PMJAY Auto Adjudication Hackathon

Despite progress, timely and consistent claim payments under AB PMJAY remain a challenge due to high claim volumes and largely manual adjudication. While NHA's in-house auto adjudication pipelines have improved efficiency for select high-volume packages, scaling across diverse packages and document formats remains a critical gap. This underscores the need for a robust, package-agnostic solution that can operate at scale.

To address this, the hackathon focuses on key pain points in the insurance ecosystem and drives the development of high-value, scalable solutions for India's health insurance claims landscape. It highlights advances in human-centric, India-hosted, interoperable AI to make claims processing faster, fairer, and more transparent.

Problem Statements

Participants are invited to develop innovative solutions addressing the following core problem statements:

• Problem Statement 1: Clinical document classification & Compliance to STG requirements Automatically classify healthcare documents and perform multilingual OCR on low-quality scans to extract structured clinical, administrative, and billing data with confidence scores and provenance.
• Problem Statement 2: Radiological Image-Based Condition Detection & Report Correlation Design an assistive solution capable of reading and interpreting medical images to help adjudicators understand the image contents, correlate findings with hospital-submitted reports, and verify consistency with the claimed condition, stage, and timeline under Standard Treatment Guidelines (STGs).
• Problem Statement 3: Document Forgery / DeepFake detection Detect tampering, manipulation, or forgery in submitted documents by identifying altered text, mismatched fonts, inconsistent metadata, signature/seal duplications, and image splicing or overwritten fields

Who Should Participate

The hackathon will convene innovators, insurers, regulators, data governance experts, and medical guideline authorities to address real-world challenges in claims processing. By participating, innovators will gain practical insights into multilingual, explainable AI that reduces administrative burden, enhances transparency, and enables faster, fairer claim decisions, improving beneficiary access and ease of business for providers.

Masterclass Schedule

To assist participants in refining their solutions, virtual masterclasses focused on specific use cases will be conducted (recordings will be available on the NHA portal):

• 13 April 2026: PS 1 (Clinical document classification & STG) + Data focused 
• 15 April 2026: PS 2 (Radiological Image-Based Condition Detection) 
• 16 April 2026: PS 3 (Document Forgery/DeepFake detection) 

Key Dates & Evaluation Timeline

Solutions will undergo a two-stage evaluation process (Screening + Live Demo) emphasizing model robustness, India-hosted interoperability, and reproducibility.

• Registration Deadline: 13 April 2026 
• Data Shared with Participants: 14 April 2026 
• Solution Submission Deadline: 27 April 2026 
• Grand Finale: 8th & 9th May 2026 

Awards & Opportunities

The hackathon offers attractive cash prizes for the top three solutions across each of the three problem statements:

• 1st Prize:₹ 5,00,000 
• 2nd Prize: ₹ 3,00,000 
• 3rd Prize: ₹ 2,00,000 

Furthermore, winners may be considered for a potential long-term collaboration with the National Health Authority (NHA) worth up to ₹50 lakhs

Venue: IISC Bangalore, CV Raman Road, Bengaluru, Karnataka - 560012, India.

Official Website: https://nha.gov.in/hackathon.