Population Health

Total Population
142,842
Active Users
97,400
68% engaged
Wellness Index
78
ROI 3.5x

Quarterly Insights · FY26 Q2

Aggregate Workforce Report

Auto-aggregated from 3 contracted services·n = 142,842 lives covered

Report sections

PDF download mirrors the current view — pick Aggregate (all) to export every report.

r.cure

Issue 02
FY26 · Q II

Vitalis.OS

Confidential · for HR

How your workforce
is doing — in plain English.

A one-glance read on 142,842 people across 3 wellness services. What to celebrate, what to watch, what to fix.

Wellness score

78

out of 100

In great shape

In one line

Your team is in great shape — the biggest single win this quarter would be tackling blood pressure & weight in the 30–49 age band.

↑ Engagement +40 pts YoY·142,842 lives·Peer median 68

People engaged

75%

finished their check-in

DoneIn progress

The good news

Habits are sticking

Mindful minutes (+14%) and steps (+8%) are climbing month-over-month. Your wellness app is working.

3 of 8 trackers improving

Worth watching

Sleep is slipping

1 in 5 employees sleeps under 6 hours. This shows up later as high blood pressure and burnout.

21% sleep < 6h

Act on this

Vitamin D deficiency

38% of your team is low on Vitamin D. Easy fix: bundle a D3 supplement into the next AMC cycle.

38% deficient

Daily habits at a glance

30-day average · from the Vitalis app & connected wearables

See full tracker page →
☾

Sleep

6.8h

↑3%
◇

Water

2.1L

↑6%
→

Steps

7.4k

↑8%
☀

Vit D

26ng/mL

↓4%
♡

Mindful

11min

↑14%
▢

Screen

6.2h

↓5%
✕

Alc-free d

21/30

↑9%
✦

Longevity

72/100

↑5%
Built from◈ Health Risk Assessment✚ Annual Medical Checkup◉ OPD Consultations+ 6 more services available
i

What this means for you

  • Celebrate: your wellness score is 78/100 — ahead of similar companies (peer median 68).
  • Notice: men make up 62% of staff and carry most of the blood-pressure and cholesterol risk; women lead on screening compliance.
  • Plan: a BP + cholesterol + sleep camp for the 30–49 male cohort would move the score most for the least spend.

What's inside

  1. 01The headlines (this page)
  2. 02Men vs. women — side by side
  3. 03Daily habits & Longevity OS
  4. 04Who's ready to change?
  5. 05Heart, diabetes, mental & more
  6. 06The clinical numbers
  7. 07Each service, in detail (2)

Generated 01 July 2026 · Aggregated & de-identified · k ≥ 25 cell suppression

Data deep-dive

The numbers behind the headlines

Everything on the cover, with the underlying breakdowns. Skim or skip — the headlines page tells you what matters.

Health Culture

Good

29%54%15%2%

Health Perception

Good

23%62%10%5%

Peer benchmark

78 vs 68

Compared to similar-size knowledge-economy employers in India.

Exams & Vaccines (AMC / PEMC)

84

Blood Pressure Check

vs 85% goal

78

Dental Exam

vs 85% goal

82

Physical Exam

vs 85% goal

70

Bowel Exam

vs 85% goal

69

Glucose Check

vs 85% goal

65

Cholesterol Check

vs 85% goal

60

Mammogram

vs 85% goal

62

Pap Test

vs 85% goal

59

Prostate Exam

vs 85% goal

Top Health Conditions (Self-Reported)

  • High Blood Pressure
    37%
  • Broken Bones
    29%
  • Back Pain
    27%
  • High Cholesterol
    24%
  • Asthma
    13%
  • Diabetes
    13%
  • Arthritis
    12%
  • Heart Disease
    9%
  • Cancer
    9%
  • Stroke
    7%
  • Osteoporosis
    5%

Who's in this report

Gender split

Male 62%Female 37%Other 1%

→ See Workforce Composition for the full gender breakdown.

Age bands

  • 18-29
    28%
  • 30-39
    41%
  • 40-49
    19%
  • 50-59
    9%
  • 60+
    3%

Top locations

Bengaluru 34%Mumbai 22%Hyderabad 14%Pune 11%NCR 9%Other 10%

Workforce

Composition · Male vs Female

Same cohort, cut by gender. Use this view to spot where the male and female sub-populations diverge on risk, screening compliance, and clinical conditions — and where targeted programmes will land.

Male

88,562

62% of workforce · avg age 35

Female

52,852

37% of workforce · avg age 32

Other / Undisclosed

1,428

1% · reported below k=25 suppression

Age pyramid · share of total workforce

Each row is an age band. Bars expand from the centerline — left = men, right = women. The widest rows are where most of your workforce lives; that's where wellness programs land hardest.

MenWomen
8%6%18-2414%9%25-2916%10%30-3411%6%35-399%4%40-494%2%50+

Plain English: ~49% of your workforce sits in the 25–34 band — that's the cohort whose habits set your 5-year cost curve.

Wellness scores · men vs women

Score is out of 100 (higher = healthier). We show two bars per topic — one for men, one for women — on the same scale so you can eyeball the gap.

HeartWomen lead +7 pts
Men
68
Women
75
DiabetesWomen lead +8 pts
Men
67
Women
75
ObesityWomen lead +11 pts
Men
58
Women
69
NutritionWomen lead +10 pts
Men
62
Women
72
FitnessMen lead +7 pts
Men
72
Women
65
MentalWomen lead +7 pts
Men
66
Women
73

Top conditions · how prevalence differs by gender

Prevalence = % of that group affected. Read each row as: "X% of men vs Y% of women". The chip on the right tells you who's hit harder and by how much.

High Blood Pressure

Men
42%
Women
28%

Hits men more

+14 pp

High Cholesterol

Men
29%
Women
17%

Hits men more

+12 pp

Diabetes

Men
16%
Women
9%

Hits men more

+7 pp

Obesity (BMI ≥ 30)

Men
31%
Women
26%

Hits men more

+5 pp

Anxiety / Depression

Men
11%
Women
19%

Hits women more

+8 pp

Anaemia

Men
4%
Women
22%

Hits women more

+18 pp

Thyroid disorders

Men
3%
Women
14%

Hits women more

+11 pp

Musculoskeletal pain

Men
24%
Women
31%

Hits women more

+7 pp

Screening & Vaccination Compliance by Gender

ScreeningMaleComplianceFemaleΔ
Annual Medical Checkup71%
78%+7
Blood Pressure84%
86%+2
Lipid Profile62%
68%+6
HbA1c / Fasting Glucose67%
71%+4
Dental Exam74%
81%+7
Mammogram (40+)—
54%n/a
Pap / Cervical (25+)—
58%n/a
PSA / Prostate (45+)47%
—n/a
Flu Vaccination53%
61%+8

Gender-specific screens (mammogram, Pap, PSA) are surfaced only for the applicable cohort. "n/a" = not clinically applicable.

Male cohort — recommended actions

  • • Cardiometabolic push: BP + lipid + HbA1c camp in 30-49 band (highest BP & cholesterol prevalence).
  • • PSA screening uptake at 47% — target 65% for 45+ male cohort this FY.
  • • Tobacco-cessation nudges via EAP; male users are 3.1× more likely to be active users.

Female cohort — recommended actions

  • • Anaemia & thyroid: 22% / 14% prevalence — bundle into AMC pathway, not opt-in.
  • • Mental wellness: anxiety/depression prevalence is 8pp higher — extend EAP session cap.
  • • Maternity & preventive screens (mammogram 54%, Pap 58%) — close to 70% target with reminders.

Lifestyle

Activity Trackers · Longevity OS

Behavioural & biometric signals captured across the Vitalis app, connected wearables, and the Longevity OS module. These are the daily levers that move the wellness score over time.

✦

Longevity Index

▲ 5%

72 /100

Peer median 68

Composite of behavioural + biometric signals.

◎

Active trackers

▲ 4%

82,848

58% of workforce · ≥1 metric / week

⌬

Wearable-linked

▲ 8%

44,281

31% · Apple Health, Fitbit, Garmin, Mi

⟳

Streak ≥ 14 days

▲ 6%

42 %

of active users · habit-formation band

Daily tracker breakdown — population %

Sleep
☾

Sleep

avg / night · target 7-9 h

6.8 h

  • Duration68%
  • Quality56%
  • Recovery71%

Sleep debt concentrated in night-shift roles & 30-39 male band. Linked to +12pp BP risk.

Hydration
◇

Hydration

avg / day · target 2.5 L

2.1 L

≥ 2.5 L41%1.5-2.5 L38%< 1.5 L14%No data7%

Hydration trend ↑ 6% after Q1 water-station rollout. Push to ≥ 2.5L for 30-49 band.

Vitamin D
☀

Vitamin D

avg serum · sufficient ≥ 30

26 ng/mL

Sufficient (≥ 30)44%Insufficient (20-30)32%Deficient (< 20)18%No data6%

38% below sufficiency — recommend AMC-bundled D3 supplementation pathway.

Steps & Movement
→

Steps & Movement

avg / day · WHO target 10k

7,400

≥ 10k22%7-10k36%4-7k28%< 4k14%

Sedentary cluster in engineering desks. Step-challenge converts 38% in pilot.

Mindful Minutes
♡

Mindful Minutes

avg / day · breath + meditation

11 min

≥ 15 min19%5-15 min41%< 5 min27%Inactive13%

Highest growth metric (+14%). Correlates with -6pp PHQ-9 in active users.

Screen Time
▢

Screen Time

after-hours · target < 4 h

6.2 h

< 4h24%4-6h33%6-8h28%> 8h15%

After-hours screen correlates with sleep < 6h and digital-eye-strain complaints.

Alcohol-free Days
✕

Alcohol-free Days

self-reported · target ≥ 25

21 / 30

≥ 25 days47%20-2528%15-2014%< 1511%

Improvement vs FY25 baseline (18/30). Tied to EAP coaching uptake.

Resting Heart Rate
♥

Resting Heart Rate

avg · healthy 60-80

72 bpm

60-70 (athletic)26%70-80 (normal)48%80-90 (caution)19%> 907%

Wearable-linked metric (n = 1,840). Elevated RHR overlaps with sleep-deficient cohort.

Longevity OS · Composite pillars

Cardio-FitnessMetabolic HealthSleep QualityMovementNutritionStress / MindSocial / PurposeSubstance-free
CurrentTarget FY27

Weighted composite of behavioural & biometric tracker signals. Index = Σ(pillar × weight).

What this means for the workforce

  • ▲Mindfulness & movement are the fastest-growing trackers (+14% / +8%) — keep nudges live in the app.
  • ▼Vitamin D & screen-time are deteriorating — recommend AMC-bundled D3 supplementation and a "wind-down" digital-hygiene campaign.
  • ●Sleep < 6h in 21% of staff overlaps with elevated resting HR — prioritise this cohort for cardiometabolic screening.
  • ●Wearable connections at 31% — expanding to 50% would unlock real-time RHR & HRV trend cards for line managers (de-identified).

Projected impact

Closing sleep + vit-D gaps lifts the Longevity OS index from 72 to ~79 within 2 quarters, with a corresponding +3-4 pt move on overall wellness score.

Behavior

Most Ready to Change

Lifestyle change-readiness across the population. Investment lands hardest on cohorts already in the Ready to Change and Interested bands.

TopicReadyRecently ChangedMaintenanceInterestedNot InterestedDistribution
Stress38%2%15%24%21%
Weight26%6%47%8%13%
Blood Pressure28%5%41%11%15%
Cholesterol22%5%47%10%16%
Glucose6%10%55%10%19%
Exercise5%21%61%2%11%
Tobacco1%32%56%6%5%
Alcohol5%1%39%11%44%
Nutrition39%7%28%17%9%
ReadyRecently ChangedMaintenanceInterestedNot Interested

Composite

Health Domain Scores

Each ring shows the domain score out of 100. The notch is the industry benchmark (68). Bigger ring fill = healthier cohort.

71Healthy

Heart

71Healthy

Diabetes

69Watch

Cancer

63Watch

Obesity

66Watch

Nutrition

69Watch

Fitness

69Watch

Mental

Domain

Heart

58% Doing Well37% Caution5% Take Action
71 /100
High riskWarningSafe

Cardiovascular disease is the leading cause of mortality globally. The drivers below are modifiable risk factors that respond to clinical and lifestyle intervention.

58

Blood Pressure

58%37%5%
60

Weight (BMI)

60%35%5%
61

Nutrition

61%34%5%
56

Tobacco

56%38%6%
57

LDL Cholesterol

57%37%6%
56

Blood Sugar

56%38%6%
56

Triglycerides

56%38%6%
58

Physical Activity

58%37%5%
Doing WellCautionTake ActionNo data

Heart drivers · breakdown

By department · n = 142,842

DepartmentPeopleBlood PressureWeight (BMI)NutritionTobaccoLDL CholesterolBlood SugarTriglyceridesPhysical Activity
Total population142,842
59
60
60
58
56
58
58
59
Tech & Product39,996
64
52
65
63
59
63
63
64
Sales & GTM31,425
58
63
59
57
53
57
57
58
Operations25,712
61
66
62
60
56
60
60
61
Manufacturing19,998
55
60
56
54
50
54
54
55
Finance & Legal14,284
57
62
58
56
52
56
56
57
HR & Admin11,427
54
59
55
53
66
53
53
54
High riskHealthyCell value = % doing well in that cohort.

Domain

Diabetes

68% Doing Well28% Caution4% Take Action
71%Low → High

1 in 11 Indian adults lives with diabetes; another 1 in 4 is pre-diabetic. Early detection and metabolic risk control yield the highest ROI.

65

Blood Sugar

65%30%5%
70

Weight (BMI)

70%26%4%
70

Blood Pressure

70%26%4%
68

Family History

68%28%4%
69

Physical Activity

69%27%4%
70

Nutrition

70%26%4%
66

Triglycerides

66%29%5%
Doing WellCautionTake ActionNo data

Diabetes drivers · breakdown

By department · n = 142,842

DepartmentPeopleBlood SugarWeight (BMI)Blood PressureFamily HistoryPhysical ActivityNutritionTriglycerides
Total population142,842
69
70
70
69
65
70
68
Tech & Product39,996
64
62
62
61
70
62
73
Sales & GTM31,425
75
73
73
72
64
73
67
Operations25,712
61
76
76
75
67
76
70
Manufacturing19,998
72
70
70
69
61
70
64
Finance & Legal14,284
74
72
72
71
63
72
66
HR & Admin11,427
71
69
69
68
60
69
63
High riskHealthyCell value = % doing well in that cohort.

Domain

Cancer

67% Doing Well24% Caution9% Take Action
69Watch

Screening compliance and tobacco/alcohol exposure are the strongest workforce-level levers on cancer risk.

66

Tobacco

66%25%9%
70

Alcohol

70%22%8%
64

Skin Protection

64%26%10%
69

Screenings

69%23%8%
68

Physical Activity

68%23%9%
68

Fruits & Vegetables

68%23%9%
Doing WellCautionTake ActionNo data

Cancer drivers · breakdown

By department · n = 142,842

DepartmentPeopleTobaccoAlcoholSkin ProtectionScreeningsPhysical ActivityFruits & Vegetables
Total population142,842
65
69
68
66
64
64
Tech & Product39,996
68
74
63
65
69
69
Sales & GTM31,425
62
68
74
59
63
63
Operations25,712
65
71
60
62
66
66
Manufacturing19,998
59
65
71
73
60
60
Finance & Legal14,284
61
67
73
75
62
62
HR & Admin11,427
75
64
70
72
59
59
High riskHealthyCell value = % doing well in that cohort.

Domain

Obesity

41% Doing Well52% Caution7% Take Action
63Watch

Body composition is upstream of cardiometabolic, musculoskeletal, and mental-health outcomes. Movement and nutrition dominate the signal.

39

Weight (BMI)

39%54%7%
40

Nutrition

40%53%7%
40

Physical Activity

40%53%7%
43

Sleep

43%51%6%
Doing WellCautionTake ActionNo data

Obesity drivers · breakdown

By department · n = 142,842

DepartmentPeopleWeight (BMI)NutritionPhysical ActivitySleep
Total population142,842
41
39
43
43
Tech & Product39,996
46
42
38
35
Sales & GTM31,425
40
36
49
46
Operations25,712
43
39
35
49
Manufacturing19,998
37
33
46
43
Finance & Legal14,284
39
35
48
45
HR & Admin11,427
36
49
45
42
High riskHealthyCell value = % doing well in that cohort.

Domain

Nutrition

56% Doing Well36% Caution8% Take Action
66Watch

Dietary patterns directly influence cholesterol, glucose, blood pressure, and inflammation markers measured elsewhere in this report.

54

Nuts & Seeds

54%37%9%
55

Beans & Legumes

55%37%8%
58

Saturated Fats

58%34%8%
56

Sugar & Sweets

56%36%8%
55

Salt

55%37%8%
58

Red & Processed Meat

58%34%8%
55

Fruits & Vegetables

55%37%8%
57

Whole Grains

57%35%8%
Doing WellCautionTake ActionNo data

Nutrition drivers · breakdown

By department · n = 142,842

DepartmentPeopleNuts & SeedsBeans & LegumesSaturated FatsSugar & SweetsSaltRed & Processed MeatFruits & VegetablesWhole Grains
Total population142,842
56
58
58
57
54
58
54
53
Tech & Product39,996
61
53
50
49
57
50
57
58
Sales & GTM31,425
55
64
61
60
51
61
51
52
Operations25,712
58
50
64
63
54
64
54
55
Manufacturing19,998
52
61
58
57
48
58
48
49
Finance & Legal14,284
54
63
60
59
50
60
50
51
HR & Admin11,427
51
60
57
56
64
57
64
48
High riskHealthyCell value = % doing well in that cohort.

Domain

Fitness

61% Doing Well30% Caution9% Take Action
69Watch

Physical activity has positive effects on 23+ health conditions. Sedentary hours are the strongest negative predictor.

63

Cardio Activity

63%28%9%
58

Strength

58%32%10%
58

Sedentary Hours

58%32%10%
63

Active Transport

63%28%9%
Doing WellCautionTake ActionNo data

Fitness drivers · breakdown

By department · n = 142,842

DepartmentPeopleCardio ActivityStrengthSedentary HoursActive Transport
Total population142,842
60
61
62
63
Tech & Product39,996
59
53
57
55
Sales & GTM31,425
53
64
68
66
Operations25,712
56
67
54
69
Manufacturing19,998
67
61
65
63
Finance & Legal14,284
69
63
67
65
HR & Admin11,427
66
60
64
62
High riskHealthyCell value = % doing well in that cohort.

Domain

Mental

59% Doing Well33% Caution8% Take Action
69Watch

Mental wellness (EAP) is not part of this contract. Add the Mental Wellness service to unlock PHQ-9 / GAD-7 surveillance, counsellor utilisation, and crisis-line metrics for this cohort.

Clinical

Biometrics

52

Blood Pressure

52%28%14%6%
48

Total Cholesterol

48%24%22%6%
44

LDL Cholesterol

44%28%22%6%
56

HDL Cholesterol

56%22%16%6%
50

Triglycerides

50%26%18%6%
58

Fasting Glucose

58%22%14%6%
54

HbA1c

54%26%14%6%
36

BMI

36%42%18%4%

Provenance

Report Provenance

Sources

  • • HRA questionnaire (n = 94,276)
  • • Annual Medical Checkup labs (n = 59,994)
  • • OPD consult outcomes

Methodology

  • • De-identified cohort aggregation (k ≥ 25 cell suppression)
  • • Risk bands derived from CDC + ICMR cut-offs
  • • Composite score = weighted avg of 7 health domains
  • • Confidence interval ±2.4% at 95% CL
Vitalis.OS · Confidential — for internal HR / benefits use onlyEnd of report

Annual Medical Checkup

AMC Compliance & Findings

Mandatory annual examination compliance, exam-wise completion and incidental findings.

Eligible cohort

88,562

Checkups done

70,141

79% compliance

Critical flags

2,876

referred to specialist

Net new diagnoses

5,050

Exam-wise completion

  • CBC
    68,738%
  • Lipid panel
    65,933%
  • LFT / KFT
    62,425%
  • HbA1c
    60,321%
  • TSH
    49,800%
  • ECG
    43,487%
  • Chest X-ray
    28,758%

Top incidental findings

  • Vitamin D deficiency
    26,654
  • Pre-diabetic HbA1c
    11,924
  • Elevated LDL
    14,730
  • Hypertension stage I
    6,313
  • Fatty liver (Grade I)
    9,118
  • Anaemia (Female)
    5,611

Cashless OPD

OPD Consultation & Claims

Network utilisation, claims throughput and clinical mix across the contracted OPD panel.

Claims processed

122,558

this quarter

Avg claim value

₹1,214

Cashless share

86%

14% reimbursement

Avg approval TAT

7.6 h

from intimation to authorisation

Top diagnoses (ICD-10 mapped)

  • J06 · Acute URI
    22,060
  • K30 · Functional dyspepsia
    13,481
  • M54 · Back pain
    11,030
  • R51 · Headache
    9,805
  • L20-30 · Dermatitis
    8,579
  • H10 · Conjunctivitis
    6,128
  • E11 · T2 diabetes follow-up
    6,128
  • I10 · Essential hypertension
    4,902

Network vs out-of-network

  • In-network cashless86%
  • Reimbursement2%
  • Network leakage12%

Leakage concentrated in NCR & Pune; recommend onboarding 4 additional polyclinics there.

Top providers by claim volume

  • Apollo Clinic — Bengaluru ORR
    11,030
  • Fortis — Mumbai Mulund
    8,579
  • Manipal — Hyderabad Madhapur
    7,353
  • Practo Care — Pune Baner
    6,128
  • Max Healthcare — NCR Saket
    4,902
  • Aster — Bengaluru Whitefield
    4,902

Denials & exceptions

  • Total denials4,167 (3.4%)
  • · Non-covered procedure38%
  • · Missing pre-auth27%
  • · Duplicate submission19%
  • · Eligibility lapse16%

⚠ Duplicate submissions are +2.4 pp QoQ — investigate top 3 providers.

Claim hotspots

Where claims are happening

What employees are spending on, in which cities, and which categories are accelerating fastest.

Spend by claim category

  • GP / OPD consult
    41,670
  • Diagnostics & labs
    25,737
  • Pharmacy refill
    19,609
  • Specialist consult
    13,481
  • Dental
    8,579
  • Vision
    7,353
  • Preventive checkup
    6,128

Diagnostics is the fastest-growing line (+18% QoQ) — largely follow-ups for cardiac & metabolic risk flagged in HRA.

Top 6 cities by claim volume & average ticket

CityClaimsAvg ticketQoQMix
Bengaluru31,865₹1,311+9%
NCR23,286₹1,384+12%
Mumbai19,609₹1,481+6%
Hyderabad15,933₹1,238+14%
Pune13,481₹1,165+4%
Chennai9,805₹1,275+7%
ConsultDiagnosticsPharmacy / Other

Forward look · model v3.2

Next 4 quarters — predicted claims & spend

Forecast blends current run-rate, seasonality, HRA risk signals and demographics shifts. Shaded band = 80% confidence.

Quarterly claim volume — actuals & forecast

Q-3102.9kQ-2107.9kQ-1115.2kNow122.6kQ+1129.9kQ+2137.3kQ+3144.6kQ+4148.3ktoday
ActualForecast80% confidence

12-month projection

Projected claims (next 4Q)

560,090

↑ 14% vs trailing 4Q

Projected spend

₹73 Cr

avg ticket trending ₹1,311

Cashless share (forecast)

90%

if 4 new polyclinics added in NCR & Pune

Categories expected to grow / decline (next 12 months)

  • Cardiac diagnostics (ECG, lipid, 2D-Echo)↑ 28%HRA flagged 12% population with BP/lipid risk
  • Mental health consults↑ 22%GAD-7 / PHQ-9 caution band grew +6 pp
  • Diabetes follow-up & HbA1c↑ 18%Pre-diabetes prevalence 24% in 30–49 band
  • Physiotherapy & MSK↑ 14%Back pain is the #3 ICD this quarter
  • Paediatric consults (dependents)↑ 9%New dependent enrolment cycle in Q+1
  • Acute URI / seasonal↓ 6%Base effect post the Q-2 viral surge
  • Dermatology (cosmetic)↓ 4%Network re-pricing, fewer eligible providers

What this means for HR & Finance

  • Budget: hold a +14% reserve on the OPD line for FY+1 — driven by diagnostics & specialist mix.
  • Network: close NCR & Pune gaps to lift cashless share from 86% → ~90% and cut reimbursement TAT.
  • Prevention: pulling cardiac & metabolic screening forward by 1 quarter is projected to defer ~4,902 claims into preventive (~40% cheaper).
  • Mental health: raise EAP session cap before Q+1 — utilisation is forecast to cross policy ceiling for ~6% of users.

Model: Holt-Winters + HRA risk regression · refreshed weekly · 82% in-sample fit

Predictive · individual claim patterns

Life events we expect — from how people are claiming today

When a person's claims start clustering (e.g. 3+ gynaec consults + folic acid + ultrasound), the model flags a likely life event ahead. Used to plan benefits, not to surveil — names are never surfaced, only cohort counts.

🤰88% conf

Pregnancy / Maternity

2,000

people · 0–9 mo

🩺79% conf

New chronic onset (HTN/T2D)

4,428

people · 3–12 mo

🏥74% conf

Planned surgery (MSK/cardiac)

1,286

people · 1–6 mo

👶71% conf

Family expansion (paeds)

3,143

people · 6–18 mo

🧓68% conf

Eldercare onset (parent dep.)

2,571

people · 3–12 mo

🧠82% conf

Mental-health escalation

3,857

people · 0–6 mo

Signal pattern → predicted event → recommended action

Claim pattern observedPredicted life eventCohort · prob.Benefits action to queue
3+ gynaec consults + folic-acid Rx + 1st trimester USGPregnancy confirmed2,00088% prob.Auto-enrol maternity rider, share antenatal package, flag 26-wk leave plan with HRBP
BP > 140/90 in 2 of last 3 AMCs + lipid borderline + family Hx flagHypertension onset2,57181% prob.Push BP cuff from wellness kit, enrol in cardio-metabolic coaching, schedule 90-day re-test
HbA1c 5.9–6.4 + waist↑ + sedentary score > 7h/dayType-2 diabetes onset (12 mo)1,85776% prob.Add to DPP (diabetes prevention) cohort, nutrition consult, glucose strip benefit
2+ orthopaedic consults + MRI knee/hip + physio claimsJoint replacement / arthroscopy85779% prob.Pre-authorise tertiary network, brief surgical-leave policy, queue physio post-op package
New paediatric registration + vaccination claim + lactation consultNewborn dependent added3,14391% prob.Auto-trigger dependent addition window, share well-baby schedule, paternity policy nudge
Parent-as-dep added + geriatric consult + 2+ chronic Rx refillsEldercare burden rising2,57172% prob.Surface eldercare concierge, home-health rider, caregiver-leave eligibility check
PHQ-9 ≥ 10 + 2+ EAP sessions + sleep < 6h on trackerMental-health escalation risk3,85784% prob.Raise EAP session cap, manager sensitisation, voluntary leave-of-absence pathway
Statin Rx + cardio rehab + smoking-cessation claimPost-cardiac recovery cohort57187% prob.Enrol in 12-wk recovery program, modified-duty conversation, annual stress-echo reminder

Patterns derived from rolling 90-day claim windows · de-identified at the cohort level (k ≥ 25) · never displays member PII

Spend impact of predicted events

Maternity claims₹37.00 Cr
Cardio-metabolic₹18.60 Cr
Surgical (elective)₹41.15 Cr
Paediatric (newborn)₹5.66 Cr
Eldercare add-ons₹16.71 Cr
EAP / mental health₹4.63 Cr

Projected event spend

₹123.7 Cr

~832% of next-year OPD outlay tied to predictable life events — most of it queue-able into pre-arranged packages at ~18% lower ticket.