Work email Password

{{ nav.label }}

{{ nav.icon }} {{ nav.label }} {{ nav.count }}

DASHBOARD DYNAMIC FILTER CRITERIA

Reset filters

{{ df.label }} {{ o.label }}

From Date

To Date

INVESTIGATION PIPELINE SUMMARY

{{ pt.label }}

{{ pt.value }}

TAT Report & Case Aging Buckets

Target: 95% SLA Compliance · Current: {{ dashCompliancePct }}%

Claim Type	Avg TAT (Open)	Avg TAT (Closed)	< 50% SLA	50% – 90%	> 90% Breach	Health
{{ tr.type }}	{{ tr.avgOpen }}	{{ tr.avgClosed }}	{{ tr.lt50 }}	{{ tr.mid }}	{{ tr.gt90 }}	{{ tr.health }}

Operational Alert: {{ tatRiskCount }} claim(s) currently flagged under TAT Risk require immediate allocation intervention to prevent client SLA penalties. Open TAT Risk queue →

Ageing = share of the stage SLA (or end-to-end benchmark, whichever is higher) consumed. * = claim type / SLA assumed — not in source documents.

TAT Master Benchmark

Rule Engine SLA

Claim Type	Max TAT Benchmark
{{ b.type }} *	{{ b.bench }}

Benchmarked against insurer SLA agreements

⚙️ Master SLA Configurations

CONTROL TOWER — LIVE OPERATIONS

{{ k.label }}

{{ k.value }}

{{ k.trend }}

{{ w.label }}{{ w.count }}

{{ dashboardDrawerTitle }} Cases ({{ dashboardDrawerRows.length }})

Open in Assignments → ✕

Case	Client	Customer	Priority	Investigator	SLA	Status
{{ c.id }}	{{ c.client }}	{{ c.customer }}	{{ c.priority }}	{{ c.investigator }}	{{ c.sla }}	{{ c.status }}

Live Operations Map

Open Live Tracking →

{{ p.glyph }}

🔴 Critical case🟠 Unassigned🔵 Investigator

Priority Overview

{{ p.label }}{{ p.count }}

Today's Operations

{{ t.label }}{{ t.value }}

SLA Monitor

View all cases →

Case	Priority	Investigator	SLA	Status
{{ r.id }}	{{ r.priority }}	{{ r.investigator }}	{{ r.sla }}	{{ r.status }}

📥 Claims Inward & Registration Desk

Multi-LOB dynamic intake — Health, Personal Accident, Motor OD, MACT / Third Party & Life

Batch: #INW-2026-{{ inwardBatchNo }}

{{ inwardMsg }}

INWARD BATCH / DOCKET ID

{{ inwardDocketId }}

INWARD DATE & TIME

{{ inwardAtLabel }}

UPLOADED FILES / DOCKETS

{{ inwardFilesSummary }}

INWARD TAT (REFERRAL → INWARD)

{{ inwardTatLabel }}

📧 Mailbox Auto-Capture

Link the shared claims inbox so referral emails are parsed and queued here for one-click import — no manual retyping.

Connected: claims-inward@zyninspect.com

Disconnect

🔗 Connect Inbox

📩

{{ mb.subject }}

From {{ mb.from }} · {{ mb.receivedAt }}

{{ mb.summary }}

Import to Form

No new referral emails — the inbox is being watched and will queue new claims here automatically.

📁 Document Attachments & OCR Intake

📎 Click to attach Policy Copy, Claim Form, Hospital ICP, FIR, etc.

📄 {{ f.name }} {{ cat }} + Add new category…

Add

1. Claim Referral & Basic Inward Details

Referral TypePortalOffline / EmailHardcopy DocketAPI Inward

Date & Time of Referral

Insurer / TPA Name{{ o }}

Line of Business (LOB){{ o.label }}

Claim Type{{ o }}

Claim Number

Claimed Amount (INR)

Policy Number

2. Policy & Proposer Details

Product Name – Policy Name

Policy TypeGroup / CorporateRetail IndividualRetail Family FloaterGovernment Scheme

Policy Start Date

Policy End Date

Sum Insured (INR)

Name of Primary Insured / Proposer

Corporate / Employer Name

Policy StatusFresh / New PolicyRenewalRollover / Ported

First Policy Inception Date

Policy Tenure1 Year2 Years3 Years4 Years5+ Years

{{ inward.earlyClaimText }}

3. Fraud Triggers & RCU Management Contacts

Claim Manager's Triggers

RCU Manager's Triggers

RCU Manager Name

RCU Manager Contact / Mail ID

🔗 {{ inward.rcuMatrixNote }}

4. LOB-Specific Dynamic Panel — {{ inward.lobLabel }} · {{ inward.claimSubType }}

Patient Name

Patient DOB (Age: {{ inward.health.ageDisplay }})

GenderMaleFemaleOther

Relationship with ProposerSelfSpouseSonDaughterMotherFatherDependent Child

Patient Contact No.

Patient Email

Patient Address

Pin Code

State / District / City

Provisional / Final Diagnosis

Hospital Name

Hospital Address

Date of Admission (DOA)

Date of Discharge (DOD)

Room Category Billed

Treating Doctor Name & Reg.

🚫 De-listed Provider: {{ inward.watchlistReason }}

🚫 Doctor Flagged: {{ inward.doctorMatchReason }}

🗺 Fraud Hotspot Pincode ({{ inward.pincodeMatchReason }})

👤 High Risk Insured: {{ inward.patientMatchReason }}

Insured / Victim Name

Victim DOB (Age: {{ inward.pa.ageDisplay }})

GenderMaleFemaleOther

Cause / Nature of IncidentRoad Traffic Accident (RTA)DrowningElectrocutionDomestic Fall / SlipHeavy FallWorkplace / IndustrialSnake Bite / Animal AttackFire / BurnAssault / Homicide

Date & Exact Time of Incident

Date & Exact Time of Death

Nominee / Claimant Name

Claimant RelationshipSpouseLegal HeirSonDaughterOther

Claimant Contact

👤 High Risk Insured: {{ inward.patientMatchReason }}

Tribunal / MACP Case No.

Vehicle Registration No.

Hospitals to Audit (count)

Chemists to Audit (count)

🚫 Repeat Offending Vehicle — "{{ inward.mact.vehicleNo }}" {{ inward.vehicleMatchReason }}

{{ inwardExtTitle }}

{{ f.label }}

{{ f.label }} {{ o }}

🚫 Repeat Offending Vehicle — "{{ inward.vehicleMatchValue }}" {{ inward.vehicleMatchReason }}

📞 Flagged Contact: {{ inward.contactMatchReason }}

5. Claim Triage, Initial Synopsis & Desk Allocation

Auto-classification: Priority {{ inward.triagePriority }} · {{ inward.triageSlaLabel }} — based on LOB, claim type and detected triggers.

⏱ Stage SLA — {{ inwardStageSlaText }}

Initial Claim Synopsis & Investigation Instructions Inward Remarks

⚠ Possible Duplicate — matching Policy No. + Patient/Victim Name + Date already exists in the system.

Automated Checks

Early Claim Trigger{{ inward.earlyClaimLabel }}

Duplicate Claim{{ inward.duplicateLabel }}

Fraud Repository ({{ inward.fraudAlertsCount }})

{{ fa.icon }}

{{ fa.label }}

{{ fa.reason }}

Watchlist MatchesClear

Actions

💾 Save Draft

❌ Reject Inward

🔄 Re-Route / Query Insurer

🚀 Confirm Inward & Dispatch to Assignments

Queue: {{ caseQueueLabel }} ({{ caseListRows.length }})

Statuses: {{ caseQueueStatuses }}

Show all assignments

{{ t.label }} {{ t.count }}

All ClientsABC General InsuranceSecureShield InsuranceNational AssurancePrime Health TPA All Case TypesHospital VerificationMotor ClaimAddress VerificationDeath Claim All PrioritiesCriticalHighMediumLow All CitiesHyderabadSecunderabad

⬆ Upload Cases

📄 Sample Template

⬇ Export

+ New Case

{{ uploadMessage }}

	Case ID	Client	Customer	Type	Priority	Stage	Investigator	SLA	Status
	{{ c.id }}	{{ c.client }}	{{ c.customer }}	{{ c.type }}	{{ c.priority }}	{{ c.stage }}	{{ c.investigator }}	{{ c.sla }}	{{ c.status }}	📞 Call 💬 WhatsApp	→

{{ callCustomer }}

✕

{{ callCaseId }} · {{ callPhone }}

📞

Dialing…

Connected · {{ callElapsed }}

{{ line.speaker }}: {{ line.text }}

End Call

✓ Call ended · remarks auto-logged to Audit Trail

Auto-generated remark

{{ callRemark }}

Close

{{ waCustomer }}

{{ waPhone }} · via ZynInspect WhatsApp Bot

✕

💬

Connecting to WhatsApp Business Bot…

{{ m.text }}

{{ m.time }}

Send template

{{ t.label }}

End Chat

✓ Conversation logged to Audit Trail

Close

Assignments / {{ selCase.id }}

{{ selCase.id }}

{{ selCase.priority }} {{ selCase.stage }} {{ selCase.status }} FO: {{ selCase.foAcceptanceStatus }} DEMO TRIAL CLAIM · fictitious data

{{ selCase.client }} · Claim {{ selCase.claimNo }} · {{ selCase.customer }} · {{ selCase.claimAmount }} · {{ selCase.type }}

SLA REMAINING

{{ selCase.sla }}

{{ t.label }}

Case record: {{ caseRecordTitle }} (supplementary — not a primary claim header) ← Back to Claim Overview

Claim information from Claim Inward · {{ claimInfoTotal }} fields (FRD §2.1)

✎ {{ claimEditLabel }}

⚠ {{ claimInfoMissing }} of {{ claimInfoTotal }} inward fields are not captured. Missing values are shown as Not captured — nothing is inferred.

{{ g.group }}

{{ r.label }} {{ r.value }}

Dual FO Assignment

Open Smart Allocation

Overall Case Progress{{ selCase.overallProgress }}%

Hospital Investigation

{{ selCase.hospitalFO }}

{{ selCase.hospitalLocation }}

{{ selCase.hospitalStatus }}

Patient / Residence Investigation

{{ selCase.residenceFO }}

{{ selCase.residenceLocation }}

{{ selCase.residenceStatus }}

Assignment

Open Smart Allocation

{{ selCase.invInitials }}

{{ selCase.investigator }}

{{ selCase.invDistance }} away · ETA {{ selCase.invEta }} · {{ selCase.invSkill }}

Reassign

Customer

Name{{ selCase.customer }}

Phone{{ selCase.customerPhone }}

Alt. Contact{{ selCase.customerAlt }}

Preferred Slot{{ selCase.appointment }}

Field Investigation — synchronised from the mobile app

Show all sections

{{ invDossierMeta }}

FO claim recommendation: {{ invClaimRec }} Hospital recommendation: {{ invHospRec }} Not-genuine grounds: {{ invGrounds }}

No field report has been submitted from the mobile app for this claim yet. Sections show their status once the field officer submits.

{{ st.n }}. {{ st.title }} {{ st.status }}

Step {{ st.n }} · {{ st.title }}

{{ st.status }}

{{ di.label }}{{ di.value }}

FIELD OFFICER REMARKS

{{ st.remarks }}

🎙 {{ st.voiceLabel }}

Documents & attachments from Claim Inward

Document	Category	Source	Uploaded by	Uploaded	Verification
{{ d.name }}	{{ d.category }}	{{ d.source }}	{{ d.uploadedBy }}	{{ d.uploadDate }}	{{ d.verification }}

Document storage is not connected in this prototype — file preview and download become available once a storage service is integrated.

Documents requested by triggers (to be collected)

⚠ {{ sd.doc }}{{ sd.trigger }}

Insurer Authorisation Letter

Issued by the insurer with the assignment. Tracked as a received document — the platform never generates letters on an insurer's behalf.

Status{{ insurerLetter }}

⬆ Upload insurer letter

Field Officer Authorisation Letter

{{ authLetter.templateName }}

TO WHOMSOEVER IT MAY CONCERN

{{ authLetter.intro }}

{{ authLetter.request }}

• {{ ld }}

{{ dt.k }}: {{ dt.v }}

🖨 Print / Save as PDF

{{ docMsg }}

Investigation Mode & Assignment Model

Investigation Mode{{ selCase.investigationModeDisplay }}

Assignment Model{{ selCase.foModelDisplay }}

Investigation Triggers

{{ tr }}

🚫 Fraud Repository Matches ({{ selCase.fraudMatches.length }})

{{ fm.type }}

{{ fm.reason }}

Automated action: {{ fm.action }}

Suggested Documents / Checklist (Trigger Mapping)

{{ s.doc }}triggered by {{ s.trigger }}

Evidence repository

⬆ Upload evidence

Evidence Manager

{{ fc.label }}

No evidence yet. Photos, documents and voice notes captured in the mobile app appear here, linked to their investigation step.

{{ ev.glyph }}

{{ ev.label }} · {{ ev.kind }}

{{ ev.name }}

Linked to: {{ ev.section }} · Source: {{ ev.source }}

Captured: {{ ev.captured }} · Watermark: {{ ev.watermark }}

📍 {{ ev.location }}

{{ ev.status }}

{{ ch.label }}

Central Review Checklist

{{ crDone }} / {{ crTotal }} reviewed

Quality verification of field investigation, documents and evidence before Medical QC. Every item is mandatory.

{{ cr.item }} *

{{ ch.label }}

A comment is required when an issue is found.

Reason / instructions (required to return or request further investigation)

Approve → Send to Medical QC

Return to FO for correction

Request further investigation

{{ centralReviewMsg }}

{{ sc.label }}

{{ sc.value }}

🔒 Recommendation submitted — fields are locked. The QC approver can return it for correction.

Claim Info from Inward

{{ r.label }}{{ r.value }}

One-page review summary RULE-BASED DRAFT

↻ Generate draft from captured data

Compiled only from inward fields, the field report and automated checks. It makes no medical inference. An AI summarisation model is not connected yet, so this is a draft for the doctor to edit.

Generated {{ medicalQC.draftSummaryAt }} · edits are kept with the QC record

Potential discrepancies — automated checks

{{ medicalQC.rulesUndecided }} awaiting reviewer decision

Deterministic checks on policy dates and field findings. They flag items for review only. They do not decide fraud, repudiation or admissibility.

{{ rc.title }}{{ rc.priority }} priority

{{ rc.finding }}

Source: {{ rc.source }}

{{ ch.label }}

No automated checks flagged.

{{ pn.num }}. {{ pn.title }}

{{ pn.toggleLabel }}

{{ pn.source }}

{{ di.label }}{{ di.value }}

FO remarks: {{ pn.foRemarks }}

{{ pn.sumLabel }}:

Past Medical History — Chronic PED Master

{{ medicalQC.pedCount }} reported by FO

{{ pr.mark }}{{ pr.label }}{{ pr.dur }}

Reviewer PED assessment (verify against proposal disclosure and records)

{{ medicalQC.finalNum }}. Final Clinical Summary:

{{ medicalQC.discNum }}. Discrepancies Noted

● {{ cd.text }} ({{ cd.source }} · confirmed check)

● {{ d.text }}Remove

+ Add

Final Recommendation

Applies to both Cashless and Reimbursement claims. Select one.

{{ rb.label }}

Recommendation remarks (optional)

Condition A: Repudiation Grounds * — select one or more ({{ medicalQC.repGroundCount }} selected)

{{ rg.mark }}{{ rg.label }}

Condition B: Deduction breakdown

Total Claimed (₹) *

Medically Admissible (₹) *

DEDUCTION AMOUNT = TOTAL CLAIMED − MEDICALLY ADMISSIBLE

{{ medicalQC.deductionLabel }}

DEDUCTION %

{{ medicalQC.deductionPct }}%

Disallowance Remarks *

Condition C: Query

Query Remarks *

Evidences Supporting Discrepancies * ({{ medicalQC.evidenceCount }} attached)

⬆ Upload evidence screenshot

{{ sh.name }}

Remove

{{ ev.label }}: {{ ev.description }}Remove

+ Add

Medical QC Doctor *

• {{ er }}

Submit recommendation for QC approval

✦ ZynProbe Intelligence

QC Approval — final QC / insurer recommendation approver

Recommendation awaiting approval: {{ medicalQC.verdict }} · by {{ medicalQC.qcDoctorName }}

Approver note (required to return or request further investigation)

Approve for insurer submission

Return for correction

Request further investigation

Insurer submission tracking

Approved by {{ medicalQC.approvalBy }}. Insurer portal integration is not confirmed, so status and outcome are recorded manually and kept separate from the internal recommendation.

Insurer submission status{{ o }}

Actual insurer outcome{{ o }}

1. Benefit Claim & Policy Contractual Profile

Claim Ref / Victim{{ selCase.claimNo }} · {{ selCase.customer }}

Sum Insured / Claimed{{ selCase.claimAmount }}

Place of Loss{{ selCase.location }}

2. Victim / Claimant Statement Part Summary

3. Spot Verification & Accident Reconstruction Summary

4. Police Documents & Medico-Legal Scrutiny

5. Hospital Documents, Autopsy PMR & Vicinity Checks

6. Final Verification — Proximate Cause & Policy Exclusions

7. Discrepancies Noted (Forensic, Claimant & Toxicology)

{{ d.text }}Remove

+ Add

8. Final Recommendation, Financial Schedule & Repudiation Grounds

Total Sum Insured Claimed (₹)

Medically Admissible (₹)

TOTAL DISALLOWED / FINANCIAL SAVINGS

₹{{ medicalQC.disallowedAmt }}

DISALLOWANCE %

{{ medicalQC.disallowedPct }}%

Final Medical QC Verdict Select verdict… {{ v.label }} Applicable Repudiation Clause Select clause… {{ c }} Repudiation Ground Summary

QC Medical Officer Name

CMO Approved

9. Evidences Supporting Discrepancies (Forensic References)

{{ ev.label }}: {{ ev.description }}Remove

+ Add

Approve

Send for Rework

Request Additional Investigation

Escalate

✦ View ZynProbe Intelligence

{{ medicalQCMsg }}

Timeline

{{ t.what }}

{{ t.who }} · {{ t.when }}

Investigation Report

✦ AI Intelligence

Open Report

Status: Draft — pending QC. Last edited by Ravi Kumar, today 10:42 AM.

Client Delivery & Legal Export

Dossier pulls live from this case's Medical QC verdict, documents and triggers.

DOSSIER CONTENTS PREVIEW

Medical QC Verdict{{ exportInfo.dossierVerdict }}

Disallowed / Savings{{ exportInfo.dossierDisallowedAmt }}

Documents Included{{ exportInfo.dossierDocCount }}

Investigation Triggers{{ exportInfo.dossierTriggerCount }}

Evidence References{{ exportInfo.dossierEvidenceCount }}

📄 Generate Client Dossier PDF

⏳ Generating dossier…

✓ Client Dossier PDF generated

🔗 Sync to Insurer API

⏳ Syncing to core claims engine…

✓ Synced to insurer core claim engine

$ {{ line }}

⚖ Generate Tribunal WS Affidavit

⏳ Drafting Section 170 WS affidavit…

✓ Tribunal WS Affidavit generated

Investigation Conclusion

Investigation Recommendation — Not Final Claim Decision. Final decision remains with the insurer.

{{ r.label }}

Save Recommendation

{{ recommendationMsg }}

FO Payout — {{ payout.category }}

Open Full Expense Sheet

Base Fee + GPS Mileage (₹5/km) + Fraud Bounty − SLA Penalty − TDS (u/s 194C)

{{ payout.baseFeeLabel }}₹{{ payout.baseFee }}

GPS Mileage ({{ payout.distanceKm }} km × ₹5)₹{{ payout.mileage }}

Fraud Bounty₹{{ payout.fraudBounty }}

SLA Delay Penalty{{ payout.slaPenaltyLabel }}

TDS ({{ payout.tdsPctLabel }}, {{ payout.panType }})−₹{{ payout.tds }}

Total Payable₹{{ payout.totalPayable }}

Billing

Billable to{{ selCase.client }}

Case Charge₹2,400

Invoice StatusNot yet invoiced

Bill & Payment Verification

Bill Amount{{ selCase.billAmount }}

Verified Payment{{ selCase.verifiedPayment }}

Payment Method{{ selCase.paymentMethod }}

⚠ Mismatch detected between bill amount and verified payment.

Audit Trail

{{ t.what }}{{ t.who }} · {{ t.when }}

Case records

{{ cl.label }}

Assignment Snapshot

{{ selCase.invInitials }}

{{ selCase.investigator }}

{{ selCase.invDistance }} · ETA {{ selCase.invEta }}

Reassign via Smart Allocation

Recent Activity

{{ t.what }} · {{ t.when }}

Smart Allocation & Dispatch

Best qualified available investigator, ranked by priority + SLA + live location + skill + workload

Rules: ≤{{ allocRadiusKm }} km radius · max {{ allocMaxCaseload }} active cases · language: {{ allocRequiredLanguage }}

{{ m.label }}

Assignment Type

{{ fm.label }}

Assigning Leg

{{ lg.label }}

{{ selCase.id }}

Client{{ selCase.client }}

Priority{{ selCase.priority }}

SLA{{ selCase.sla }}

Type{{ selCase.type }}

Skill Required{{ selCase.invSkill }}

Stage{{ selCase.stage }}

Location{{ selCase.location }}

Hospital Part{{ selCase.hospitalFO }}

Patient Part{{ selCase.residenceFO }}

✓ {{ allocAssignedMsg }}

{{ p.glyph }}

{{ p.tipName }}
{{ p.tipDistance }} from case

Recommended Investigators — {{ allocLegLabel }}

{{ inv.initials }}

{{ inv.name }} RECOMMENDED

{{ inv.distance }} away · ETA {{ inv.eta }} · {{ inv.skill }} · {{ inv.workload }} active cases

{{ inv.score }}

MATCH SCORE

{{ inv.availability }}

Assign

Excluded by Rules ({{ excludedInvestigators.length }})

{{ ex.initials }}

{{ ex.name }}

{{ ex.reasonText }}

{{ f.label }}

{{ p.glyph }}

Field Force ({{ trackListCount }})

{{ inv.name }} {{ inv.status }}

{{ inv.city }} · {{ inv.currentCase }}

Today: {{ inv.todayCases }} cases · {{ inv.distanceToday }} travelled · ETA to next {{ inv.eta }}

{{ f.label }}

+ Upload Additional Evidence

{{ e.glyph }}

{{ e.name }}

{{ e.caseId }} · {{ e.investigator }}

{{ e.time }} · GPS {{ e.gps }}

PreviewDownloadDelete

Hospital Verification

{{ s.done }} {{ s.label }}

{{ formProgressPct }} complete

Admission Details

Was hospitalization confirmed?

Yes No

Date of Admission

Ward / Room Type General WardSemi-PrivatePrivateICU

No. of Days Admitted

Attending Doctor

Discharge Summary Available? YesNo

Hospitalization not confirmed — Admission, Treatment and Doctor sections skipped. Flagged for QC review.

Investigator Observations Patient records tallied with hospital register. Cross-verified with front-desk staff.

Upload Supporting Document

📎 Drop file or tap to capture photo

Save Draft

Next: Documents →

ZynProbe Intelligence AI-GENERATED · REVIEW REQUIRED

{{ selCase.id }} · {{ selCase.type }} — draft analysis, nothing is finalized until reviewed

Investigation Summary

Field visit completed on schedule. Hospitalization confirmed via register cross-check; 4-day admission consistent with claimed treatment. Bills reconcile with pharmacy records within 3% variance. No discrepancy found in patient identity documents.

Key Findings

{{ f.text }}

{{ f.badgeLabel }}

Red Flags & Contradictions

• Discharge summary date (Aug 14) precedes final pharmacy bill date (Aug 15) by one day — recommend clarification.
• No contradictions found in customer statement vs hospital records.

Missing Information

• Doctor's signature on discharge summary
• Original pharmacy bill (photo blurred)

Recommended Follow-up

1. Re-request clear pharmacy bill photo
2. Confirm discharge date discrepancy with hospital desk

Use in Report Draft →

{{ selCase.id }} · {{ selCase.type }}

{{ selCase.client }} · {{ selCase.customer }} · Investigator: {{ selCase.investigator }}

{{ selCase.priority }}

QC Checklist

{{ q.label }}

Evidence: 6 items · Report: draft ready · Form completion: 100%

QC Decision

✓ Approve

↺ Send for Rework

＋ Request Additional Evidence

{{ qcMessage }}

{{ selCase.id }} — Investigation Report

Save Draft

Generate PDF

Send to QC

Submit to Client

{{ s.title }}

{{ s.body }}

Name	City	Skill	Status	Active Cases	SLA %	Rating
{{ i.name }}	{{ i.city }}	{{ i.skill }}	{{ i.status }}	{{ i.workload }}	{{ i.sla }}	⭐ {{ i.rating }}

{{ c.name }}

{{ c.type }}

Active Cases

{{ c.active }}

SLA %

{{ c.sla }}

TAT (avg)

{{ c.tat }}

{{ t.label }}

{{ selCase.id }} — Rate Card & Inputs

Category auto-detected from LOB/claim type: {{ payout.category }}

GPS-Tracked Distance (km)

Verified Entities (hospitals/chemists)

SLA Delay (hours, simulated)

Investigator PAN TypeIndividualFirmInvalid/Unlinked

Toll (₹)

Parking (₹)

Public Transport (₹)

Other, receipt attached (₹)

QC rejected this case (blurred photos / missing statement / unmapped entity) Fraud confirmed by Medical QC — apply bounty

Fraud Bounty Amount (₹800–₹2,000)

💡 Medical QC verdict recommends repudiation for fraud — consider applying the fraud bounty above.

Receipts

🧾

Toll receipt

Payslip Breakdown

{{ payout.baseFeeLabel }}₹{{ payout.baseFee }}

GPS Mileage ({{ payout.distanceKm }} km × ₹5)+₹{{ payout.mileage }}

Fraud Bounty+₹{{ payout.fraudBounty }}

SLA Delay Penalty{{ payout.slaPenaltyLabel }}

Gross Before TDS₹{{ payout.grossBeforeTds }}

TDS ({{ payout.tdsPctLabel }} u/s 194C)−₹{{ payout.tds }}

Net Payout₹{{ payout.netPayout }}

Reimbursable Expenses+₹{{ payout.reimbursables }}

Total Payable₹{{ payout.totalPayable }}

Submit for Approval

{{ k.label }}

{{ k.value }}

Investigator	Cases	Fees	Conveyance	Total	Status
{{ p.name }}	{{ p.cases }}	{{ p.fees }}	{{ p.conveyance }}	{{ p.total }}	{{ p.status }}

{{ k.label }}

{{ k.value }}

Client	Billable Cases	Invoiced	Paid	Outstanding
{{ b.client }}	{{ b.billable }}	{{ b.invoiced }}	{{ b.paid }}	{{ b.outstanding }}

Profitability — This Month

{{ r.label }}{{ r.value }}

{{ t.label }}

QC Cases Reviewed

{{ misTotalCases }}

Total Claimed

₹{{ misTotalClaimed }}

Total Disallowed / Saved

₹{{ misTotalDisallowed }}

Avg. Disallowance %

{{ misAvgDisallowancePct }}%

Savings by LOB

{{ b.value }}

{{ b.label }}

Filters

LOB / CATEGORY

{{ f.label }}

VERDICT

{{ f.label }}

Medical QC Forensic Audit Master MIS

⬇ Export CSV

QC Docket	Claim Ref	LOB	Patient/Victim	Facility	Claimed	Admissible	Disallowed	%	Necessity	PED	Chemist	Tox	Verdict	Clause	QC Doctor	CMO
{{ r.docketId }}	{{ r.claimRef }}	{{ r.lob }}	{{ r.patient }}	{{ r.hospital }}	₹{{ r.claimed }}	₹{{ r.admissible }}	₹{{ r.disallowed }}	{{ r.pct }}%	{{ r.necessityValid }}	{{ r.pedFlag }}	{{ r.chemistFlag }}	{{ r.toxFlag }}	{{ r.verdict }}	{{ r.clause }}	{{ r.qcDoctor }}	{{ r.cmoApproved }}

📋

No Medical QC reviews recorded yet

Rows appear here once a case's Medical QC verdict is saved in Case Detail → Medical QC.

{{ analyticsHeading }}

{{ b.value }}

{{ b.label }}

{{ t.label }}

Central Fraud Repository — 8 monitored entity types, cross-checked in real time against every claim inward, field check-in, and pharmacy/chemist scan.

{{ t.label }}

{{ watchlistEntityLabel }} ({{ watchlistRowCount }})

{{ watchlistCol1Label }}	{{ watchlistCol2Label }}	{{ watchlistCol3Label }}	{{ watchlistCol4Label }}	Reason
{{ w.c1 }}	{{ w.c2 }}	{{ w.c3 }}	{{ w.c4 }}	{{ w.reason }}

+ Add {{ watchlistEntityLabel }} Entry

{{ r.name }}

Active

IF

{{ r.ifText }}

THEN

{{ r.thenText }}

+ New Allocation Rule

Priority	SLA (TAT)	Escalation	Applies to
{{ s.priority }}	{{ s.sla }}	{{ s.escalation }}	{{ s.appliesTo }}

Stage-wise SLA targets (Process Flow sheet) and end-to-end TAT benchmarks (UI design PDF). Values in hours — edits apply live to the dashboard ageing buckets, inward TAT check and TAT-Risk queue. Assumed rows are not in the source documents (scope open questions 1–2).

{{ slaConfigMsg }}

Stage SLA by Claim Group (hours)

Claim Group	1 · Inward & Fraud Tagging	2 · Triage & Allocation	3 · On-Field Audit	4 · Medical QC	5 · Insurer Disposal	Sum of Stages
{{ g.label }} Assumed		{{ g.totalLabel }}

TAT Master Benchmark by Claim Type

Claim Type	Stage SLA Group	End-to-end Benchmark (hours)	Displayed As
{{ t.type }} Assumed	{{ o.label }}		{{ t.e2eLabel }}

💾 Save SLA Master

↺ Restore Defaults

LOB & claim-type master (LOB Master sheet) — drives the Inward Desk dropdowns, SLA group, FO mobile workflow and Medical QC template for every claim type.

LOB	Claim Sub-Type	TAT Claim Type	SLA Group	E2E Benchmark	FO Mobile Workflow	Medical QC Template
{{ r.lob }}	{{ r.subType }}	{{ r.tatType }}	{{ r.slaGroup }}	{{ r.e2e }}	{{ r.workflow }}	{{ r.qc }}

Insurer → RCU Manager matrix — auto-fills "RCU Manager Name / Contact" on the Inward Desk (section 3).

Insurer / TPA	RCU Manager	Contact	Mail ID	Region
{{ r.insurer }}	{{ r.name }}	{{ r.phone }}	{{ r.email }}	{{ r.region }}

+ Add RCU Manager Mapping

Updated Chronic PED master (FRD §4, 23 conditions) — powers the PED picker in the FO app and the Past Medical History panel in Medical QC. A reported condition is screening information only, not proof of a policy exclusion.

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⚙️

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Configuration workspace — part of the full ZynProbe information architecture.

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Time	Case	Customer	Investigator	Location	Priority	Status	Actions
{{ a.time }}	{{ a.id }}	{{ a.customer }}	{{ a.investigator }}	{{ a.location }}	{{ a.priority }}	{{ a.apptStatus }}	Reschedule Cancel

🗂️

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This module is part of the ZynProbe roadmap and follows the same design system shown across the console.

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