthcare services.
The company reported significant operational outcomes over the past year. Notably, 15% of all discharges, involving over 400,000 members, now occur before the final bill is generated. Additionally, 25% of its provider network, comprising over 4,000 hospitals, has been enabled with next-generation cashless workflows. Furthermore, 70% of the total claim value is now processed on a cashless basis, with 85% of cashless claims being digitally submitted. These developments aim to enhance the speed and reduce the friction of claims processing for all stakeholders involved.
Medi Assist has introduced two AI-powered platforms, MAven Guard and MAgnum, to further strengthen service delivery. MAven Guard is a self-learning transaction integrity platform designed to detect, prevent, and deter fraud, waste, and abuse in real-time. MAgnum is a hospital enablement solution that aims to make the cashless experience more efficient for members. Both platforms are built on Medi Assist’s comprehensive AI Stack, which supports the company’s long-term goal of making health benefits sustainable and member experiences seamless.
In collaboration with Boston Consulting Group, Medi Assist released a report titled “From Suspicion to Solution: A Strategic Approach to Health Insurance Fraud.” The report identifies ₹8,000–10,000 crore in annual claim payouts lost due to fraud, waste, and abuse. It highlights systemic issues such as fragmented data, weak controls, and misaligned incentives that contribute to these losses. The report recommends a three-pillar framework of prevention, detection, and deterrence, supported by a unified national codebook, governed GenAI, and digital intelligence. These measures align with the government’s Viksit Bharat 2047 vision of “Insurance for All.”
The implementation of these platforms and the insights from the report are part of Medi Assist’s strategy to build a more accessible, efficient, and trusted health benefits ecosystem in India. The company continues to focus on leveraging technology and AI to address inefficiencies and improve operational efficiencies in the health insurance sector.
Boston Consulting Group partners with business and societal leaders to tackle significant challenges and capture opportunities. The firm offers management consulting, technology, and design solutions to drive transformation and competitive advantage for its clients.
Medi Assist Healthcare Services Limited provides health benefits administration services and technology platforms to the health insurance ecosystem. Through its subsidiaries, Medi Assist TPA and Paramount TPA, the company facilitates interactions between insurance companies, policyholders, healthcare providers, and government health schemes. Medi Assist is listed on both the National Stock Exchange and the Bombay Stock Exchange.