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Top Insurance Claim Management Software and Systems
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Top Insurance Claim Management Software and Systems

April 2024

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.

51

Ventiv Claims

250+ Employees
Atlanta, United States
Est. 1972
Ventiv Technology is a leading global provider of innovative risk and insurance software solutions for a vast array of industries, serving some of the largest companies in the world. Committed to excellence in data analytics, technology and customer success, Ventiv transforms the way companies manage risk and insurance information to enable optimal outcomes. With over 45 years’ experience, Ventiv proudly partners with over 500 organizations and 350,000 users in more than 40 countries. Ventiv Claims is the most feature-rich administration solution that empowers examiners to focus completely on claim resolution. The system is comprised of one or more Claims Management modules and a variety of supporting modules, including Absence Management, Enterprise Legal Management, Workers’ Compensation, Policy Management, Claims Intelligence, Corrective Action Plans, Incident Reporting, and more. Ventiv Claims was designed as a claims management system from the perspective of claims examiners. This is reflected in how easy and intuitive it is to manage claims, with functionality like diaries, business rules, workflow management, notepads, and financial management. Ventiv Claims makes it easy to define custom workflows tailored to each client’s specific business process, making claim, document, and policy administration more efficient. Ventiv Claims offers an “out of the box” solution to clients. At the same time, the Ventiv Claims architectural design was developed with the fundamental requirement of flexibility to adapt to meet the changing business requirements of clients. The system modules, fields, interfaces, and reports are highly user configurable so that Ventiv Claims can be adjusted to meet most organizational processes without custom programming.
Specialities
  • Claims Programs
  • Insurance
  • Programs
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52

Vision for Claim Management

250+ Employees
Tampa, United States
Est. 1977
A free web-based application for viewing and correcting existing claims.
Specialities
  • Quality Services
  • Compliance
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53

1insurer Claims

50-249 Employees
Farmington, United States
Est. 2015
Specialities
  • Information Technology
  • Insurance
  • Software
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54

360SiteView

50-249 Employees
London, United Kingdom
Est. 2010
The fully digital no-code insurance claims management software platform that choreographs the actions of all participants
Specialities
  • Digital Claims Platform
  • Digital Solution
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55

Actec Claims Management

50-249 Employees
Atlanta, United States
Est. 1989
Our philosophy is that any and all customer requirements take absolute precedence. Because we use a proprietary FNOL intake solution in house, we have fewer constraints than a software/ASP vendor, and can implement customizations quickly, as needed rather than on a rigid schedule. We have in the past developed an entirely custom browser-based solution to intake claims for an oil company during a catastrophic event. Additional client- or customer-specific questions and instructional scripts can be set up, changed or deleted within minutes by the Account Manager.
Specialities
  • Finance
  • Insurance
  • Security
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56

Attune ClaimBook

50-249 Employees
Chennai, India
Est. 2008
ClaimBook helps hospitals by accelerating overall discharge process of insurance patients, enhances Hospital revenue collection by increasing effective bed care days in hospitals for new admissions and preventing revenue leakages in payment collections from TPA/Insurance companies. Integration with TPA backends for all TPAs and Hospital HIS systems helps in accelerating the overall claim processing cycle with TPA. Automatic TAT Analysis, Automated TPA Reminders and Aging reports help hospitals to track the TPA aged and defaulted cases.http://attunelive.com/claimbook/
Specialities
  • Healthcare
  • Cloud-based Products
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57

AudaExpress

50-249 Employees
Leeds, United Kingdom
Est. 1987
Audaexpress+ is a secure, web-based service providing remote access to real-time claim status information on demand.
Specialities
  • Asset Management
  • Digital Innovation
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58

Bdeo

50-249 Employees
Madrid, Spain
Est. 2017
Bdeo’s vision is to transform the insurance industry thanks to visual intelligence. We digitize the interactions of insurance companies with their end customers, from policy underwriting to claims management, even providing damage valuation tools. Bdeo provides visual intelligence, with a combination of technologies that make Bdeo a unique product in the insurance industry. Artificial intelligence automates both claims and pre-existing damage verification processes. A geo-localized video channel allows connecting with the insured at the time of the claim, in order to inspect the most complicated claims, reducing management time and improving the cost of inspection/peritation. Thanks to the augmented reality utility, the agent can remotely take measurements of the damages and finally all the information is secured with time stamps and blockhain to leave digital evidence of the generated contents.
Specialities
  • Insurance Automation
  • Visual Intelligence Technology
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59

BizFlow Insurance

50-249 Employees
Falls Church, United States
Est. 1998
Solutions for Sales, New Business, Underwriting, Policy Maintenance, Billing, Collections, Commissions, Customer Service, and Claims.
Specialities
  • Business Process Management
  • Tasking and Compliance Software
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60

BriteCore

50-249 Employees
Springfield, United States
Est. 2009
BriteCore is a fully-managed core software platform for property and casualty insurers that supports digital transformation, emerging technologies, and new business models. BriteCore offers end-to-end insurance capabilities, including policy administration, claims management, underwriting rules, and rating, agent quoting and inquiry, contact management, billing, imaging, printing, data warehousing, and reporting. Designed as a cloud-native solution, BriteCore is deployed using Amazon Web Services and is continually updated for maximum security, efficiency, and durability at scale. Insurance carriers, MGAs, and InsurTechs partner with BriteCore to gain a competitive edge through efficient operations, compelling customer experiences, and speed to market. For more information, please visit www.britecore.com.
Specialities
  • Insurance Processing Systems
  • Custom Software
  • Policy Processing
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61

ClaimControl

50-249 Employees
Northampton, United Kingdom
Est. 1996
ClaimControl is a cloud-hosted claims, incident, contractual and insurance risk management software solution. We have created a management system that feeds into your business and works from anywhere. Built, from the ground up, this advanced cloud-based system can assist with: Managing the claims workflow Identifying root cause Subcontractor/3rd party performance management Automated diary workflow Escalation of tasks
Specialities
  • Software Solutions
  • Legal and Financial Services
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62

CLAIMExpert

50-249 Employees
King of Prussia, United States
Est. 2002
Cutting-edge technology platform, proprietary workflows, and unique rules-driven engine completely automates the claim handling process.
Specialities
  • Claims Processing Solutions
  • Analytics
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63

CLAIMplus

50-249 Employees
Irving, United States
Est. 2001
Claimplus solutions and services assist property insurance carriers gain accurate values for items lost, settle claims and help policyholders recover.
Specialities
  • Insurance
  • Solutions and Services
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64

Claimsforce

50-249 Employees
Hamburg, Germany
Est. 2018
Claimsforce creates great claims experiences by building P&C claims technologies.
Specialities
  • Artificial Intelligence
  • Financial Services
  • Insurance
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65

ClaimsManager

50-249 Employees
Fort Lauderdale, United States
Est. 1999
ClaimsManager is your one stop shop to enter data and review real time information.
Specialities
  • Marketplace
  • Data
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66

ClaimsVision

50-249 Employees
New York, United States
Est. 1978
PCIS is a provider in comprehensive policy administration and claims
Specialities
  • Insurance Processing Solutions
  • Claims Solutions
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67

Clarity

50-249 Employees
Carlsbad, United States
Est. 2003
ACD delivers the leading virtual claims workflow technology that flexes to an auto insurer’s specific business needs. ACD’s AutoLink® incorporates multi-channel methods of inspection into one, unified platform. ACD provides mobile self-service photo estimating, the largest crowdsourced on-demand field appraisal network, collision repair shops and salvage – all to help lower costs, deliver faster cycle times, improve accuracy and increase customer satisfaction.
Specialities
  • Claims Insurance
  • Insurance Automation
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68

ClearRisk

50-249 Employees
St. John’s, Canada
Est. 2006
Software designed by risk managers to help organizations streamline their incidents and claims process.
Specialities
  • Cloud-based Software
  • Risk Management
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69

Contemi Claims Management

50-249 Employees
Singapore, Singapore
Est. 2001
Contemi Solutions is a leading global technology provider to the insurance, capital markets, and asset & wealth management industry. With a growing presence in the wider financial services sector.
Specialities
  • Digital Transformation
  • Wealth Management
  • Capital Markets
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70

Copernicus SS/G

50-249 Employees
Cheltenham, United Kingdom
Est. 1995
Comprehensive Life, Health, Pensions, Annuity and Investment administration system that can support Individual and Group processing.
Specialities
  • Data Analytics
  • Policy Administration
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71

Diamond Claims

50-249 Employees
Tuscaloosa, United States
Est. 1993
Diamond Claims combines a comprehensive set of features and functionality .
Specialities
  • Insurance Platforms
  • Billing and Claims
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72

EdgeWise

50-249 Employees
Denver, United States
Est. 2006
Unemployment claims processing system for submitting claims online with real time notification functionality.
Specialities
  • Employment and Income Verification
  • Claims Management
  • Training and Account Management
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73

Effisoft

50-249 Employees
Paris, France
Est. 1989
Effisoft delivers software solutions to the Insurance, reinsurance and Risk Management industries worldwide. This products are designed for all insurance professionals comprising from risk managers to reinsurers, insurance companies and brokerage firms.
Specialities
  • Business Processes
  • Health Insurance
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74

enservio

50-249 Employees
Needham, United States
Est. 2004
The Enservio Contents Platform is transforming the way insurance carriers do business. By empowering carriers to enable policyholder self-service and leveraging real-time business intelligence, our platform allows carriers to unlock the highest quality business outcome for their contents programs achieving superior customer satisfaction and efficient workflow.
Specialities
  • Claims Process
  • Management Software
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75

F2F Video Insurance Solution

50-249 Employees
Kolkata, India
Est. 2011
Video Customer Acquisition Processes, Video Insurance Renewals and Live Exchange Claim Settlement / Documents/ Pictures / Videos.
Specialities
  • Software Products
  • Product Innovation
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76

Healthaxis

50-249 Employees
Tampa, United States
Est. 1965
Healthaxis is the premiere healthcare payer solutions company that offers customized solutions for commercial and governmental health benefit administrators.
Specialities
  • Claims Processing
  • Healthcare
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77

HEALTHsuite Advantage

50-249 Employees
Fort Washington, United States
Est. 1981
For nearly 40 years RAM Technologies has been providing enterprise software solutions for health plans administering government sponsored healthcare with a specific focus on Medicare Advantage (MA) and Special Needs (SNP) programs. We are located in Fort Washington, Pennsylvania (suburb of Philadelphia). HEALTHsuite Advantage is a comprehensive, end-to-end solution for health plans administering MA / SNP programs. This software platform represents the next evolution of Medicare Advantage administration and comes pre-configured to administer ‘Original’ Medicare, slashing implementation durations, eliminating risk and greatly reducing costs. This innovative offering includes all of the essential core capabilities and complete integration with CMS required by Medicare Advantage organizations. Additionally, Medicare Advantage-in-a-Box, HEALTHsuite Advantage’s disruptive approach to implementation, provides the simplest and most cost effective way for new organizations to enter the MA market.
Specialities
  • Healthcare Administration
  • Insurance Technology Solution
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78

Hi Marley

50-249 Employees
Boston, United States
Est. 2017
Hi Marley is the intelligent communication platform for the insurance industry.
Specialities
  • Intelligent Communication Platform
  • Insurance Industry
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79

HyperQuest

50-249 Employees
Chicago, United States
Est. 1999
With a balance of perception and precision, HyperQuest deliver customized information services that help customers overcome complex claims challenges.
Specialities
  • Development Automation
  • Web-based Technologies
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80

i2S

50-249 Employees
Porto, Portugal
Est. 1984
Total Solution For The Global Insurance Market.
Specialities
  • Insurance Business
  • Core Systems
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81

i3claim

50-249 Employees
Mumbai, India
Est. 2016
i3claim is i3systems’ platform for medical claim process automation. It enables insurers to rapidly deploy AI and RPA enabled solutions to streamline key activities in medical claims. i3claim extracts, classifies, and validates over 300 data points in every claim document, to reduce the manual efforts of a practitioner. The vendor states this leads to an increase in productivity by over 300%, and reducing costs by 50-80%. i3claim creates standardized data from a claim document set received from any hospital, and makes a decision on every claim, boasting a short turnaround time of 5 minutes. This is to help insurance companies settle claims faster and more accurately, improving customer experience while reducing costs at the same time.
Specialities
  • Financial Services
  • Health Insurance
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82

INSIS Life

50-249 Employees
Munich, Germany
Est. 1990
INSIS fully supports individual and group life products, unit-linked products, commercial and personal non-life lines of business, health products.
Specialities
  • Software Solutions
  • Software Development
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83

Insur-Claim

50-249 Employees
Tampa, United States
Est. 1965
Claims processing, benefits administration, and self-service portals for health care benefits administration.
Specialities
  • Claims Processing
  • Healthcare
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84

JopariPay

50-249 Employees
Concord, United States
Est. 2004
Comprehensive claim disbursement automation and interactive Payment Portal services.
Specialities
  • Digital Transaction Processing
  • Payment Processing
  • Health Industry
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85

Merimen IFE

50-249 Employees
Serdang, Malaysia
Est. 2000
Claims management with document imaging, communication management and risk management.
Specialities
  • Cloud-based Enterprise Solutions
  • Software Development
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86

mobile claims

50-249 Employees
Toronto, Canada
Est. 2004
Multi-platform enabled field estimating solution.
Specialities
  • Insurance Claims Solutions
  • Development Strategy
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87

omni:us

50-249 Employees
Berlin, Germany
Est. 2015
omni:us is an Artificial Intelligence as a Service (AIaaS) provider for cognitive claims management. Built on a fully data-driven approach, omni:us is transforming the way insurers interact with their insured parties. It provides all the necessary tools and information to make fast, transparent and empathetic claims decisions, whilst improving operational efficiency and reducing loss adjustment expenses.
Specialities
  • Intelligent Insurance
  • Claim Automation
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88

PCRS

50-249 Employees
Park Ridge, United States
Est. 2012
PCMI Corporation offers a modular package of software solutions for the administration of F&I Products, Service Contracts, and Extended Warranties. Our cloud-based platform, Policy Claim and Reporting Solutions™ (PCRS), supports and automates the full lifecycle of all aftermarket products.
Specialities
  • Policy Claim
  • Cloud-based Platform
  • Reporting Solutions
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89

TerraClaim

50-249 Employees
Bryan, United States
Est. 2020
TerraClaim is a Risk Management and Automation Solution for all lines of Insurance. Our offering includes all-in-one Claims Management & Benchmarking platform that streamlines operations with Artificial Intelligence built specifically for MGA’s, TPA’s and individual adjusters. – Claims Benchmarking for Self-Insureds, TPAs, PEOs, or Risk Managers: A powerful cross-industry claims benchmarking and data analytics solution that analyzes your claims performance against industry peers, helping you set better goals, manage risk reserves and improve claim outcomes. 1. Dashboard to view graphical and tabular results of claim benchmarking performance. 2. Comparison reports on avg. cost per claim, number of claims, total incurred, etc. 3. Powerful search filters and search capabilities for more granular segmentation. – Claims Management for TPAs or Self-Insureds: A world-class property and casualty claims management system that streamlines your internal claims processes, improves productivity levels, drives desired results and proactively prevents fraud. 1. Real-time dashboards with relevant claim data. 2. Claimant and employer demographics, claim details. 3. Policy and coverage information with corresponding certificates. Effectively Manage Your Entire Claims Lifecycle and experience for yourself why Terraclaim is the most trusted provider for benchmarking and managing insurance claims.
Specialities
  • Risk Management
  • Data Analytics Solution
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90

TIA

50-249 Employees
Copenhagen, Denmark
Est. 1997
Comprehensive, fully flexible, insurance application for insurers and brokers; continuous upgrade and maintenance.
Specialities
  • Analytics
  • Insurance
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91

Xemplar Insights

50-249 Employees
Wayne, United States
Est. 2015
Xemplar Solutions Suite is a digital transformation platform for Personal & Commercial Auto Carriers to collect, analyze and apply deeper insights to their business. It opens a new engagement channel with their policyholders to improve customer loyalty by influencing better driving habits and offering right-priced premiums. Carriers can leverage these insights to design insurance programs and realize better business outcomes by way of lower claims and costs, increased ROI and improved bottom line. Businesses can influence a positive change in the driving habits of their drivers to reduce the overall risks and optimize their fleet operations.
Specialities
  • Digital Transformation Solutions
  • Risk Management
  • Claims Services
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92

A1 Tracker

10-49 Employees
Las Vegas, United States
Est. 2001
Risk, insurance, contracts, litigation, asset, & financial management software by A1 Tracker is an integrative solution for companies looking to better manage risk for at various levels of their business. Portals provide end-users, employees, vendors, and external users to submit data and documents for approval & workflow routing. Risk managers from different locations around the world can submit risk audits, claims, contracts, incidents, and more through a web-based risk assessment form, with threat assessments, ratios, costs, documents, and impact. Real-time risk management software notifications warn company officials of escalated risks by region, department, and business unit. Risks may be assigned to assets, projects, claims, insurance policies, projects, regional locations, and more. Our powerful risk management dashboard shows risk metrics that help your risk management team make competent decisions for to mitigate, avoid, and transfer risk. A1 Tracker risk management software also tracks the cost of risk, risk management staff training, licensing, certifications, incidents, and claims. Contact us for a free demo or pricing information.
Specialities
  • Risk Management Software
  • Core Data Management Software
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93

Advanced Insurance System

10-49 Employees
Halifax, Canada
Est. 1992
Modular policy, quoting, billing and claim administration application.
Specialities
  • Insurance Software
  • Policy Administration Software
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94

Agiliux

10-49 Employees
Cyberjaya, Malaysia
Est. 2020
A cloud-based insurance software with extensive policy and claims management capabilities.
Specialities
  • Insurance Technology
  • Cloud-based Insurance Software
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95

Ahshay

10-49 Employees
San Jose, United States
Est. 1998
DataCare provides software solutions for the workers’ compensation industry to better manage medical treatment and billing. Their Medical Process Manager and UR platforms help integrate a medical aspect to the claims workflow and expedite the communication process between the URO and requesting physician.
Specialities
  • Medical Case Management Software
  • Utilization Review Software
  • Patient Mobile Messaging
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96

AiClaim

10-49 Employees
Dubai, United Arab Emirates
Est. 2018
AiClaim© uses Artificial intelligence, deep learning and data science to automate the claim management and processing of medical claims, provide actionable knowledge, and support the decision making through an all-in-one solution designed for healthcare payers (insurance companies and government entities) as well as providers (hospitals, medical centres, and clinics). – AiClaim provides 30% improvement in the current business by analyzing ALL claims ALL the time with less overhead and quicker turnaround time – The deep learning algorithm takes into account millions of historical points, analyzes +10,000 dimensions and can be scaled to capture billions of medical insurance claims – The real-time insights dashboard provides a simple and robust way to understand the analyzed claims data to guide the actions for better clinical and financial outcomes
Specialities
  • Healthcare Solutions
  • Data Science
  • Artificial Intelligence
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97

AquariumClaims

10-49 Employees
Hale, United Kingdom
Est. 2006
Processes claims and takes cases through from information capture to invoicing.
Specialities
  • Web-based Application
  • Software Solution
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98

AutoMatch

10-49 Employees
Coral Springs, United States
Est. 1979
Uses data from practice management system, as well as electronic remittance from Medicare to match claims to EOBs.
Specialities
  • Healthcare Industry
  • Document Management
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99

C2MS Insurance ERP

10-49 Employees
Reading, United Kingdom
Est. 2004
C2MS is an innovative Insurance ERP, providing sales pipeline, claims and policy administration.
Specialities
  • IT investment
  • Research and Development
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100

CaseworksPro

10-49 Employees
Madison, United States
Est. 2000
Web based P&C Claims Administration System supporting a wide range of claim processing requirements. TPA, SIR Entities, Risk Managers. Client-centric workflow, Email integration, Messaging and Alerts, Shared Calendar, Litigation Support, Document Management – store any format including MP3 and DVD, Form Letters, Stat Reporting, Robust Transaction Processing – Reserving, Payment/Check Issuance and Recoveries.
Specialities
  • Insurance Technology Solutions
  • Casualty Insurance
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