Normalized claim
Time: 40% decrease
Reduced average claim handling time by 40%.
Bajaj Finserv Health uses Azure GenAI + Copilot to streamline health insurance claims (Enigma)
Use case typeClaims automationUpdated Jun 13, 2026
Bajaj Finserv Health (BFHL), India, is a leading provider of OPD and IPD health claims processing services. Its AI-driven SaaS/PaaS platform, Enigma, helps minimize fraud, optimize resource utilization, and improve healthcare insurance management for insurers. Enigma uses Microsoft Azure GenAI technologies for document processing, bill digitization, medical encoding (ICD/PCS), tariff standardization, and Copilot functionality to assist customer service agents with unstructured claim inquiries.
- Organization
- Bajaj Finserv Health
- Industry
- Insurance
- Location
- India
- Published
- April 2025
Reported outcomes
5x
quantified impactOther quantified impact
−40%time
Strategic outcomes
Risk & complianceImproved fraud detection in claimsSpeed & agilityStreamlined claim handling workflowCost efficiencyImproved operational efficiency through automationNew product / capabilityAdded AI-assisted claims processing capabilities
Why do we believe this?Outcome claims, sources, and evidence checks
Normalized claim
Quantified impact: 5 x increase
Identified 5x more fraudulent claims than conventional methods.
Why do we believe this deployment?Customer identity, provider attribution, maturity, and source checks
- Customer
- Bajaj Finserv Health
- Provider
- Microsoft
- Maturity
- Production
- Linked source
- Microsoft News / Microsoft Source
Improved operational efficiency and consistency by automating classification, encoding, and billing
Customer identity supportedSource describes one deploymentMaturity supported
Primary read
Use case focus
Showing 3 of 3
- 1Claims processing automation
- 2Fraud detection
- 3Customer service augmentation
Minimize fraud and reduce manual effort in health insurance claim processing while improving accuracy, classification, and billing.
- Enigma automates document classification, medical encoding (ICD/PCS), tariff standardization, and claim document handling.
- The platform integrates with insurer systems and uses Copilot to help customer service agents turn unstructured input into actionable responses.
- The provider portal identifies missing documents from uploaded PDFs and images to improve accuracy without manual intervention.
Technologies
- Reduced average claim handling time by 40%.
- Identified 5x more fraudulent claims than conventional methods.
- Improved operational efficiency and consistency by automating classification, encoding, and billing.
Sources & evidence1
Evidence: Medium65/100Evidence strength
- Customer explicitly identified
- Deployment status explicitly supported
- Independent source available
- Quantified outcome available
- Technical implementation details available
Type: News ArticlePublished: Apr 3, 2025Publisher: MicrosoftEvidence: VendorConfidence: High
AI-generated summary. Verify important details with the linked sources before relying on this case.
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