Top Insurance Claim Management Software and Systems

Top Insurance Claim Management Software and Systems

May 2022

Insurance claim management software is designed to help insurance companies evaluate and manage insurance claims. It minimizes the risk of fraud while staying true to the principle of payments for those in need. What are the best claim management solutions out there and how can you get inspired for your product?

What exactly is insurance claims management?

The product in question should have a few functionalities that are necessary for insurance companies. Among them are:

  • storing information about claims in the database
  • allow users to submit claims
  • analyze data and historical patterns to highlight potential frauds
  • provide risk assessment functionalities through analysis of claim complexity
  • automate business processes – client onboarding, claims analysis, payments
  • medical evaluation
  • the revision process for annuities
  • appeals and complaints
  • court cases
  • recourses
  • reimbursements
  • integration with an accounting system
  • integration with the home-banking system

Comprehensive insurance claim management software is not an easy thing to develop. In fact, due to compliance and delicate matter, insurance software development is one of the toughest fields out there. That’s why you want to make sure the previously mentioned functionalities are identified and successfully implemented.

Claims management systems for insurance are about people, not data

Consumers use products, but in fact, trust the people behind them. That’s why it’s important to design claim management solutions in a way that enhances customer experience. Make claim uploading process seamless, analysis short, and decision making automated. Not with a human touch, though. It’s hard to automate and generate trust at the same time. That’s why we have made this list of insurance claim management software. Take a look at what’s already there and think about how your claim management solutions, implemented in your application, can help the market. You may also want to check our insurance compliance software list.

1

AIM

250+ Employees
Denver, United States
Est. 1969
AIM centralizes your underwriting, accounting, and claims operations in order to be a more efficient and profitable insurance business. Designed to manage the full policy lifecycle, AIM helps increase your speed to market, while ensuring accuracy throughout the entire process.
Specialities
  • InsurTech
  • Agency Consolidation
Visit site
2

Applied Epic

250+ Employees
University Park, United States
Est. 1983
Applied Epic is the industrys most technologically advanced, flexible and secure cloud-based agency management system, providing powerful automation capabilities and a greater level of visibility across an entire book of business. The system offers a single, open application with integrated capabilities to efficiently manage customer relationships, policy and benefits administration, sales automation, and financial accounting processes.
Specialities
  • Software Development
  • Agency Management Software
  • Brokerage Management Software
Visit site
3

C.L.U.E. Auto

250+ Employees
Alpharetta, United States
Est. 2005
LexisNexis C.L.U.E. Auto is a claim history information exchange containing up to seven years of personal automobile claims matching the search criteria submitted by the inquiring insurance company.
Specialities
  • Fraud Detection
  • Identity Management Solutions
  • Insurance Risk Management
Visit site
4

Change Healthcare Office

250+ Employees
Nashville, United States
Est. 2007
Integrated, flexible software solution for creating claims with intuitive data entry and support for compliance with state mandates.
Specialities
  • Healthcare Technology
  • Healthcare Platform
Visit site
5

Claim Processing Engine

250+ Employees
Reading, United Kingdom
Est. 1982
Provides benefits of a custom-made unified claim processing solution and allows for rapid integration with legacy systems.
Specialities
  • Enterprise Digital Transformation
  • Application Development
Visit site
6

ClaimCore

250+ Employees
San Francisco, United States
Est. 2008
ClaimCore is powered by the EIS Platform which comes with a full range of common business services and tools that increase business velocity in every phase of the claim cycle.
Specialities
  • Insurance Platform
  • Core Insurance Operations
Visit site
7

Claims Compass

250+ Employees
Alpharetta, United States
Est. 2005
Claims Datafill leverages data and analytics to improve your business results.
Specialities
  • Fraud Detection
  • Identity Management Solutions
  • Insurance Risk Management
Visit site
8

Claims Datafill

250+ Employees
Alpharetta, United States
Est. 2005
More data earlier improves claims handling efficiency and reduces costs.
Specialities
  • Fraud Detection
  • Identity Management Solutions
  • Insurance Risk Management
Visit site
9

Claims Processing

250+ Employees
New Delhi, India
Est. 1992
A solution to automate the claims journey, from omnichannel intimation of the first notice of loss to fraud detection and claims adjudication, and finally claims settlement. Aims to increase process efficiency and standardization by empowering users to perform manual tasks digitally and reduce human intervention. Offers flexibility of addressing various claim types, like death and maturity claims, differently, and aims to improve regulatory compliance and eliminate non-compliant penalties.
Specialities
  • Automation Platform
  • Digital Transformation
Visit site
10

ClaimsEnterprise

250+ Employees
Milpitas, United States
Est. 2006
ClaimsEnterprise is a complete claims processing system, from FNOL through adjudication.
Specialities
  • Casualty Insurance Software
  • Data Analytics
Visit site
11

ClaimVantage Claims Management

250+ Employees
Morristown, United States
Est. 1982
ClaimVantage offers industry-leading software for managing life, health, and absence claims efficiently and securely, helping you deliver superior customer service for a competitive edge. Hosted on the Salesforce platform, our configurable and intuitive cloud-based software is developed and updated by industry experts. We provide regular enhancements to keep you on top of market changes and industry developments. Our best-in-class solutions are fully integrated and can be accessed anytime, anywhere, helping you minimize fraud, streamline operations and improve productivity, while saving on implementation costs.
Specialities
  • Leading Software
  • Insurance Markets
Visit site
12

ClaimXperience

250+ Employees
Lehi, United States
Est. 1986
ClaimXperience provides insurance companies with important tools that help claims representatives work more effectively with policyholders.
Specialities
  • Property Insurance
  • Estimating Software
Visit site
13

ClaimZone Manager

250+ Employees
Rolling Meadows, United States
Est. 1962
ClaimZone Manager is designed from the ground up to be a comprehensive, web-based claims management system.
Specialities
  • Proper Management
  • Health and Financial Wellbeing
Visit site
14

CoreLogic Symbility Claims Connect

250+ Employees
Irvine, United States
Est. 2010
CoreLogic Symbility Claims Connect is a platform that makes the claims process.
Specialities
  • Insurance Claims Solutions
  • Property Insurance
Visit site
15

Duck Creek Claims

250+ Employees
Boston, United States
Est. 2000
Duck Creek Claims allows you to manage the entire claims lifecycle.
Specialities
  • Distribution Management
  • Reinsurance Management
Visit site
16

Ebix WCIRS

250+ Employees
Johns Creek, United States
Est. 1976
WCIRS – Workers’ Compensation Injury Reporting Service is an internet-based solution that fulfills state regulations for workers’ compensation claims submissions.
Specialities
  • Insurance Carrier Systems
  • Insurance Certificate Management
  • Risk Management
Visit site
17

Fee Basis Claims System

250+ Employees
Juno Beach, United States
Est. 1991
FBCS is a powerful software solution that simplifies the administration and tracking of claims.
Specialities
  • Health Information Software
  • Services and Solutions
Visit site
18

FINEOS Claims

250+ Employees
Dublin, Ireland
Est. 1993
FINEOS Claims is a best in class, customer-centric, web-based claims processing software solution.
Specialities
  • Insurance Software
  • Insurance Platform
  • Core System
Visit site
19

Gateway

250+ Employees
Whiteley, United Kingdom
Est. 1999
Claim and repair AI workflow engine. Gateway enables mobile self-service to policyholders and drivers and integrates with insurer, fleet owner, car manufacturer and repair shop processes to provide a real-time single source of truth. Artificial Intelligence at the core of Gateway drives the claim and repair workflows and notifies all parties involved of the changes and progression. It enables insurance companies to handle the entire claims process end-to-end via a simple online platform. Workshops can simplify calculation, ordering and billing processes that significantly reduce the administrative costs and times.
Specialities
  • Claims Handling Solutions
  • Claims as a Service
Visit site
20

Guidewire ClaimCenter

250+ Employees
San Mateo, United States
Est. 2001
Guidewire ClaimCenter is a claims management system that supports all lines of personal, commercial, and workers’ compensation insurance.
Specialities
  • Data Management
  • Predictive Analytics
  • Risk Analysis
Visit site
21

Guidewire InsuranceNow

250+ Employees
San Mateo, United States
Est. 2001
InsuranceNow is a cloud-based, all-in-one solution that enables rapid implementation, quick upgrades, and freedom from the constraints that come with daily system maintenance.
Specialities
  • Data Management
  • Predictive Analytics
  • Risk Analysis
Visit site
22

HealthRules Payor

250+ Employees
Burlington, United States
Est. 2004
Claims and benefits administration solution for health plans managing & processing. Provides the patented configuration feature.
Specialities
  • Employee Education
  • Benefit Administration
Visit site
23

IBM MobileFirst for IOS – Insurance

250+ Employees
Armonk, United States
Est. 1911
IBM MobileFirst for iOS Insurance offers a set of solutions designed to help insurers exceed customer expectations, operate more efficiently and find a new competitive edge.
Specialities
  • Consulting
  • Analytics
  • Internet of Things
Visit site
24

Identifi

250+ Employees
Arlington, United States
Est. 2011
Comprehensive benefit management system offers Payers a single Web-based system for administering benefits across all lines of business.
Specialities
  • Clinical and Administrative Solutions
  • Health Services
Visit site
25

Insurance Policy Administration

250+ Employees
Ahmedabad, India
Est. 2000
Web-based solution for policy management, claims processing and insurance agency administration.
Specialities
  • Outsourcing
  • Software Consultation
Visit site
26

InsureEdge

250+ Employees
Princeton, United States
Est. 1996
InsureEdge is an all-in-one insurance software that helps Insurers deliver a connected, relevant, and seamless experience to customers while empowering their employees, agents, and partners to do what they do best. It orchestrates a unified platform that eliminates the need for disparate IT systems generating operational efficiency, and cost savings. Leading insurance companies worldwide use InsureEdge across multiple lines of businesses, including P&C Insurance, Life Insurance, and General Insurance streamlining their policy management, claim management, document management, CRM and agency portal.
Specialities
  • Product Management
  • Remote Infrastructure Management Services
  • Digital Marketing
Visit site
27

Insurity Claims Solutions

250+ Employees
Hartford, United States
Est. 1985
Insurity Claims Solutions is a complete claims lifecycle administration system for all standard Commercial & Personal Lines, Workers Comp, Specialty and Custom lines of business.
Specialities
  • Analytics
  • Insurance
Visit site
28

Intellect Claims

250+ Employees
Piscataway, United States
Est. 2014
Intellect Claims provides comprehensive proactive claim management for life, annuity, disability, critical illness and long term care.
Specialities
  • Artificial Intelligence
  • Intelligent Solutions
Visit site
29

LexisNexis Carrier Discovery

250+ Employees
Alpharetta, United States
Est. 2005
Identify insurance carrier information quickly and easily
Specialities
  • Fraud Detection
  • Identity Management Solutions
  • Insurance Risk Management
Visit site
30

LexisNexis Claims Discovery

250+ Employees
Alpharetta, United States
Est. 2005
Improve claims outcomes with a trusted source for claims history information.
Specialities
  • Fraud Detection
  • Identity Management Solutions
  • Insurance Risk Management
Visit site
31

LexisNexis OrderPoint

250+ Employees
Alpharetta, United States
Est. 2005
Streamline vehicle and accident report ordering and retrieval.
Specialities
  • Fraud Detection
  • Identity Management Solutions
  • Insurance Risk Management
Visit site
32

Majesco Claims for L&A and Group

250+ Employees
Morristown, United States
Est. 1982
Majesco Claims for L&A and Group is a comprehensive claims management platform that delivers impressive results in some of the most demanding claims operations.
Specialities
  • Leading Software
  • Insurance Markets
Visit site
33

Majesco Claims for P&C

250+ Employees
Morristown, United States
Est. 1982
Majesco Claims handles all types of claims across all lines of P&C insurance, allowing carriers to consolidate their business environment and reduce costs.
Specialities
  • Leading Software
  • Insurance Markets
Visit site
34

NIS for Claims & Assistance

250+ Employees
London, United Kingdom
Est. 2000
The leading global software provider to the Travel and Assistance, Expatriate Health and Specialty insurance sectors.
Specialities
  • Digital Transformation
  • Insurance Industry
Visit site
35

OneShield Claims

250+ Employees
Marlborough, United States
Est. 1999
OneShield provides browser-based solutions to automate the sales and service of insurance products for Personal, Commercial and Specialty lines.
Specialities
  • Business Intelligence
  • Smart Analytics
Visit site
36

Origami Risk Insurance and Risk Management Solutions

250+ Employees
Chicago, United States
Est. 2009
Origami Risk is a highly configurable, integrated SaaS platform for insurance, risk, safety, and compliance management. Origami Risk provides organizations with a centralized system to automate critical workflows, collect data, leverage analytics, and engage with stakeholders. Origami’s P&C Insurance solution includes policy administration, rating, and billing; claims administration; loss control; analytics, dashboards, and reporting. Origami’s Risk Management solution unifies insurable and non-insurable risk data and automates risk, audit, compliance, health & safety processes, helping you achieve control, visibility, improved efficiency, and the power to proactively manage your complete risk environment. The most experienced service team in the industry ensures that client success is our central focus.
Specialities
  • Risk Management
  • Incident Collection and Tracking
  • Policy Management
Visit site
37

Passport® Claims Defense

250+ Employees
Houston, United States
Est. 1998
Passport Claims Defense is designed to enable smart and efficient procurement, management, and delivery of legal services for claims organizations to help insurers improve expense and loss ratios.
Specialities
  • Legal Management Software
  • Risk and Compliance
Visit site
38

Pega Claims Management

250+ Employees
Cambridge, United States
Est. 1983
Improve efficiency and effectiveness with a claims management desktop that modernizes your underwriting environment on an enterprise scale.
Specialities
  • Intelligent Automation
  • Low-code Platform
Visit site
39

QIS Claims Management

250+ Employees
Utrecht, Netherlands
Est. 2012
The claims management system offers you a complete solution for the management of claims files and the financial handling of claims.
Specialities
  • Auto Insurance
  • Health Insurance
  • Software
Visit site
40

RiskEnvision

250+ Employees
Johns Creek, United States
Est. 1976
RiskEnvision is a modular suite of enterprise-level RMIS products that offers web-based risk management and claims administration solution. RiskEnvision can be deployed to support risk management and claims administration functions including payment processing, reserve management, form letters and correspondence, policy management, diary, reporting, and more for auto, GL, product, property, and worker compensation lines of insurance coverage.
Specialities
  • Insurance Carrier Systems
  • Insurance Certificate Management
  • Risk Management
Visit site
41

Robotic Process Automation for P&C insurance

250+ Employees
Morris Plains, United States
Est. 2001
Robotic Process Automation (RPA) is designed to enable insurers to direct more resources into key activities like enrolling more customers and adjudicating insurance claims.
Specialities
  • Digital Transformation
  • Business Applications
Visit site
42

Salesforce Industries Insurance

250+ Employees
San Francisco, United States
Est. 1999
Omni-Channel Policy, Benefit Plan and Customer Insurance Applications in the Cloud.
Specialities
  • Customer Relationship Management
  • Enterprise Cloud Computing
Visit site
43

Sapiens ClaimsPro

250+ Employees
Holon, Israel
Est. 1982
Sapiens ClaimsPro for Property & Casualty (formerly StoneRiver Stream Claims) is a critical piece of the Sapiens CoreSuite for Property and Casualty (P&C). It is a fully integrated component that can also be deployed standalone. ClaimsPro streamlines end-to-end claims processing for all personal and commercial lines, preparing carriers to adapt to new business requirements. The solution provides full lifecycle support for handling claims for all personal and commercial lines of business, including workers’ compensation. ClaimsPro operates with configurable business rules and workflow.
Specialities
  • Insurance Software Solutions
  • Innovative Business Decisions Management System
Visit site
44

Sapiens Intelligence

250+ Employees
Holon, Israel
Est. 1982
P&C and Reinsurance policy administration and expert underwriting systems.
Specialities
  • Insurance Software Solutions
  • Innovative Business Decisions Management System
Visit site
45

Shift Technology Claim Automation

250+ Employees
Paris, France
Est. 2013
Shift Technology Claim Automation provides insurance companies with a SaaS solution designed to improve and scale fraud detection.
Specialities
  • Decision Automation
  • Optimization Solutions
Visit site
46

SIMS Claims

250+ Employees
Hartford, United States
Est. 1985
SIMS Claims is a browser-based solution utilizing modern technology to streamline your claims administration processes.
Specialities
  • Analytics
  • Insurance
  • Finance
Visit site
47

Snapsheet

250+ Employees
Chicago, United States
Est. 2011
Snapsheet is the pioneer in virtual appraisals and a leader in cloud-native claims management software, enabling the most innovative claims organizations to deliver the best experiences for customers. With a focus on engagement, digitization, and intelligent automation, Snapsheet provides unmatched software and processes to improve customer experience, drive greater organizational agility, and deliver transformational benefits through its Snapsheet Cloud software suite and Appraisal Services offerings. Snapsheet leads the industry in claims innovation including the deployment of the fastest digital auto insurance claims process in the United States. As a trusted innovation partner, Snapsheet works with more than 100 clients, including many of the largest insurance carriers, third-party administrators, MGAs, insurtech and sharing economy disruptors. For more information, visit snapsheetclaims.com.
Specialities
  • Management Software
  • Leading
Visit site
48

Solera

250+ Employees
Westlake, United States
Est. 2005
Through the power of data, Solera revolutionized the insurance claims processing industry by bringing transparency, efficiency and connectivity to a once fragmented process.
Specialities
  • Management Software
  • Data Services
Visit site
49

TrueClaim Payment Integrity

250+ Employees
Nashville, United States
Est. 2007
Software suite that offers healthcare payers a total claims management solution to validate payment integrity and maximize savings.
Specialities
  • Healthcare Technology
  • Healthcare Platform
Visit site
50

V3

250+ Employees
New York, United States
Est. 1986
V3 is a complete investment administration solution that helps organizations achieve administrative excellence, harness significant processing efficiencies and realize the potential of true business intelligence.
Specialities
  • Investment Administration Software
  • Analytical Insights
Visit site