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Introduction

The agentic Claims OS for TPAs and Insurers in India
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Gooclaim is the agentic Claims OS — plug in any CMS, any channel, and any knowledge layer, and ship any claims workflow.

This documentation covers the public API surface Gooclaim exposes to its TPA and Insurer partners. If you’re integrating your claim-management system with Gooclaim, start here.

What Gooclaim does

Gooclaim runs claim-related conversations end-to-end across messaging channels (WhatsApp today, more coming) using a multi-agent platform. Three workflows ship in v1.0:

Claim Status

Claimant asks “where’s my claim?” — Gooclaim fetches live status from your CMS, formats it through an approved template, and replies on the channel.

Pending Documents

Stateful follow-up workflow. Gooclaim asks for missing documents, waits (via Temporal), reminds on a schedule, and notifies you when received.

Query Reason

Claimant asks “why was X rejected?” — Gooclaim looks up the reason in your knowledge base, runs it through the Policy Gate, and replies with a safe, template-formatted answer.

What you’ll find here

Authentication

How to obtain and use JWTs to call Gooclaim APIs.

Workflows

Trigger, observe, and integrate with the three pilot workflows.

Webhooks

Receive workflow lifecycle events on your side.

API Reference

Full reference for the four partner-facing services.

Four services in this API

This documentation covers only the partner-facing services. Gooclaim runs on a larger internal architecture, but you’ll integrate with these four:

ServiceWhat it doesWhen you call it
Auth ServiceIssues short-lived JWTsOnce per session (then refresh)
Workflow EngineWorkflow status + controlWhen you want to inspect a workflow
Audit LedgerTenant-scoped audit queryFor your own IRDAI compliance reporting
Outbound WebhooksEvent schemas (we push to you)Configure once, receive events forever

All other services (Channel Gateway, Truth Layer, Knowledge Layer, Policy Gate, Model Gateway, etc.) are internal to Gooclaim. Their behavior is described where it affects you, but you do not call them directly.

Versioning

Gooclaim uses SemVer. All business endpoints are mounted under /v1/*. When breaking changes ship, the new version becomes /v2/* and /v1/* keeps working until the deprecation window closes.

VersionStatusWhat it ships
v1.0Pilot (current)3 workflows, WhatsApp only, read-only Truth Layer
v1.1PlannedPost-launch polish, MCP server tab, new templates
v2.0FutureVoice, Workflow Studio, Learning Loop, write-back

Compliance posture

Gooclaim is built for the Indian insurance regulatory regime:

  • IRDAI Outsourcing Regs + Master Circular + Cybersecurity Guidelines — all workflow decisions emit an immutable audit event you can query.
  • DPDP Act — explicit Consent Capture is Step 0 of every workflow; you can query consent state and trigger Right-to-be-Forgotten via the API.
  • Data residency — all processing in Azure centralindia (Mumbai).

For full compliance documentation, see compliance.gooclaim.com.

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