Best Insurance Claims Management Software

Insurance claims management software helps insurers manage and evaluate insurance claims. Insurance claims management systems allow agents to manage the claims process with automated workflows, ensuring that all claim details are recorded within a centralized system of record. Claim details can include litigation, negotiation, settlement communications, relevant policy information, and claim assessments. Insurance claims management systems are commonly used by both independent and enterprise insurance agencies to support agents manage their clients’ claims. Insurance claims management products can help insurers reduce claims management costs, reduce fraudulent claims, and enhance customer experience. Insurance claims management products can be implemented either as a standalone solution or as part of an integrated insurance suite.

To qualify for inclusion in the Insurance Claims Management software category, a product must:

  • Support claims and settlement workflows
  • Provide risk assessment capabilities to identify claim complexity and likelihood of litigation
  • Analyze data to detect potential instances of fraudulent claims
  • Allow users to create claim reports

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    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.

    Guidewire ClaimCenter is a claims management system that supports all lines of personal, commercial, and workers' compensation insurance.

    Snapsheet utilizes proprietary technology to optimize virtual claims operations.

    ClaimXperience provides insurance companies with important tools that help claims representatives work more effectively with policyholders.

    ClaimZone Manager is designed from the ground up to be a comprehensive, web-based claims management system.

    CSCs RISKMASTER Accelerator claims software for carriers gives P&C claims professionals.

    Healthcare claims management solution that's designed to track financial transactions, capture and analyze detailed insurance coverage.

    Virtual Claims Adjuster is a web based claims management software package which was built with you in mind.

    ClaimsEnterprise is a complete claims processing system, from FNOL through adjudication.

    Medical claims forms scanning solution that provides data recognizing, validating and formatting.

    Web-based claims management system; worker's comp, multi-line liability, FROI, EDI, bill review, group health.

    SIMS Claims is a browser-based solution utilizing modern technology to streamline your claims administration processes.

    Web-based claims processing solution that helps with managing revenue cycle and scheduling patient appointments online.

    Simplifies management, record keeping and reporting.

    Integrated, flexible software solution for creating claims with intuitive data entry and support for compliance with state mandates.

    Medical, dental and vision claims, health benefits administration, and claims adjudication software in one solution.

    Claims Decisions is a complete claims lifecycle administration system for all standard Commercial & Personal Lines, Workers Comp, Specialty and Custom lines of business.

    Improving efficiencies within the healthcare billing process through automation and seamless integration.

    Duck Creek Claims allows you to manage the entire claims lifecycle.

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

    The # 1 ranked Claim management system for independent adjusters, TPA's, MGA's, & Mutual Ins. Co.'s. System does not apply to Public Adjusters. Entire system is based on the input from our 1000's of Users. Integrates with Outlook, Quick Books, Xactimate, Xactanalysis, Symbility, NFIP/NFS, LEDES and Google Maps.

    HIPAAsuite has products for every HIPAA transaction including CORE Certified solutions.

    Manage everyday claims requirements, including salvage, subrogation and litigation processing, coverage limits editing and more.

    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.

    Fully integrated customized claims processing solution for TPAs, self insured, claims administrators.

    Majesco Claims handles all types of claims across all lines of P&C insurance, allowing carriers to consolidate their business environment and reduce costs.

    Streamlines claims, policy, reporting and overall business process management needs.

    Component based, fully integrated, insurance processing system.

    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.

    QuickCap is an advanced healthcare claim processing system built for IPAs, PHOs, MSOs and other management organizations. It is designed to process EDI and manual claims, capitation, eligibility, referrals, authorizations, premium billing, case management and other healthcare related items.

    Record360 offers software for digital condition documentation, asset condition management, and claims management.

    Claims processing solution with unlimited system variables that can be programmed to meet your specific needs.

    Web based claims management system that handles lines including property, casualty, auto, marine, liability.

    Manages provider and client demographics, fee schedules and contracts, credentialing, customer service functions and claims repricing.

    A1 Tracker is a customizable claims management software to streamline your businesses. A1 Tracker software covers a vast array of claims management needs, including workflow approvals, notices, letters, and document management. Track approval workflow, costs, payments, and reserves. Offered as fully hosted and self hosted with technical support, data migration, and full training.

    Act-isure is a medical and protection insurance system supporting products, policy, enrollment & billing, and claims & accounts management.

    Modular policy, quoting, billing and claim administration application.

    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.

    Comprehensive benefit management system offers Payers a single Web-based system for administering benefits across all lines of business.

    Processes claims and takes cases through from information capture to invoicing.

    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.

    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.

    Uses data from practice management system, as well as electronic remittance from Medicare to match claims to EOBs.

    Solutions for Sales, New Business, Underwriting, Policy Maintenance, Billing, Collections, Commissions, Customer Service, and Claims.

    Bridge insurance claims software offers powerful features to improve the speed and efficiency of claims management and settlements.

    CaseBlocks for Claims Management provides a platform for managing the end-to-end claims process.

    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.

    Claimable prides themselves on making simple, affordable claims management software. Their software has been carefully crafted to provide the tools necessary for timely and efficient claims management.

    System used for calculation and payment of group disability claims. The adjudicator's workflow is task driven.

    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.

    Cutting-edge technology platform, proprietary workflows, and unique rules-driven engine completely automates the claim handling process.

    Web-based claims management system with features such as functional security and reporting.

    Provides benefits of a custom-made unified claim processing solution and allows for rapid integration with legacy systems.

    Claims Datafill leverages data and analytics to improve your business results.

    Case Management Software with Workflow-Processing for many different Case Types.

    More data earlier improves claims handling efficiency and reduces costs is a claims management for loss adjusters, claims managers, fleet managers, smash repairers, brokers & insurers.

    ClaimsManager is your one stop shop to enter data and review real time information.

    Improving customer service and satisfaction, streamlining business processes, and reducing costs.

    A complete claims management software solution for insurance Claims, Property Claims, and Workers Compensation Claims.

    Web-based system for loss adjusters, in-house claims, brokers, captives, and claims management companies.

    PCIS is a provider in comprehensive policy administration and claims

    ClaimFirst is a market-leading automated Life and Health claim management software solution suitable for Insurance Carriers and Third Party Administrators (TPAs). Offering full lifecycle claim management, this flexible SaaS solution can be integrated into current business and workflow processes resulting in efficient and improved claim processing capability from claim intake, to adjudication, and through to payments. ClaimFirst supports both group and individual policy benefits in the claim management system. The system is claimant centric, and a claim examiner can see all insurance plans for each claimant across all lines of business, including historical claims. ClaimFirst can completely or partially overtake manual processing allowing quick and accurate processing of claims; which will reduce reserves, and improve customer and employee satisfaction. Hosted on Salesforce’s secure and reliable platform, this cloud-based software provides fast, anywhere anytime access, the flexibility to integrate with other applications, and the scalability to increase capacity as necessary. With fast implementation (in as little as 90 days) and continual software upgrades, ClaimFirst gives you a competitive edge.

    ClickClaims requires no hardware or software, allowing your company to focus on claims, rather than on IT.

    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.

    Claims processing and payment software with unlimited plans, on-line repricing and PPO fee schedules capabilities.

    Comprehensive Life, Health, Pensions, Annuity and Investment administration system that can support Individual and Group processing.

    Delphi Claims is a complete and proven, end-to-end, multi-line claims tracking and management system that captures extensive information for all claims functions, and puts that data at your fingertips.

    Diamond Claims combines a comprehensive set of features and functionality .

    Total environment designed to manage the needs of workers' compensation claims.

    Unemployment claims processing system for submitting claims online with real time notification functionality.

    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.

    Leading claims management system to optimise your claims handling. Exceptional reporting and automation help reduce claims burden.

    A web-based automated medical claims solution that has a variety of features including online referrals & authorizations management.

    Video Customer Acquisition Processes, Video Insurance Renewals and Live Exchange Claim Settlement / Documents/ Pictures / Videos

    FBCS is a powerful software solution that simplifies the administration and tracking of claims.

    FileHandler Enterprise is an intuitive claims administration system designed to help streamline and automate workflows for the claims and risk management market. Complete with new dashboards, reporting functionality, business intelligence tools, and improved security.

    FINEOS Claims is a best in class, customer-centric, web-based claims processing software solution.

    Healthaxis is the premiere healthcare payer solutions company that offers customized solutions for commercial and governmental health benefit administrators.

    Claims and benefits administration solution for health plans managing & processing. Provides the patented configuration feature.

    HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment/eligibility, benefit administration, provider contracting/reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more.

    With a balance of perception and precision, HyperQuest deliver customized information services that help customers overcome complex claims challenges.

    Total Solution For The Global Insurance Market

    Claims adjudication and processing system that includes payee accounting, automated correspondence, anesthesia pricing capabilities.

    IMS is an industry-leading claims/risk management system, covering all commercial lines including P&C, workers' compensation, auto, and general liability. IMS accurately manages the entire claims lifecycle, from first report of incident through issuing payments and collections.

    INSIS fully supports individual and group life products, unit-linked products, commercial and personal non-life lines of business, health products.

    Manages submissions and quotes, policies and premiums, claims, losses payable and premiums receivable.

    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

    Robust software for underwriting, new business processing, policy services, billing, agent commissions, and claims adjudication.

    Web-based solution for policy management, claims processing and insurance agency administration.

    Claims processing, benefits administration, and self-service portals for health care benefits administration.

    Intellect Claims provides comprehensive proactive claim management for life, annuity, disability, critical illness and long term care.

    JCAD LACHS offers Claims Handling system, LACHS, for efficient claims management.

    Comprehensive claim disbursement automation and interactive Payment Portal services.

    Identify insurance carrier information quickly and easily

    Improve claims outcomes with a trusted source for claims history information.

    Streamline vehicle and accident report ordering and retrieval

    Loan management platform for secondary markets. A true end-to-end platform for managing all loan processes from acquisition to exit.

    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.

    Benefit administration and claims processing software for Insurance Companies, Government Plans, TPAs and Self Administered Groups.

    Specialized software for the international health insurers business with back-office functionality, BI, and mobile applications.

    Megalodon delivers a client-centered policy and claims management system that is powerful and easy to use, yet affordably priced for the small to mid-size company.

    Claims management with document imaging, communication management and risk management.

    Risk, Continuity, Audit, Insurance and Claims Management.

    Multi-platform enabled field estimating solution.

    Claims Assistant is a device agnostic, messaging-based, self-service tool for insurers or agents.

    OneShield provides browser-based solutions to automate the sales and service of insurance products for Personal, Commercial and Specialty lines.

    Award-winning risk, insurance and claims management technology.

    Claims management system specifically for the insurance industry.

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

    Modular adjudication software designed to achieve accurate processing results.

    Policy claim administration for manufacturer, retailer/dealer, and third party administrators.

    Improve efficiency and effectiveness with a claims management desktop that modernizes your underwriting environment on an enterprise scale.

    Insurance software system with underwriting, claims, accounting and reporting functions.

    Complete property adjusting software package; quickly complete estimates and create photo sheets, diagrams, captioned reports and more.

    P&C claims management software for personal & commercial lines of business.

    Workers' compensation software system with policy and claims administration, document management and email alerts.

    A mobile collaboration tool suitable for all contractors designed to streamline the claims processing procedure.

    The claims management system offers you a complete solution for the management of claims files and the financial handling of claims.

    An integrated suite of programs for the administration of worker compensation and property & casualty claims.

    Robotic Process Automation (RPA) is designed to enable insurers to direct more resources into key activities like enrolling more customers and adjudicating insurance claims.

    Sapiens IDIT Claims rich functionality and flexibility combine with the systems integrated.

    P&C and Reinsurance policy administration and expert underwriting systems.

    ScanNStore claim scanning and document storage solution for healthcare industry. Works with a variety of scanners and databases.

    The Shift Technology Solution provides insurance companies with a SaaS solution designed to improve and scale fraud detection.

    SmartSimple CMS360 is a platform for designing and deploying solutions that help insurers, health care providers and independent medical examiners gather the right content, make more accurate decisions, and take action to advance business outcomes.

    Through the power of data, Solera revolutionized the insurance claims processing industry by bringing transparency, efficiency and connectivity to a once fragmented process.

    SpyGlass is a web-based medical claims software that handles health, dental, vision, standard or lifetime disability, time-loss payments, COBRA and life claims.

    SSI Claims Management helps improving efficiencies within the healthcare billing process through automation and seamless integration.

    Teamworks software for IRO, peer review, and insurance companies.

    Comprehensive, fully flexible, insurance application for insurers and brokers; continuous upgrade and maintenance.

    Risk and claims management software that tracks issues related to general liability, auto, P&C, incidents and professional liability.

    Tropics can dramatically improve productivity for claims system users by integrating documents and forms, imaging, and an effective rules engine.

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

    Software suite that offers healthcare payers a total claims management solution to validate payment integrity and maximize savings.

    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.

    Reduce claims processing time and improve customer satisfaction with an omnichannel, digital management experience for service vendors

    A free web-based application for viewing and correcting existing claims.

    Features for: claim recording, time and expense recording, billing, reserve and payment control, and more.