Top 10: Claims Automation Platforms

The claims management industry, like many other industries, is currently being propelled forward by advancements in tech and changing customer demands.

Artificial intelligence and machine learning algorithms are redefining the claims lifecycle and are arguably leading this transformation.

Predictive models assessing claim severity and optimising resource allocation help the industry with a perfect storm of challenges, from climate-related catastrophes to cyber risks.

IoT devices provide real-time data, enabling proactive risk management and expediting claims processing, while blockchain technology provides value by enhancing transparency and automating validations through smart contracts.

Sophisticated fraud detection systems, employing complex algorithms, are safeguarding insurers and policyholders alike. The integration of 5G networks, edge computing, and augmented reality is poised to revolutionise on-site assessments, potentially eliminating the need for physical inspections in many instances. 

10. OneShield

Its claims management system offers a low-code development environment, enabling insurers to deploy and modify their claims processes rapidly. The platform's embedded analytics provide real-time performance monitoring and decision support.

According to their website: "OneShield Claims is a robust and flexible enterprise-class solution that gives your team members the ability to focus solely on the critical decisions needed to efficiently and effectively manage claims across all lines of business."

9. ClaimVantage

ClaimVantage takes the ninth spot,  Its suite of products includes specialised solutions for disability and absence manageent claims. The platform's rules engine allows for easy configuration of complex business logic, adapting to changing regulatory requirements.

8. Insurity

The Insurity Platform is a cloud-based solution for insurance providers, offering end-to-end management for policy, billing, claims, and analytics. It supports over 500 P&C carriers, MGAs, and brokers, helping them improve operational efficiency, automate workflows, and enhance decision-making through integrated data tools.

With its configurable design, the platform is flexible enough to support personal, commercial, and specialty insurance lines, delivering quicker go-lives and scalability for growing businesses.

The solution features AI-powered chatbots for customer interactions and automated claims validation. The platform's advanced reporting tools provide insurers with actionable insights to improve their claims processes continually.

7. Claimable

Claimable secures seventh place as a cloud-based claims management platform. It offers features like customisable claim types, CRM integration, and daily task management, making claims handling faster and more efficient.

What differentiates Claimable from competitors is its focus on a customer-first approach, simplifying communication and optimising workflows for quicker settlements. Additionally, it provides GDPR compliance and paperless data storage, ensuring security and legal readiness.

6. Riskonnect

Riskonnect offers a comprehensive, cloud-based platform designed to manage risk and compliance under one roof. Its platform connects various risk factors, enabling organizations to make well-informed decisions by providing real-time insights into risk relationships.

What helps Riskonnect stand out is its ability to integrate multiple areas, including claims management, governance, risk and compliance (GRC), and business continuity, all in a single system. This integration fosters collaboration and allows users to visualise and prioritize risks more effectively​

5. EIS ClaimCore

EIS’s ClaimCore offers a comprehensive solution for insurers to streamline and automate their claims management processes.

The platform enhances efficiency with customisable workflows that cover the entire claims lifecycle, from First Notice of Loss (FNOL) to payment and closure.

Key features include AI-driven fraud detection, automated claims routing, and real-time analytics, allowing insurers to reduce manual tasks, improve accuracy, and deliver faster, more transparent customer service.

4  Duck Creek Technologies

Duck Creek Technologies provides claims management software through its Duck Creek Claims platform, a key component of its cloud-based insurance suite. Duck Creek Claims is designed to handle the entire claims lifecycle, from FNOL to resolution.

The platform offers configurable workflows, automated decision-making, and real-time analytics, enhancing operational efficiency and accuracy.

It supports complex claims scenarios, such as multi-party claims and high-severity losses, with integration capabilities for external data providers and third-party systems. Duck Creek’s modular design allows insurers to customise claims processes, including modules for property, casualty, liability, and catastrophe claims, ensuring flexibility for diverse insurance lines.

3. Sapiens Insurance Software Solutions

Sapiens Insurance Software Solutions provides comprehensive digital platforms tailored for insurers. Their offerings include core systems for policy administration, claims management, underwriting, and billing.

With integrated AI, analytics, and automation, Sapiens helps insurers streamline operations, improve decision-making, and enhance customer experiences. Their solutions support life, property, casualty, and health insurance sectors.

2. Guidewire

Guidewire offers a suite of claims management software under its Guidewire ClaimCenter, a key component of the Guidewire InsuranceSuite. ClaimCenter is a cloud-based platform designed for P&C insurers to streamline claims operations, improve accuracy, and reduce cycle times.

It provides capabilities like FNOL intake, automated workflows, fraud detection, and regulatory compliance support. The software supports complex case management, liability assessment, and multi-party claims.

Integrated with Guidewire’s data analytics tools and third-party services, ClaimCenter enables real-time data insights. It also includes types like standard and custom workflows, catastrophe claims, and liability-driven modules.

1. LexisNexis

LexisNexis offers claims management software that focuses on data-driven insights and risk assessment for insurance carriers. Its flagship tool, LexisNexis Risk Solutions, leverages proprietary databases and advanced analytics to streamline the claims process.

The platform integrates features like claims history reports, fraud detection, and identity verification to enhance decision-making. With real-time access to public records, police reports, and third-party data, it helps insurers assess claims more accurately and efficiently.

LexisNexis also provides specialised modules for subrogation, bodily injury claims, and property damage, enabling tailored workflows for various claim types across multiple insurance lines.