Insurance Claims Management Software

Insurance Claims Management

What is Insurance Claims Management Software?

Insurance claims management software helps insurance companies manage and evaluate insurance claims. Products usually support workflow automation and document management to capture policy details, litigation actions, settlement information and evaluations of the claims.

Common Features

  • Collaboration
  • Analytics and Reporting
  • Risk and Fraud Assessment
  • Document Management
  • Workflow Management
  • Case Management
  • Claims Management
  • Compliance Management
  • Audit Management
  • Adjudication Process
  • Policy Management

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Top Insurance Claims Management Software 2024

Products below are ineligible for awards due to insufficient recent reviews

Composite Score
8.5 /10
CX Score
8.5 /10

A complete set of core systems that support the insurance lifecycle, including underwriting, policy, claims, and billing management

Composite Score
8.2 /10
CX Score
6.6 /10

HealthRules Payor is a next generation core administration system that provides transformational capabilities to health plans of all types and sizes. HealthRules Payor features the patented HealthRules Language, a revolutionary approach to configuration, claims processing and transparency of information that leverages an English-like vernacular to enable health plans to quickly react to market changes and new opportunities. With HealthRules Payor, your organization can design and implement any benefit plan or provider contract in significantly less time and at less cost than typically required with other systems.

Pros

  • Continually Improving Product
  • Reliable
  • Performance Enhancing
  • Enables Productivity

Cons

  • Inhibits Innovation
  • Under Delivered
Composite Score
8.1 /10
CX Score
8.5 /10

This modern, rules-based platform helps forward-looking life and annuity insurers lay the foundation for new levels of back-end performance and connectivity, as well as faster and more efficient go-to-market strategies.

Pros

  • Helps Innovate
  • Continually Improving Product
  • Reliable
  • Performance Enhancing
i2S Insurance Knowledge

i2S Life

Composite Score
8.0 /10
CX Score
7.6 /10

i2S Life software, built on state-of-the-art technologies and following the best insurance practices, allows insurers to offer differentiated products and services, without being limited by technological factors. The software’s flexibility and versatility lend agility to the insurance business, with new products being created and launched on the basis of a configuration that fits the company’s needs, without requiring specific developments.

Pros

  • Helps Innovate
  • Continually Improving Product
  • Reliable
  • Performance Enhancing
OceanWide Canada Inc.

Bridge Claims Management

Composite Score
7.9 /10
CX Score
6.5 /10

Bridge insurance claims software offers powerful features to improve the speed and efficiency of claims management and settlements, further enhancing customer service and satisfaction levels.

Pros

  • Helps Innovate
  • Reliable
  • Performance Enhancing
  • Enables Productivity

Cons

  • Slower Product Innovation
  • Commodity Features
  • Vendor Friendly Policies
Composite Score
7.9 /10
CX Score
7.9 /10

PCMI Corporation offers a modular package of software solutions for the administration of F&I Products, Service Contracts, and Extended Warranties. The cloud-based platform, Policy Claim and Reporting Solutions™ (PCRS), supports and automates the full lifecycle of all aftermarket products in the automotive and consumer goods sectors.

Pros

  • Helps Innovate
  • Continually Improving Product
  • Reliable
  • Performance Enhancing
Composite Score
7.8 /10
CX Score
8.2 /10

Flexible, fast and intuitive for examiners, Ventiv Claims Enterprise saves claims organizations money through enhanced productivity and consistency; improved process automation; and regulatory compliance. The most feature-rich, examiner-preferred claims administration system, Ventiv Claims Enterprise is built on the most current technology and continually delivers new, cutting-edge capabilities for claim organizations.

Pros

  • Helps Innovate
  • Continually Improving Product
  • Reliable
  • Performance Enhancing

Cons

  • Under Delivered
Beacon Technologies Group Inc.

Beacon SpyGlass

Composite Score
7.7 /10
CX Score
7.1 /10

A fully cloud-based health claims management software offering a flexible solution for accurate and timely claims processing. SpyGlass makes benefit and plan setup straightforward and handles full medical, dental, vision, standard or lifetime disability, time-loss payments, COBRA and life claims. Configurable rules and roles-based framework allows business users to easily manage plan setup for increased security and improved workflow systems. SpyGlass integrates with advanced tools, like Microsoft Word and Excel, to deliver the flexibility and functionality necessary to increase efficiency and improve performance.

Pros

  • Helps Innovate
  • Continually Improving Product
  • Reliable
  • Performance Enhancing
Composite Score
7.5 /10
CX Score
7.3 /10

Gain unparalleled agility with business rules, processes, analytics, and case management integrated into a unified claims management platform. By implementing reusable processes and rules across your operations, Pega ensures a consistent execution by every adjuster regardless of skill or experience.

Pros

  • Helps Innovate
  • Continually Improving Product
  • Reliable
  • Performance Enhancing
Composite Score
7.5 /10
CX Score
8.0 /10

HyperQuest services compress cycle time, improve severity accuracy, and provide transparency into the claims process. To company managers, adjusters, repairers and part retailers, our products provide rich information, better control over how you operate, and improved profitability.

Pros

  • Helps Innovate
  • Continually Improving Product
  • Reliable
  • Performance Enhancing

Cons

  • Less Transparent