The insurer representative workspace

1. The big picture

Two distinct workspaces sit behind your login. The Resolution Room is where a single disputed case is worked toward settlement; the data platform is where your organisation's aggregate claims data is analysed. You reach /resolution automatically after sign-in and open a specific room from there.

flowchart TB
  login(["Sign in admin invite"])
  ws["Land on the Insurer Workspace /resolution"]
  pick{"Dispute or analytics?"}
  room["Open a Resolution Room"]
  settle["Message, propose, meet, settle"]
  esign["E-sign the agreement"]
  data[/"Open the /data analytics platform"/]
  done(["Case resolved / insight exported"])
  login --> ws
  ws --> pick
  pick -->|"dispute"| room
  pick -->|"analytics"| data
  room --> settle
  settle --> esign
  esign --> done
  data --> done

2. Sign in to your workspace

Insurer reps do not self-register. A BimaHaq admin invites you and provisions the insurer_rep role; you set your password from the emailed link, then sign in.

1. 1
   Set your password from the invite

   Open the invitation email from BimaHaq and follow its link to set your password. If the link has expired, use “Forgot password?” on the sign-in page to get a fresh reset link.

   Forgot password? /auth/login
2. 2
   Sign in

   Enter your email and password. If two-factor is set up, enter the 6-digit code.

   Sign in /auth/login

   → You land on the Insurer Workspace at /resolution

3. 3
   Read your workspace

   The header shows an “Insurer Workspace” pill and your role badge. A three-card strip counts your active disputes, upcoming meetings and proposals awaiting your review.

   Insurer Workspace /resolution

3. Respond to a dispute in the Resolution Room

From your workspace, open an assigned dispute, read the thread, post messages, and make or answer a settlement proposal. Cards flagged “N proposals to review” are waiting on you.

1. 1
   Open an assigned dispute

   In the “My rooms” list, click a dispute card. A badge shows how many proposals need your response.

   Open room /resolution
2. 2
   Read the discussion

   The room opens on the Discussion tab by default; the thread shows the full multi-party conversation.

   Discussion /cases/[caseId]/room
3. 3
   Post a message

   Type in the message box (up to 5,000 characters) and send. The box appears only while the room is open.

   Send /cases/[caseId]/room
4. 4
   Open the Settlement tab

   Switch to Settlement to see every proposal and its status.

   Settlement /cases/[caseId]/room
5. 5
   Make your own offer

   Click “+ Make a proposal”, enter the rupee amount and the terms, then post it. This button shows only when the room is open and no proposal is already pending.

   + Make a proposal /cases/[caseId]/room

   → Your offer appears in the Settlement tab

6. 6
   Answer the other side’s offer

   On a pending proposal that is not yours, Accept it, Reject it (a written reason is required), or Counter with a new figure.

   Counter /cases/[caseId]/room

flowchart TB
  open(["Open the room"])
  read["Read the discussion"]
  talk["Post messages"]
  prop{"Who has an offer on the table?"}
  make["Make your own proposal"]
  answer["Accept / Reject / Counter theirs"]
  settled(["Proposal accepted → Resolved"])
  open --> read
  read --> talk
  talk --> prop
  prop -->|"none pending"| make
  prop -->|"theirs pending"| answer
  make --> settled
  answer --> settled

4. Accept a settlement and e-sign the agreement

Accepting the counterparty’s proposal moves the case to Resolved. The case manager sends the settlement agreement for signature; you sign your own party row in the eSign tab.

1. 1
   Accept the proposal

   In the Settlement tab, click Accept on the pending proposal and confirm the “Accept ₹…?” dialog.

   Accept /cases/[caseId]/room

   → “Proposal accepted — case moved to Resolved.”

2. 2
   Open the eSign tab

   Switch to eSign to see the settlement-agreement signature envelope.

   eSign /cases/[caseId]/room
3. 3
   Sign as the insurer party

   On your own invitee row, click “Sign now” to open the provider’s signing page and complete your signature.

   Sign now /cases/[caseId]/room
4. 4
   Confirm execution

   Once every party has signed, the tab shows “Agreement fully executed”; follow the link to view it in the case documents.

   View it in the case /cases/[caseId]/room

   → The executed agreement is filed to the case

flowchart TB
  acc(["Accept proposal confirm dialog"])
  res["Case moves to Resolved"]
  tab["Open eSign tab"]
  avail{"eSign enabled & your row unsigned?"}
  sign["Sign your party row"]
  wait["Read-only until enabled / sent"]
  done(["Agreement fully executed"])
  acc --> res
  res --> tab
  tab --> avail
  avail -->|"yes"| sign
  avail -->|"no"| wait
  sign --> done
  wait --> done

5. Join a scheduled mediation session

Video mediation sessions are scheduled by the case manager. You join them from your workspace or from inside the room.

1. 1
   Find upcoming sessions

   Scroll to “Upcoming meetings”. Each row shows the case number, provider, time and duration.

   Upcoming meetings /resolution
2. 2
   Join the call

   Click Join to open the meeting link in a new tab. Join appears only once a meeting link is set.

   Join /resolution
3. 3
   Or join from the room

   Inside the room, switch to the Meetings tab and use the join link on a scheduled meeting.

   Meetings /cases/[caseId]/room

6. Upload a claims dataset with privacy review

On the /data platform your organisation’s claims data becomes analytics. Uploading is a deliberate two-step: the file is analysed first and stored only after you approve how each column is anonymised.

1. 1
   Open the analytics platform

   Type /data in the address bar (there is no menu link for your role). The header confirms your raw personal data is never stored.

   Data platform /data
2. 2
   Select or create your organisation

   Pick your insurer/TPA in the selector, or click “Organisation” to create one (it prompts for the name).

   Organisation /data
3. 3
   Upload a file

   Choose a CSV, XLSX or JSON file. It is analysed immediately but not yet stored.

   CSV, XLSX or JSON /data
4. 4
   Review the anonymization policy

   For each detected column, inspect its class and disposition (pseudonymize / mask / generalize / drop / keep) and change any you disagree with. Nothing has been stored yet.

   Review before ingest /data
5. 5
   Confirm ingest

   Click “Confirm & ingest”. Only the transformed rows are written; the dataset shows “Anonymizing & processing…” then “ready”.

   Confirm & ingest /data

   → A ready, anonymised dataset appears in your list

flowchart TB
  open(["Open /data"])
  org{"Have an organisation?"}
  create["Create your org"]
  up[/"Upload CSV / XLSX / JSON analysed only"/]
  review["Approve per-column anonymization"]
  ingest["Confirm & ingest transformed rows only"]
  ready(["Dataset ready"])
  open --> org
  org -->|"yes"| up
  org -->|"no"| create
  create --> up
  up --> review
  review --> ingest
  ingest --> ready

7. Explore KPIs, build a report, and ask your data

On a ready dataset you get KPI tiles, a pivot/chart report builder, plain-English questions, anomaly and predictive views, and exports — all over anonymised data.

1. 1
   Open a ready dataset

   Click a dataset in the left list. The Dashboard tab shows KPI tiles and an “Anonymization applied at ingest” summary.

   Dashboard /data
2. 2
   Build a pivot report

   In the Report builder pick up to three group-by columns and a measure (count / sum / avg / min / max), then run it to render a bar chart and pivot table.

   Run /data
3. 3
   Ask your data in plain English

   On the Ask tab, type a question such as “rejection rate by insurer” and ask it.

   Ask /data
4. 4
   Check anomalies and segments

   Open the Anomaly / fraud and Predictive tabs; they load on first open.

   Predictive /data
5. 5
   Export the report

   Download the current report as PDF, XLSX or CSV.

   PDF /data

   → A shareable report file

flowchart TB
  ds(["Open a ready dataset"])
  kpi["Read KPI tiles Dashboard"]
  pivot["Build a pivot report Run"]
  ask{"AI provider configured?"}
  nl["Ask in plain English"]
  builder["Use the report builder only"]
  export(["Export PDF / XLSX / CSV"])
  ds --> kpi
  kpi --> pivot
  pivot --> ask
  ask -->|"yes"| nl
  ask -->|"no"| builder
  nl --> export
  builder --> export

8. Privacy, boundaries & compliance

A few rules define what this role can and cannot do. They protect the neutrality of the room and the privacy of the data.

• Raw personal data is never stored on the data platform — files are anonymised on upload and only transformed rows are written after you approve the policy.
• You cannot close a case or record its outcome — those controls belong to the case manager. The Outcome tab is read-only for you.
• You cannot send the eSign envelope or schedule/cancel meetings — those are case-manager and admin actions. You sign your own row and join sessions.
• Settlement steps are on-the-record — rejecting needs a written reason and accepting needs a confirmation before the case moves to Resolved.
• No outcome is guaranteed — the room facilitates a settlement; it does not promise one, and BimaHaq drafts paperwork without promising any result.