While India’s health insurance ecosystem has long focused on hospitalization, a significant share of medical expenses actually stems from outpatient needs doctor visits, diagnostic tests, and medicines. Addressing this overlooked yet essential segment, Livlong 365 has emerged as a pioneering health-tech platform redefining healthcare financing through its unique Payvidor model, which blends payer and provider capabilities for a seamless OPD experience.
Under the leadership of Gaurav Dubey, Founder and CEO, Livlong 365 is transforming how Indians access and manage everyday healthcare from AI-driven, real-time claim settlements to personalized elderly care programs that combine technology with empathy. With a presence spanning 800+ cities and 19,000+ pin codes, the company’s rapid scale-up underscores both innovation and execution strength in a complex, fragmented healthcare market.
In this conversation with Medtech Spectrum, Gaurav Dubey discusses how Livlong 365 is bridging India’s OPD insurance gap, empowering preventive care, building a phygital ecosystem for deeper reach, and shaping the future of integrated healthtech in India.
Livlong 365 has positioned itself as a pioneer in bridging the OPD insurance gap through its Payvidor model. Could you explain how this model uniquely addresses India’s outpatient care challenges compared to traditional insurance offerings? Technology plays a central role in your platform, from DIY claim settlement to real-time healthcare access. How do you ensure both speed and accuracy in tech-enabled claims while keeping the system user-friendly?
In India, health insurance has traditionally centred around hospitalization, often overlooking everyday medical expenses. However, the reality is that a significant portion of healthcare spending goes toward outpatient needs such as doctor consultations, medicines, and diagnostic tests, rather than hospital stays. To bridge this long-standing gap, OPD (Outpatient Department) cover was introduced, addressing essential day-to-day healthcare requirements across all age groups.
By focusing on OPD, we’re not only improving affordability but also enhancing accessibility. This marks a crucial shift from hospitalization-based care to a more preventive and proactive healthcare approach. For us at Livlong 365, the OPD cover is not merely a product; it represents a reimagination of healthcare financing in India, designed to simplify and manage everyday medical expenses effectively.
As a health-tech platform, technology lies at the core of this transformation. Our AI-driven OCR and Medical Intelligence systems automate claim validation and adjudication, ensuring accuracy, transparency, and speed with most claims processed within four hours. Complementing this is a lean human oversight layer that ensures empathy and exceptional case handling when required.
This synergy between automation and assurance enables us to deliver healthcare that is fast, transparent, and human-centered, redefining how OPD care is accessed and experienced across India.
Your Regard Elderly Care Programme is an interesting innovation. What specific needs of India’s rapidly growing senior population does this program address, and what uptake have you seen so far?
The Regard Elderly Care Program was conceptualized to provide holistic, preventive, and compassionate care for India’s rapidly growing senior population. Built on the philosophy of dignity, independence, and continuous care, the program assigns a dedicated Healthcare Manager (HCM) to every enrolled senior citizen, serving as a single touchpoint for all health and wellness needs.
Each HCM ensures end-to-end care management from scheduling regular health assessments and maintaining digital health records to coordinating monthly doctor consultations and timely interventions. This personalized approach goes beyond addressing medical issues; it fosters a sense of security, emotional comfort, and trust, especially for families living away from their parents.
Encouraged by the strong uptake so far, we’re now scaling our program across metros and Tier-1 cities. We’re also collaborating with corporates, SMEs, and housing societies to introduce customized elderly care solutions for their employees, clients, and residents; redefining senior wellness through technology, empathy and continuous support.
With a presence across 800+ cities and 19,000+ pin codes, scalability is a significant achievement. What were some of the operational or technological hurdles in building such a wide healthcare network, and how did you overcome them?
Indeed, building a scalable and reliable OPD network in India came with its share of challenges from logistics and service consistency to network expansion and initial resistance from doctors and hospitals toward cashless OPD. To address these, we adopted a hyperlocal, micro-market strategy focusing on deep, localized partnerships rather than a one-size-fits-all approach.
For instance, instead of taking a broad city-level view, we divided each city into smaller micro-markets to identify high-demand clusters and build doctor networks accordingly. While many industry players concentrated primarily on large hospitals in metro cities, we created a balanced network that included smaller hospitals and clinics in non-metro regions, enabling both scale and inclusivity.
Our lab network strategy also followed this dual approach partnering with reputable national brands in Tier 1 and Tier 2 cities for credibility, while onboarding trusted regional labs in smaller towns to enhance reach. Recognizing that most players overlooked last-mile collection in smaller towns, we prioritized home sample collection and regional tie-ups, significantly improving accessibility.
In essence, our scale and efficiency are powered by a micro-market approach, hybrid partnerships, strong home collection capabilities, and dedicated network teams; all working cohesively to ensure comprehensive coverage, operational consistency, and accessible healthcare across India.
Fraud, waste, and abuse are common concerns in healthcare financing. Could you elaborate on how Livlong 365’s in-built controls mitigate these risks?
At Livlong 365, our constant endeavor is to minimize fraud and abuse through robust, evolving controls. Our Fraud, Waste, and Abuse (FWA) framework is dynamic and monitored/reviewed continuously to analyze claims data & identify unusual utilization trends, investigate anomalies and implement corrective actions. These interventions may involve enhancements to our platform, client communications, or operational SOPs. In parallel, we are leveraging AI-based claim prompts to strengthen adjudication and gradually move towards auto-adjudication with higher accuracy.
While fraud risk can never be eliminated entirely, we are confident that our proactive governance, rigorous monitoring, and technology-led safeguards enable us to detect issues early and act decisively, ensuring trust and transparency for all stakeholders.
Looking ahead, what new technologies or service verticals are you planning to integrate into Livlong 365 to strengthen its position as India’s leading OPD insurance and health-tech platform?
We have already built a strong healthcare ecosystem through strategic partnerships with leading diagnostic labs, pharmacy networks, and telemedicine providers across India’s major cities. Having successfully implemented our solutions in urban markets, our next focus has been to extend this integrated model to underserved regions.
Our decision to invest ₹100 Cr in setting up 100 physical branches by 2027 is a strategic step towards building a phygital (physical + digital) ecosystem that aligns with India’s diverse healthcare and insurance landscape. To achieve this, we launched Frontier Markets — a dedicated distribution channel designed to deliver tech-enabled health insurance and wellness solutions tailored for Tier-2 and Tier-3 cities.
We are moving beyond insurance distribution to becoming a unified Healthtech platform that serves individuals, families, and enterprises across their entire healthcare journey. Our aim is to solve healthcare holistically from cover to care. The future of healthcare lies at the intersection of risk cover and care delivery. Livlong 365 is building that intersection.
