At the worst moment, the system offers your people a form. Ethika answers with a person.
Protect is the safety net: group health and the cover around it — and at its heart, Red Carpet: a real team that fights your claim and reaches it before the insurer does, and stays until it's settled.
Anyone who has waited on a claim knows the feeling. The paperwork is moving — or maybe it isn't. The helpline is polite and powerless. And behind every case number is a family quietly afraid of one word: rejected. This is the page we built for exactly that moment.
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The difference is who picks up.
When a claim goes wrong, most systems hand the family a workflow: a portal, a helpline queue, the insurer's call centre. Ours hands them a person. A real Ethika person picks up — not a portal, not a queue, not a call centre — and doesn't hand them back to the system. They make the calls. They chase the paperwork. They explain what's actually happening, in plain words, as many times as it takes.
Here's the detail that says it best: most of the people we've helped through a claim couldn't tell you the name of their TPA — the administrator that processes claims. They never had to deal with them. We did.
How Red Carpet actually works
Every claim comes to Ethika first. Our team audits it before it's ever submitted, so problems get caught on your side of the table — early and quietly, instead of after a rejection.
How Red Carpet works — the full process
Most help arrives after the damage is done. We get there first. A claim reaches our own specialists before it reaches the TPA or the insurer: the file is checked, the gaps closed, the inflated line items questioned — and only then is it routed onward. Behind the person your employee talks to sit specialist teams for each stage — cashless, reimbursement, endorsements, placement, renewals — built deliberately so the relationship is with Ethika, not with any one individual. People take leave; the team never does. That's what keeps the service fast as we grow.
How group claims run
Group claims run two ways. Cashless: the hospital and insurer settle directly — your person never touches the bill, and the pre-authorisation is where speed is made or lost. Reimbursement: the bill is paid first and claimed back — and the file's completeness decides everything. Both have steps that can go wrong quietly. The same Ethika team fronts both.
If a claim comes back denied or cut
Don't treat the first answer as the last one, and don't pay and hope. Denials quote clauses — and clauses can be read back. We match the medical record against the exclusion being claimed, put the response in writing, and take it back through every level the policy allows. If we're your broker, the claim reached us first anyway — that's the point of the model above.
What happens when a claim hits trouble (how our process works — not a specific case)
Day 0: the claim reaches Ethika first — our team audits the file before it ever goes to the TPA or insurer, so gaps and errors are caught on your side of the table. If a denial or deduction comes anyway, a specialist takes it: the policy read line by line, the medical record matched against the exclusion being claimed, the escalation built in writing. You deal with one Ethika person throughout — not a portal, not the insurer's call centre. We fight it as far as the policy's own words allow. We can't promise outcomes — no one honestly can. We can promise the fight, and that you'll never face it alone.
A real claim · "The Clause They Overlooked"
The knee-replacement claim was approved — minus 75%. The insurer invoked a "reasonable and customary" clause: the surgery looked expensive next to others nearby, so they cut the number. What their checklist missed: this policy carried a Modern Treatments clause with no sub-limits — negotiated in at placement, precisely for advanced procedures like this one. We pointed to the page. The deduction was reversed in full. A policy is only as strong as the clauses someone fought to put in it — and fights to enforce.
A real claim on a policy Ethika placed and serviced, shared with consent. Past experience; outcomes depend on individual policy terms.
The people who fight for you
Red Carpet isn't a department name. It's Amit, Sumanth, Bhanu and Venkat — and the specialist teams behind them. In our Google reviews, clients thank them by name — for picking up, for staying on it, for explaining one more time. They stand here for the whole team — because the promise is the team, and the team is what makes it hold.
The people who pick up.
Covered twice? We coordinate both.
Plenty of people have a company policy and one of their own — and at claim time, almost nobody uses both well. We coordinate the two, in the right order, so your people claim everything they're actually entitled to. Most people don't know that's even possible. It's routine here.
Even when the hospital isn't on the network
The worst version of a bad day: the right hospital, the wrong network — and a family scrambling to arrange money at the door. When that happens, we work to make the admission cashless anyway, under the industry's network-wide cashless arrangements, and we do the running — the hospital desk, the insurer, the paperwork — so your people can stay where they're needed: with the patient.
A safety net that flexes to each person
The company policy is the floor, not the ceiling. Through Ethika, your people can extend their own safety net — top up their health cover, add personal accident protection, cover their home — each one optional, each one their choice, and each one serviced by the same team that handles everything else. Protection that flexes to the person.
The rest of the safety net
Red Carpet is the heart of Protect — but the net is wider than the claim. The cover: group health, group personal accident, and term life — placed, negotiated and serviced by the same team that defends them at claim time. And around the cover, the safety and compliance layer: PoSH training for safer workplaces, and cyber & DPDP awareness for safer data — stated plainly, because this part of the job is about prevention, not promises.
Promises are easy. Here's the record.
A real claim · "The ₹9,000 We Wouldn't Drop"
After six days in hospital with a respiratory condition, Prasad was sent home with one instruction: oxygen support for sixty days. Still weak, he bought a concentrator for ₹27,000 — not knowing the policy excluded instrument purchases. Claim rejected. We found the opening the rejection ignored: rental and servicing fall under post-hospitalisation expenses. Weeks of correspondence later, ₹9,000 came back. Not everything — we won't pretend otherwise. But it was his, the policy owed it, and nobody else was going to fight for it.
Consented; past experience.
We fight for your people. Because we answer only to you.
That's the whole model. If it's the broker you've been missing, the next step is small — and it starts wherever you sit.
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Protect is the worst-day half of one designed system. The everyday half — benefits your people actually use — is Rise. Explore Rise →