Ravi Tiwari: Harmonizing Legal Erudition & Insurance Profundity With Innovative Claims Solutions
Ravi Tiwari
CEO
During a personal interview with us, Ravi disclosed numerous intriguing details about himself and provided comprehensive insights into both his background and the industry.
Can you provide a concise overview of your professional history and experiences? Additionally, what drives your daily routines and serves as your motivation?
I commenced my career as a Medical Social Worker (MSW) at the Medical College hospital but shifted gears within a couple of years to join the insurance sector. Starting with Teaching Healthcare Services, my journey led me to roles at Pharma, Melius Insurance in Delhi, and eventually to Bhopal, where I played a crucial role in the startup of a new insurance company as the Head of Claims. Specializing in health insurance and entering the field in 2005, I oversaw multiple data centres and managed various departments, including networking, hospital relationships, cashless processing, reimbursement processing, legal affairs, and investigations into suspicious claims.
In 2021, I founded my own startup, providing consultancy services for insurance claims across diverse categories. The platform, officially
launched in March 2022, aims to assist individuals in addressing insurance related challenges and grievances. Motivated not only by financial gain but a genuine desire to help, our services extend to working with insurance companies and representing cases before relevant platforms to ensure fair resolution and justice for policy holders.
What key factors do you consider in proposing financial or wealth management plans to clients, and how do you customize your offerings to suit their individual needs?
We do not have financial clients, as our focus is not on selling policies or creating portfolios. Instead, our role revolves around resolving disputes for individuals/groups who encounter issues with their insurance policies. Financial planning, which involves advising and selling policies, is distinct from our dispute resolution function. Our expertise lies in handling claims and legal matters, with a team comprising individuals with over a decade of experience in the insurance sector. Our team includes insurance doctors, legal experts, and insurance experts, collectively contributing to our ability to effectively solve complex problems. The challenges we address require in-depth knowledge of insurance guidelines, policy terms, medical backgrounds, and legal aspects, all of which our team possesses.
How does Claims Nidan streamline its operations, from marketing and case registration to medical reviews and legal management?
Our marketing department oversees sales through multiple channels, including referrals from advisors, social media advertising, and service centres in different locations. Once a case is received, our operations team registers it in the software, collects necessary documents, and communicates with clients to understand their concerns. Subsequently, the medical department reviews the case, providing an initial opinion free of charge to clients on whether it is viable or requires additional documentation. If the case is payable merits, our review committee accept the case for processing, the case is forwarded to the processing department, where experts handle the details according to the nature of the case.
What key factors do you consider in proposing financial or wealth management plans to clients, and how do you customize your offerings to suit their individual needs?
We do not have financial clients, as our focus is not on selling policies or creating portfolios. Instead, our role revolves around resolving disputes for individuals/groups who encounter issues with their insurance policies. Financial planning, which involves advising and selling policies, is distinct from our dispute resolution function. Our expertise lies in handling claims and legal matters, with a team comprising individuals with over a decade of experience in the insurance sector. Our team includes insurance doctors, legal experts, and insurance experts, collectively contributing to our ability to effectively solve complex problems. The challenges we address require in-depth knowledge of insurance guidelines, policy terms, medical backgrounds, and legal aspects, all of which our team possesses.
Our primary function revolves around handling cases through litigation, positioning us in the legal industry
How does Claims Nidan streamline its operations, from marketing and case registration to medical reviews and legal management?
Our marketing department oversees sales through multiple channels, including referrals from advisors, social media advertising, and service centres in different locations. Once a case is received, our operations team registers it in the software, collects necessary documents, and communicates with clients to understand their concerns. Subsequently, the medical department reviews the case, providing an initial opinion free of charge to clients on whether it is viable or requires additional documentation. If the case is payable merits, our review committee accept the case for processing, the case is forwarded to the processing department, where experts handle the details according to the nature of the case.
This team, which includes doctors/experts /advocates, works on resolving complaints and processing claims for disposal. We charge a consultancy fee only when a client's claim is successfully settled, ensuring a fair and attractive feature for our services. Additionally, our legal department, comprised of skilled advocates, manages legal matters, while our marketing team contributes to our diverse set of departments. Our team operates full-time from Monday to Saturday, fostering a positive and motivated work environment akin to a close-knit family.
Where do you see yourself heading in the future?
Over the next five years, our plan involves expanding our reach. We initiated our journey from Madhya Pradesh and gradually extended our services to other regions like Chhatisgarh and Uttar Pradesh. Currently, our focus is on broadening our presence in states such as Maharashtra, Telangana, and Delhi. Our goal is to establish branches and service centres in every state, aiming to transform our operations into a national-level project. Subsequently, we plan to attract investors and transition into a Private Limited company. This strategic vision guides our aspirations for the future.
Given your extensive experience in the industry, what guidance would you offer to emerging leaders in the field?
The industry we operate in is primarily insurance but has a unique aspect centred around litigation. While we don't engage in selling, designing, or creating policies, our work involves handling cases through litigation, aligning with both the legal and social work domains. It's essential to consider our role beyond a traditional insurance industry perspective. Our company is closely connected to the sales of insurance policies, and as the insurance sector continues to grow, our industry, dependent on dispute resolution, will also see significant growth. Over the past decade, there has been a noticeable increase in the number of insurance policies sold, and this trend is expected to continue. With this growth in the insurance sector, disputes related to claims are also on the rise, ensuring a promising future for our industry.
Ravi Tiwari, CEO, Claims Nidan
With more than 19 years of experience in the insurance industry, Ravi Tiwari has developed expertise in managing Health Insurance Claims, Life Insurance Claims, and General Insurance Claims. Recently, he founded Claims Nidan, a firm that has proven instrumental in helping policy holders secure approval for their initially rejected insurance claims.
Where do you see yourself heading in the future?
Over the next five years, our plan involves expanding our reach. We initiated our journey from Madhya Pradesh and gradually extended our services to other regions like Chhatisgarh and Uttar Pradesh. Currently, our focus is on broadening our presence in states such as Maharashtra, Telangana, and Delhi. Our goal is to establish branches and service centres in every state, aiming to transform our operations into a national-level project. Subsequently, we plan to attract investors and transition into a Private Limited company. This strategic vision guides our aspirations for the future.
Given your extensive experience in the industry, what guidance would you offer to emerging leaders in the field?
The industry we operate in is primarily insurance but has a unique aspect centred around litigation. While we don't engage in selling, designing, or creating policies, our work involves handling cases through litigation, aligning with both the legal and social work domains. It's essential to consider our role beyond a traditional insurance industry perspective. Our company is closely connected to the sales of insurance policies, and as the insurance sector continues to grow, our industry, dependent on dispute resolution, will also see significant growth. Over the past decade, there has been a noticeable increase in the number of insurance policies sold, and this trend is expected to continue. With this growth in the insurance sector, disputes related to claims are also on the rise, ensuring a promising future for our industry.
Ravi Tiwari, CEO, Claims Nidan
With more than 19 years of experience in the insurance industry, Ravi Tiwari has developed expertise in managing Health Insurance Claims, Life Insurance Claims, and General Insurance Claims. Recently, he founded Claims Nidan, a firm that has proven instrumental in helping policy holders secure approval for their initially rejected insurance claims.