Research suggests that one in ten insurance claims is fraudulent, and US insurance providers report an average loss of $40 billion per year due to fraud.
The claims management process is complex, and any gap in the documentation, wrongful claims, or mismatching of quotes can result in rejected, delayed, or fraudulent claims. Insurance companies are increasingly implementing claims management software with advanced AI-automation features to digitally transform the reviewing and settlement of insurance claims, ensuring quick & transparent payouts.
In this blog, we explore in-depth a type of InsurTech known as claims management software, its features, and the best software available in the industry for P&C providers’ digital transformation projects.
What Is a Claims Management System?
Insurance claims management systems are used by enterprise insurance agencies & independent insurers to support agents in managing their clients’ claims. It primarily facilitates the knowledge and information essential for evaluating claims with a centralized record system. These applications improve operational efficiency, reduce claims management costs, and automate insurance workflows through digital claims.
Claims management software decreases fraudulent claims by monitoring the authorization process and ensuring that all claim details, such as litigation, policy terms, and claim assessments, are recorded within a centralized system.
Additionally, insurance claim software automates the calculation & payment process, streamlines case management, and provides better overall claim insights.
Features of P&C Claims Management Software
Claims management software includes several features designed to guide users through the automated workflow.
Here are the most crucial features of P&C claims management software:
- Electronic Claims: This feature facilitates the filing of claims online, and stores them securely in the cloud.
- Claims Tracking: Claims tracking standardizes the workflow management for all incoming claims. Claims management software also allows users to modify existing or customized workflows to customize for a service provider’s needs.
- Document Management: Claims management software helps insurers manage their crucial claims-related documents by storing and organizing them in the claims management process.
- Reporting & Analytics: Claims management is a data-intensive process & can be analyzed to reveal areas of improvement such as processing times to provide actionable insights into managing the claims on P&C platforms.
- Customer Relationship Management: Claims management systems integrate tightly with CRM applications to review the customer details during the claims management process.
- Risk Assessment & Fraud Detection: This is a highly critical feature as it allows insurers to conduct a risk assessment of the claims. Insurers can further identify and manage fraudulent claims by verifying details from various sources of information.
- Payment Processing: With payment processing features, insurers can directly view the claim’s amount and pay online.
- Integration: EDI data exchange integration facilitates managing several claims at once, importing them from multiple insurance carriers.
- Customer Portal: Customer portals make it convenient for the customers to submit and view their claims online.
Related Resources
Best Claims Management Software
Here are the best claims management software for P&C companies to automate claims and provide faster, more compliant claims processing:
1. BriteCore
- G2 Review Score: 4.0 out of 5 stars
- Price: BriteCore pricing is composed of four components: BriteCore Access: 1% of Premium BriteApps Access: .25% of Premium Services Work: $200/hr (Avg) AWS Hosting: $500/month
BriteCore is an intuitive cloud-based software platform for P&C insurers that supports digital innovation, digital transformation, and new business processes.
It offers a holistic insurance platform for policy administration, claims management, underwriting, agent quoting and inquiry, contact management, billing, imaging, printing, data warehousing, and reporting. The software is deployed using Amazon Web Services and receives continuous updates for maximum security, efficiency, and durability at scale.
2. Guidewire ClaimsCenter
- G2 Review Score: 4.2 out of 5 stars
- Price: Offers custom pricing based on features, customizations, support & insurance agent training requirements.
Guidewire claim software solution in based in California offers an automated end-to-end insurance claims management system ClaimsCenter. ClaimCenter is for personal, commercial, or workers compensation, designed to eliminate the need to perform repetitive tasks associated with managing claims. Gartner recognized Guidewire as a leader in GMQ 2016 and recommended this solution for organizing cross-department processes, reducing costs, enabling collaboration between teams, and tracking performance.
Features offered by Guidewire include:
- Billing & Invoicing
- Broker / Agent Portal
- Claims Management
- Customer Portal
- Insurance Rating
- Policy Management
- Reinsurance Administration
- Underwriting Management
3. Applied Epic
- G2 Review Score: 4.5 out of 5 stars
- Price: Applied Epic offers custom pricing based on customer requirements.
Applied Epic is a cloud-based agency management system that provides powerful automation capabilities and clear visibility across the business. It’s a single open application that integrates well with your existing CRM application to efficiently manage customer policies and benefits, sales automation, and financial accounting processes.
The prominent features of Applied Epic include:
- Contract Lifecycle Management
- Policy Management
- Claims Management
- Payments Processing
- Sales Enablement
- Invoicing & Receipts
- Reporting & Dashboards
- Payment Processing
- Email Integration
- Task Management
4. Pega Claims Management
- G2 Review Score: 3.6 out of 5 stars
- Price: Pega Claims Management system offers custom pricing based on customer requirements.
Pega Claims Management platform is is an easy-to-use claims management system that improves the efficiency and effectiveness of claims management and modernizes your underwriting environment on an enterprise scale. It allows insurance agencies to create intelligent, dynamic business rules to drive automated end-to-end claims processes that are agile and deliver higher ROI.
5. FileHandler Enterprise
- G2 Review Score: 4.6 out of 5 stars
- Price: Filehandler Enterprise offers custom pricing to its customers.
FileHandler Enterprise is a scalable & intuitive claim administration system designed to streamline and automate the workflow for claims and risk management organizations. FileHandler Enterprise system sets a new benchmark in the insurance industry by providing tools like reporting and analytics, business intelligence, and security features to ensure a seamless claims management experience.
The platform is designed on a Microsoft platform. It enables professional employment organizations (PEOs) to schedule notices about critical updates or claims-related tasks and display key activities with date and time stamps.
Teams can also use the optional imaging tool to upload attachments and images to improve claim verification further. The key features of this software include:
- Case Management
- Claim Resolution Tracking
- Customer Management
- Co-Pay and Deductible Tracking
- Forms Management
- Policy Administration
- Risk Assessment.
6. Snapsheet
- G2 Review Score: 4.0 out of 5 stars
- Price: Snapsheet offers feature-based pricing to its customers.
Snapsheet is a leader in the insurance industry due to its claims innovation. It facilitates the deployment of the fastest digital auto insurance claims process. Snapsheet works with more than 100 customers as a trusted partner, including many of the largest insurance carriers, third-party administrators, MGAs, insurtech, and sharing economy disruptors.
It is a cloud-based claims management software that focuses on digitization, engagement, and intelligent workflow automation. It provides unparalleled software and processes to enhance customer experience, drives organizational agility, and deliver transformational benefits via its Snapsheet Cloud software suite and Appraisal Services offerings. A few of the key features offered by Snapsheet are:
- Adjustor Management
- Claims Tracking
- Electronic Claims
- Forms Management
7. LexisNexis Carrier Discovery
- G2 Review Score: 4.6 out of 5 stars
- Price: The organization offers custom-based pricing.
LexisNexis Carrier Discovery identifies critical insurance carrier information at various points throughout the claims process. It assists with call center scripting and makes the adjusting process more informative and efficient throughout the life of the claim settlement process. The software effectively improves the adjustment process, policy management, changing the claim course, and identifying fraudulent claims.
8. A1 Tracker
- G2 Review Score: 4.8 out of 5 stars
- Price: $8000 per year
A1 Tracker is easy-to-use, web-based insurance software supporting all types of insurance. Insurers can personalize the software instance by choosing a language, currency, and hosting option. The software allows insurers to track policies, applications, premiums, certificates, renewals, billing, payments, commissions, & sales opportunities.
Features offered by A1 Tracker include:
- Audit Management
- Billing & Invoicing
- Broker / Agent Portal
- Business Process Control
- Commission Management
- Compliance Management
- Contract Management
- Corrective and Preventive Actions (CAPA)
- Customer Management
- Co-Pay & Deductible Tracking
- Claims Management & Tracking
9. 360SiteView
- G2 Review Score: 4.7 out of 5 stars
- Price: The organization offers custom feature-based pricing.
360SiteView offers a digital no-code insurance claims platform that tracks the actions of all participants. It further reduces costs via end-to-end automation and supply-chain orchestration, allowing them to empathize and reassure the customers.
Claims Management Software FAQs
1. What are the benefits of implementing claims management software?
A claims management software expedites your claims processing and settlement by minimizing the turnaround time, reducing operational costs, and improving accuracy. It further automates the payment and calculation process, streamlines case management, and provides better claim insights.
2. What are the key considerations while choosing claims management software?
With a variety of insurance management software available in the market, you should look at the following criteria before implementing a new software:
- Type of Deployment: Based on the requirement, two types of deployments are available on-premise or cloud. While on-premise offers more customization and requires a team of IT experts, cloud software is accessible via web browser and saves a lot on the implementation cost.
- Integration: Enterprises use multiple applications such as CRM, procurement solutions, CLM, and advanced business intelligence systems. You must discuss the integration options to connect these applications with the claims management system.
- Cost: Although most vendors offer custom-based pricing. The cost of claims management software can range from $10/user/month to over $200/user/month.
3. How can you improve the adoption of the claims management software?
Digital adoption platforms such as Whatfix help boost employee productivity with better P&C insurance software training. You can create better onboarding and training programs to improve your organization’s P&C solution adoption and proficiency.
It also allows users to create interactive walkthroughs and task lists for different employee personas such as account managers, claims offices, and underwriters. Whatfix further integrates directly into P&C apps such as Guidewire, Duck Creek, and other popular P&C platforms.
Learn more about Whatfix for claims management software adoption now!
