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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.

151

Venue Claims Management

1-9 Employees
Mississauga, United States
Est. 1995
Web based claims management system that handles lines including property, casualty, auto, marine, liability.
Specialities
  • Information Technology
  • Insurance
  • Software
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152

W5

1-9 Employees
Barrie, Canada
Est. 1987
Features for: claim recording, time and expense recording, billing, reserve and payment control, and more.
Specialities
  • Document Management
  • Information Technology
  • Software
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153

WebDM/WebCR

1-9 Employees
Richardson, United States
Est. 1996
Manages provider and client demographics, fee schedules and contracts, credentialing, customer service functions and claims repricing.
Specialities
  • Health Care
  • Insurance
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154

EDI Smart Reader

Simple yet powerful Electronic Response File Reader that translates Medicare HIPAA 5010 277CA and 999 responses into a readable format.
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155

iScope

iScope is a claim software for public insurance adjusting professionals that delivers loss estimating tools from the public adjusters perspective that includes tools to help the estimating process.
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156

KMR Medical Claims Manager

Syosset, United States
Fully integrated customized claims processing solution for TPAs, self insured, claims administrators.
Specialities
  • Integration
  • Claims Processing
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157

PayorLink

Healthcare claims system for payors, designed to reduce health cost and optimize provider claims quality.
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158

Polygonal

London, United Kingdom
Est. 1980
Insurance software system with underwriting, claims, accounting and reporting functions.
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159

Teamworks IRO

Arlington, United States
Est. 2012
Teamworks software for IRO, peer review, and insurance companies.
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160

TopSail

TopSail is a insurance policy software that provides a fully web based policy administration system for carriers and MGA’s writing personal and commercial lines (both standard and specialty). It comprises fully integrated modules for rate, quote and issue, claims management and billing.
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161

Truck Insurance Form Automation

Automates truck insurance form processing by transferring data to any carrier application, broker agreement, permits or any other form.
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