Alternatives to Cloud Claims
Compare Cloud Claims alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to Cloud Claims in 2026. Compare features, ratings, user reviews, pricing, and more from Cloud Claims competitors and alternatives in order to make an informed decision for your business.
-
1
Mize Warranty Software
Syncron
Mize Warranty software enables global manufacturers to streamline all warranty processes including inspections, registrations, service plans, claims, returns, supplier recovery, and warranty analysis. Mize warranty software helps companies to improve customer satisfaction, reduce warranty costs, and improve product quality. Mize warranty software is easy to use, configure, and integrate. Request a demo now to learn how you can optimize warranty management and maximize service contract sales. -
2
Duck Creek Claims
Duck Creek Technologies
Duck Creek Claims is a comprehensive claims management solution designed to streamline the entire claims lifecycle for insurers. From the initial report to final settlement, it automates workflows, simplifies data analysis through integrated analytics, and ensures seamless integration with existing systems. Key features include dynamic first notice of loss (FNOL) capabilities, automated assignment based on adjuster skills and workload, instant access to policy and coverage data, and efficient adjuster workflows. By enhancing operational efficiency and reducing manual workloads, Duck Creek Claims enables faster claims resolution, improved customer satisfaction, and compliance with the latest regulations. -
3
Guidewire ClaimCenter
Guidewire Software
Guidewire ClaimCenter is a leading claims management system designed to streamline the entire claims lifecycle for property and casualty (P&C) insurers. It offers comprehensive functionality from initial claim intake to resolution, enabling insurers to process claims efficiently and accurately. Key features include automated workflows, embedded analytics, integrated fraud detection, and real-time performance monitoring, all of which enhance operational efficiency and improve customer satisfaction. ClaimCenter supports various lines of insurance, including personal, commercial, and workers' compensation, and can be deployed as a standalone solution or as part of the Guidewire InsuranceSuite. By leveraging ClaimCenter, insurers can accelerate claims processing, make data-driven decisions, and adapt to evolving market demands. -
4
Five Sigma
Five Sigma
Five Sigma set out on a mission to allow claims organizations to innovate. With the set of claims management tools and unique platform, Five Sigma's suite is what Insurers need to bring their claims operation to the rapidly changing world. With our suite of Claims-First Cloud-Native and User-Centric products, we enable adjusters to handle claims better and faster. With Automating administrative tasks, Adjusters can focus on making the right decisions, while the system takes care of everything else. Clive™ by Five Sigma is the industry's first AI-powered claims adjuster, transforming how claims are processed by insurers, MGAs, and TPAs. Leveraging advanced AI and automation, Clive streamlines the entire claims lifecycle, from FNOL (First Notice of Loss) through to settlement. The AI agent enhances claims handling efficiency, accuracy, and cost reduction by automating tasks. -
5
Terra
Terra
Antiquated on-premise systems are a liability. Streamline your claims operations and improve efficiency with Terra's Automation, Integration, and Intelligence. Terra's products include Claims Management, Policy Management, Benchmark, and an Ancillary Services Marketplace. Manage risk with Automation, Cloud-Native, Integration, and Intelligence! Terra is a Cloud-Native Risk Management Information System for Property & Casualty Insurance. -
6
Direct Claim Solution
Innovative Computer Systems
Claims and Litigation management software for Captive or Risk Retention Group property and casualty claims. Direct Claim Solution is a complete system with claims, policy and vendor management for Self-Insured, Captive or Risk Pool programs. Offers industry specific tools for investigating and analyzing law as well as coverage. Modules for litigation management, subrogation and loss recovery as well as document management included. Merge feature makes for easy letter or email creation. For management, the robust report screen allows multi-conditional querying of claims by exposure type, state of loss, date ranges and policy issuance periods. Vendor isolation feature allows external service providers to access and populate fields in the system as needed to expedite reporting and collaborative analysis. See our website at www.directclaimsolution.com -
7
A1 Tracker
A1 Enterprise
A1 Tracker is presented by the vendor as a robust & configurable risk management software offering either stand-alone or fully-integrated risk management software covering many business segments across an organization. Claims & Incident Management Claims & incident reporting for claims of any type: injuries, medical, commercial, customer, insurance, work comp, asset, auto, liability. Risk Management & Threat Assessment: Risk register for tracking risks at any level in an organization, including by entity, project, asset, contract, vendor, division, business, unit, region, and more. Real-time risk reports & heat maps, dashboard metrics, alerts, & notifications. Contract Management: Contract module for tracking contracts of any type with vendors, employees, customers, and any other parties. Insurance Policies & Certificates: Policies & certificates of insurance tracking with reminders & renewals. For agencies & carriers policy management includes tracking clients.Starting Price: $800/month -
8
ALFRED Claims Automation
Artivatic.ai
Filing claims are complex and critical processes. More than 60% of people do not file complex due to its complex processes and time taking nature. Artivatic’s dedicated claims platform for each insurance vertical helps insurance businesses to enable digital claims journeys, self-claims processing, automated assessment, risk & fraud intelligence and claims payout. ONE PLATFORM FOR ALL YOUR CLAIMS NEEDS. End to End Claims Automation and Assessment Platform AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL CLAIMS – DEATH CLAIMS – FIRE CLAIMS – SME CLAIMS – BUSINESS CLAIMS – COMMERCIAL CLAIMSStarting Price: $10/claims/month -
9
360Globalnet
360Globalnet
360Globalnet's award-winning no-code digital claims platform, 360SiteView, enables insurers to orchestrate and automate the entire claims process from First Notice of Loss (FNOL) to settlement. This fully digital end-to-end solution allows customers to report and manage their claims through a simple, incident-specific template accessible via a website, app, or contact center. The platform maximizes the use of video, imagery, and documents to streamline the claims process, reducing lifecycle times and enhancing customer satisfaction. An automated customer portal keeps clients informed of claim progress without the need for additional logins or passwords. 360SiteView is virtually 100% configurable, allowing operational teams to design and implement digital processes without technical expertise. It supports various claim types, including motor, property, casualty, travel, pet, warranty, commercial, engineering, aviation, and marine. -
10
FileTrac Evolve
Evolution Global
FileTrac has a long-standing legacy of being the #1 claims management system in the industry. Building on this reputation, it has now evolved into FileTrac Evolve. This enhanced version is a crucial component of the Evolve Suite, a comprehensive platform designed to revolutionize your claims management process. FileTrac Evolve is a leading web-based claims management system for independent adjusters, third-party administrators (TPAs), managing general agents (MGAs), and insurance companies of all sizes. Comes with a built-in diary system with reminders and provides integrations with Quickbooks, Outlook, Xactanalysis, Symbility, LEDES, NFIP/NFS, and Google Maps, FileTrac Evolve helps businesses manage their adjusters while ensuring accountability to their customers. Other key features include time and expense tracking, invoicing, adjuster timesheets, image and video uploads, accounting reports, quick notes, and more. -
11
FileHandler Enterprise
JW Software
Built with insurance claims and risk management in mind, our software features live dashboards, detailed reporting functionality, business intelligence tools, and the latest security technology. FileHandler Enterprise™ has become the benchmark for claims administration and risk management information systems (RMIS) in the industry. Our intuitive claims management software is great for third party administrators (TPA's), insurance carriers, risk pools, risk management companies, and a variety of other business professionals looking to make better and faster claims management decisions. No matter your size, our software is scalable from one employee to thousands. FileHandler Enterprise™ software will help you manage and close claims quickly, process payments to parties or vendors, and provide advanced reporting necessary to manage your business. -
12
Mitchell WorkCenter
Mitchell International
Auto insurers need tools to simplify physical damage claims processing from the first notice of loss (FNOL) to settlement. Mitchell WorkCenter is an open, end-to-end modular solution that allows you to configure the modules and integrations specific to your unique business needs. Achieve better outcomes through improved accuracy and efficiency, while lowering the total cost of ownership. Our platform provides you with the ability to send and receive all information straight into your claims management system. With a proven track record of projects implemented in 90 days or less, your IT department will find integration with Mitchell WorkCenter simple. No two businesses work the same way. With WorkCenter, you can configure and manage your software based on your business needs. Access our entire suite or select certain features that best fit into your claims management workflow. -
13
Sapiens ClaimsPro
Sapiens
Sapiens ClaimsPro is a comprehensive claims management software designed for Property & Casualty (P&C) insurers, offering auditable, configurable, and AI-driven automation across all lines of business. Its intelligent, rules-driven workflow ensures faster claims cycle times, resulting in lower expenses and settlement costs. The intuitive, easy-to-use interface provides one-click access to key features, enhancing the adjuster's experience. A central repository offers a 360-degree view of claims, policies, and accounts, improving customer service and vendor management. ClaimsPro enables insurers to adapt quickly to new business requirements, efficiently handle complex claims with superior case management, identify and prevent fraud, and proactively manage exposure for responsive service during catastrophic events. -
14
Aclaimant
Aclaimant
Empower your employees to drive productivity and reduce the total cost of risk with the RMIS built to deliver insight and results. Active risk management is a strategy where you empower your employees to more productively manage risk by leveraging technology that is centralized, connected, scalable, and data-driven to deliver results. Successfully decrease accidents, claim lag time and case duration using Aclaimant’s centralized system that connects your risk management office to incidents in the field. Reduce the cost of claims through better prevention and better mitigation to ultimately improve your insurability. Better utilize superior risk and safety talent with mobile-first, modern technology and automation. Aclaimant keeps your team focused and improves talent appeal, morale, and retention. Get access to case studies and content to better understand how you can put the Aclaimant platform to work for you and your team.Starting Price: Free -
15
TrackAbility
Recordables
Liability claims management software solutions from Recordables. Software solutions to improve claims management including General Liability, Auto, Property, Incidents, and more. Recordables Liability insurance tracking software organizes incidents and claims that include auto, property, and general liability policies. Tracking all liability and risk incidents and claims, TrackAbility provides comprehensive liability claims tracking software solutions Benefits of TrackAbility liability claims management include start to finish injury liability claims management from incident through completion. Create customizable liability claim types with user-selectable criteria. Safety professionals and field users can collaborate on claims and reports, continuing to add pictures and videos for incidents or claims. Receive a holistic view of financial data necessary for claims management, such as payments and losses based upon individuals, locations, policy specifications, and other data. -
16
Mobotory
Mobotory
Our data predictor has a dynamic artificial intelligence core with proprietary algorithms and machine learning applications to identify and predict problematic risk for potentially high loss, excessive litigation, and other costs. We apply machine learning and statistical modeling methods to client data, then integrate it with external data sources for the AI to learn and id risk accurately. Our suite of products can be used end-to-end or incorporated into your current BI systems such as Board, Tableau, or MS BI. From worker’s compensation intake to processing general liability claims, we have a solution that integrates with your insurance company, TPA, or your own system if self-insured. Lower your risk with complete and accurate defense files, reduced settlement costs, faster resolution, and proactive risk reduction. We have general liability or worker’s comp claim cost prediction, rapid settlements, and more accurate premium settings. -
17
RiskVille
RiskVille
RiskVille can help you automate core routine tasks within policy, claims and risk management. Manage your day-to-day operations including customer relationships, claims, policies and risks in one system. RiskVille is a cloud-based solution designed for any type of insurance business. We understand your business and know how important it is to see not only the whole picture of the business results but also to carry out carefully and accurately daily operations. Free up your people from doing monkey jobs and let RiskVille automate their routine. We all have audits and want to meet auditors with a smile feeling secure and compliant. Improve compliance by making audit processes more straightforward. RiskVille is GDPR compliant and hosted on the safe and secure Microsoft Azure platform ensuring safety and security for your data and processes. You can exceed clients' expectations by providing access to policies and claims via a simple online interface or friendly remind them about renewals. -
18
Klear.ai
Klear.ai
Klear.ai is an innovative and comprehensive software solution for claims and risk management, powered by native artificial intelligence. It offers a unified system encompassing risk management, claims administration, analytics, audit, and policy management, all designed to streamline operations and enhance decision-making. Klear.ai's AI-driven predictive analytics enable organizations to anticipate adverse situations, detect hidden exposures, and receive guided recommendations, facilitating smarter decisions and better outcomes. Klear.ai's intuitive interface and configurable features allow for seamless adaptation to unique business requirements, ensuring a user-friendly experience. By integrating advanced machine learning algorithms, it automates workflows, reduces manual efforts, and continuously learns from new data to refine processes over time. Additionally, Klear.ai's robust fraud detection capabilities help organizations minimize unnecessary payouts. -
19
Quadient Correspondence
Quadient
Quadient® Correspondence, manage claims correspondence, in the cloud. Quadient® Correspondence is a subscription-based SaaS solution that enables insurers to create, approve and deliver regulatory compliant, accurate and personalized claims correspondence to customers across print and digital channels, with no reliance upon IT. Quadient Correspondence was designed and priced for insurers who want to further their transformation to digital, but don’t have the resources to invest in an end-to-end customer communications management (CCM) solution. Business analysts create and update templates. Claims managers and compliance experts edit & approve templates for use. Business users write correspondence using a controlled editing experience. Designated personnel review and approve correspondence for delivery. Instant delivery via email, PDF and SMS. Business users start by selecting the appropriate claims correspondence template and customizing the content within pre-defined editable fields. -
20
ClaimLogik
Claim Central Consolidated
Connect everyone in your property claim. ClaimLogik connects everyone in a property claim from first notice of loss through to completion. Property assess & repair ecosystem. We connect everyone in your property claim from start to finish. Stakeholder Management. ClaimLogik connects EVERY stakeholder in a claim with real time access, to complete tasks and manage activities at the right time, in the right order and with complete transparency. All stakeholders have access to workflow modules that have been customized to enable them to track, manage and complete tasks throughout the claim. Stay connected. All stakeholders connected on one claim. Complete transparency on claim status for all stakeholders. Line of sight for all activities across the entire claim. Digital contracts between Insurer and supply chain. Service level agreements with all suppliers and trades KPI management to measure and compare supplier performance. Automated exception management when tasks fall outside SLAs -
21
Origami Risk
Origami Risk
Origami Risk provides integrated SaaS solutions designed to help organizations—insured corporate and public entities, brokers and risk consultants, insurers, third party claims administrators (TPAs), risk pools, and more, transform their approach to managing critical workflows, leveraging analytics, and engaging with stakeholders. Origami Risk is a 5-time Business Insurance Innovation Award Winner, and we've kept that title because we collaborate closely with our clients to develop solutions that address real-world challenges they're facing. Since our founding, Origami Risk has aimed to deliver industry-leading, real-world solutions for risk professionals around the globe. Our acceptance of the 2021 European Risk Management Award for Technology Innovation of the Year underlines this continuous effort. Fully-integrated, comprehensive solutions for reducing incidents & hazards. -
22
omni:us
omni:us
Seamless integration into existing claims systems. Automate processes and reduce costs. No longer is it a choice between saving costs and improving the customer experience. Better decisions with data-driven insights. Automate manual processes. Empower your claims personnel. Invest in your customers’ happiness. Seamlessly integrate incoming claims with your insurance core system. Tackle process inefficiencies with claim automation and watch your customer satisfaction skyrocket. Reduced manual claims incidence of low to moderate complexity by automating claims handling. Improved triaging and manual claims assignment increased case team effectiveness drastically. Decreased process time for remaining manual claims. Allowed a real-time claims settlement in significant amount of cases. Automated digital claims journey by applying FNOL-completeness check, coverage check, automated claims file creation. -
23
Verisk A-PLUS
Verisk
A-PLUS™ Personal Lines Loss History Solutions by Verisk provide insurers with customizable tools to access up to seven years of loss and claim data, aiding in accurate underwriting and rating decisions. These solutions offer flexible options, including full reports regulated by the Fair Credit Reporting Act (FCRA) and the Claims Activity Profiler (CAP), an indicator of claims activity at the point of quote. By integrating A-PLUS into their workflows, insurers can enhance initial quoting accuracy, reduce unexpected premium changes at binding, and improve the overall customer experience. The system's proprietary algorithm ensures comprehensive claim capture with minimal required input, streamlining the underwriting process. Additionally, A-PLUS offers enhancements like access to over 300 million crash records, bridging gaps in loss history reports and providing a more complete view of an applicant's risk profile. -
24
Claims Manager
JDi Data
Claims Manager is a comprehensive, integrated RIMS system built to streamline your process from FNOL to settlement. A unique, configurable business rules engine automates workflow, reduces manual and duplicate work, saves time, and improves outcomes for all stakeholders. Claims Manager’s integrated solutions streamline workflow by helping you administer, adjust, and report your property and casualty claims. Claims Manager is a versatile, and simple to use Risk Management Information System that offers tomorrow’s solutions, today. Its intuitive interface seamlessly integrates with an automated workflow that is accessible anytime, anywhere, from any device. Letting you easily capture, benchmark, administer, and report claims for all lines of property and casualty insurance. -
25
Mercury Policy & Claims Administration
Quick Silver Systems
Mercury by Quick Silver Systems allows Automobile, Property, and Casualty insurance carriers to easily rate, quote, bind, make payments, and report claims online. Minimize customer service calls through online document access, bill payments, and first notice of loss. Modular API based system allows seamless integration with new or existing data providers. Fully digital document production and 100% web-based system works on any device. Create custom, event-driven work-flows with our visual work-flow designer. Access the most up-to-date information on Written, Earned, and Unearned premiums. Automatically save every page, card, report, email, and more to review and share with associates. Collect currency in any digital format including: ACH, EFT, Electronic Checks, Credit, or Bank Card. Information Technology within an insurance company not only needs a system that provides wide accessibility. -
26
Total Loss Pro
Vemark
The frequency of total loss claims continues to rise, now accounting for some 20 percent of collision and liability losses across the auto insurance industry. Yet, far too often, carriers’ total loss operations lack cohesive integrated digital workflows, leading to excessive costs, customer dissatisfaction, and poor visibility and oversight. Enter Total Loss ProTM from Vemark. It’s the one solution you need to transform total loss claims processing from a frustrating black hole to a well-oiled machine while allowing you to keep up with the rapid pace of change. Faster settlement for Improved policyholder experience and satisfaction. Higher employee morale from reduced frustration, and fewer tedious processes. Increased visibility and transparency for data-driven decision-making. Auto claims that result in a total loss are more complex than vehicle repair claims. Total Loss Pro is a cloud-based solution that improves all stages of this complex salvage vehicle workflow. -
27
Ventiv Claims
Riskonnect
Lower costs by administering claims with unparalleled efficiency and accuracy. With 500+ global customers and counting, Ventiv is one of the premier leaders in the risk management, insurance claims and advanced analytics space. Helping some of the biggest brands on the planet with products like our industry leading risk analytics solution. -
28
AdInsure
Adacta
AdInsure is a line-of-business agnostic insurance platform helping insurers keep pace with industry changes. It allows Adacta, partners, and insurers’ IT teams to build LoB-specific solutions across the insurance value chain—from product design and sales to claims and reinsurance. It supports all insurance teams, helping them work smarter and launch faster, delivers modern CX, and connects insurers with emerging tech, service providers, and partners. Built on best practices, AdInsure powers award-winning solutions: • AdInsure Non-life • AdInsure Life • AdInsure Commercial • AdInsure for Brokers Features for business teams: • AdInsure PAS • AdInsure Claims • Billing and Collections • Digital tools (agent portals) • Integrated Data Analytics Capabilities for IT & operations: • No-code/low-code compliant architecture • Modern integration framework with out-of-the-box API • AdInsure Studio (for product design, testing, and distribution) • Cloud support -
29
Newgen Claims Processing
Newgen Software
Newgen’s Insurance Claims Automation & Management software, built on AI-first low-code platform, streamlines the full claims lifecycle, from first notice of loss to final settlement, through automated workflows, smart routing, and integrated document management. Customers can register and track claims through a web or mobile self-service portal, while the system automatically retrieves policy details, prevents duplicate entries, and routes cases based on workload and expertise. Built-in rules classify claims as fast-track or non–fast track, with flexibility to add assessors, investigators, and other stakeholders. Adjusters gain a unified view for registration, adjudication, document review, and communication. AI-driven insights support fraud detection, highlight missing information, and improve decision accuracy. Real-time dashboards monitor KPIs, SLAs, and escalations for transparent and timely processing. -
30
EvolutionIQ
EvolutionIQ
Our solutions drive lower loss costs, lower expenses, and higher customer satisfaction, and are proven at tier 1 carriers. EvolutionIQ enables the future of claim handling for complex lines of coverage, a deep partnership between skilled professional adjusters, and a highly specialized predictive guidance system. Equipped with clear prioritization, pro-active claim alerts, and rich context, empowered adjusters reduce losses and expenses while delivering an enhanced claimant experience. Reduce unwanted variability in the claims pipeline with a consistent, scalable claim guidance system. With the more efficient allocation of adjuster resources & fewer wasted claim reviews. With targeted claim investigations, litigation avoidance, and timely claim settlement. Our claims AI acquires and harnesses data to deliver the tactical guidance your team needs. EvolutionIQ combines structured and unstructured carrier data with our proprietary third-party data. -
31
Insurium
Insurium
A unified solution providing a 360º view of the P&C insurance process lifecycle. Generate premium and save time with a powerful rules-based, multi-state underwriting module that automates the collection of information and the creation of quotes, endorsements, cancellations, audits, and renewals. Reduce combined ratios with a modern and streamlined approach to the claims adjudication process that is both intuitive and collaborative. Increase new business by making it easy to exchange information with brokers. From streamlining and standardizing the intake of information to providing brokers access to the information they need anytime. Control what submissions your underwriters are focusing on. Drive customer satisfaction and retention by providing your policy holders self-service access to policy information, claims intake and review, online bill pay and more. You decide what portal features to provide your customers for the best user experience. -
32
ClaimsControl
Claims Control
Our goal is to digitize the data exchange between all claims handling participants: insurers, brokers, their customers, loss adjusters, and all others. Use our platform to account and share your claims or connect your claims system to our API hub to get integrated with your partners. Connect your claims system to our API hub to start exchanging the data with your partners. Direct integration of all claims systems is impossible, therefore information is exchanged manually. This slows down the process, increases costs and complicates claims process automation. The purpose of ClaimsControl is to enable digital data exchange for all insurance claims handling process participants. If you develop any solutions related to claims management, let's talk and find the ways how we could help you to exchange the data with other systems or how we can provide your solution to our users.Starting Price: $400 per year -
33
VCA Software
VCA Software
Dreaming of happy, efficient claim handlers; fast, accurate claims resolution; and 5-star policyholder ratings? Our agile, future-ready platform enables your people to perform like rockstars, and equips your company with scalable, intuitive processes to fuel profitable growth. By simplifying and automating the workflow, our clients reduce the cost of the claims journey by as much as 30%. VCA Software is one of the most scalable and integration-friendly platforms in the market. Our robust features, at a mid-range price point, make us a favorite among TPAs and adjusting firms. Yes, VCA is lightning fast, but the system is also whip-smart – equipped with a cutting-edge analytics suite so you can make fact-based decisions. You can count on VCA for industry-leading uptime, privacy, and data security. Our Tier 1 data centers are located in the USA, UK, Canada, and Australia. Our solutions can be easily customized to meet your team’s unique requirements.Starting Price: $65 per month -
34
CLAIMExpert
Acrometis
The Acrometis flagship claims processing solution offers unparalleled workflow management, with documents automatically routed by a configurable rules engine. Based around claim assessment scoring, body part to claim compensability matching, jurisdictional directives, relatedness scoring and a host of other claim elements the Acrometis business rules are designed to reduce claim duration and costs. CLAIMExpert automatically processes 65 percent of incoming medical bills and non-medical documents with no user intervention. Documents requiring adjuster intervention are flagged and sorted for easy review and straightforward decision making. Automatically processes incoming documents with NO adjuster intervention. Clients typically see between 11 and 23 points medical loss improvement in the first year. CLAIMExpert contains rules for over 190 different document types, quickly handling whitemail and any other documents that come across your adjuster’s desk. -
35
Beagle Labs
Beagle Labs
Streamlining the claims process from end to end. Technology-driven, people-centric, and built on integrity. A robust claims service interaction platform for insurance carriers, MGAs, captives, and self-insured entities. Deployments, claims organization, and advanced file management at your fingertips. At Beagle, we understand the unique challenges faced by insurance service providers and independent adjusters when it comes to claims handling. Our core software functionality is designed to streamline the process, reduce costs, and provide rapid responses to your claims. Our technology brings efficiency and expertise to every step of the adjustment process. Express claims and inspection responses that reduce liability and drive efficiency. New policy inspections, policy renewals, and daily losses. Beagle was developed to handle the processes required on a daily basis. Streamlined claims handling by leveraging the latest technologies that enable a more efficient resolution. -
36
ClaimScore
ClaimScore
ClaimScore is the only independent software solution dedicated to resolving the ever-expanding claim fraud problem in class action settlements. Each claim is reviewed individually using our proprietary AI, ML, & Cloud Architecture in real-time and each result is reported instantaneously in an interactive dashboard. Each claim begins with a ClaimScore of 1,000 and is reduced each time it fails a criterion. Each criterion has either a fixed weight or sliding weight depending on both the correlation to fraudulent claims and the correlation to valid claims. To maximize transparency, each claim is tagged with deduction codes associated with the criteria it fails, thus ensuring that the parties, the administrator and the court definitively know all specific reasons why each claim was rejected. -
37
Claims Signal
Athenium Analytics
Claims Signal™ is the next-generation open claims quality platform from Aon & Athenium Analytics that enables insurers to identify high-risk claims sooner. Enhance the policyholder experience while achieving a 4-6% improvement in claims indemnity and expenses. Today’s claims teams are under increasing pressure to improve the customer experience, operate more efficiently and mitigate leakage. Routine quality audits are effective at identifying root causes and deviations from best practices, but audit results may not be available for weeks or even months after claims are closed. What if you could monitor open claim files and address quality issues before they affect outcomes? The Claims Signal platform from Aon & Athenium Analytics uses artificial intelligence to analyze open claims, spot potential issues and push instant alerts so your front-line managers can intervene before a claim is closed. Reduce claims leakage by up to 4% with predictive analytics and proactive alerts. -
38
Qantev
Qantev
Automated end-to-end claims platform with AI decision models for data acquisition, policy & coverage checks, medical coding & consistency checks. Reduce leakage and improve your loss ratios with our robust & specialized AI fraud, waste, and abuse detection models for health and life. Qantev enhances the performance of health and life insurers around the globe, helping them reduce losses, optimize their processes, and increase client satisfaction. By blending artificial intelligence with medical expertise, our team of specialized data scientists and engineers has built innovative solutions that boosts the claims management process and uncover instances of fraud, waste, and abuse. Specialized and contextual AI-driven tools to capture, clean, enrich & digitize data from any type of claims document, in any language. Improve your medical provider network's performance through automated AI-driven insight, pricing gap detection, strategy recommendations, simulations, and more. -
39
InsureEdge
Damco Solutions
InsureEdge is an end-to-end Insurance Software designed to help insurance businesses gain maximum value through its comprehensive modules. The highly customizable and configurable solution boasts of the industry’s best insurance processing functionalities. Suitable for multiple lines of insurance businesses, InsureEdge can effectively and efficiently manage and streamline workflows to boost performance, profitability, and accuracy. It supports a variety of everyday operations through back office automation and other modules including customer relationship management, policy administration, claims processing, and more. As a flexible and scalable insurance software, InsureEdge is the key to future proofing your business. -
40
Adjustify
Adjustify
Adjustify is a web-based video calling application that allows professionals to connect with their customers to conduct on-site inspections or in-home meetings remotely. Schedule a call with your customer to start connecting digitally through the mobile app. During the video call, users can take digital measurements and access customer phone features including zoom and flash to capture unlimited photos. After the call, users can view a video recording of the meeting and add notes to photos. Innovative video conferencing technology assisting claims management for any industry providing much needed continuity during social distancing. During the time of social distancing and working from home, Adjustify offers a safer and faster way to process claims. Using Advanced Video Calling, users can connect with their customers and conduct on-site inspections efficiently from anywhere.Starting Price: $12 per claim -
41
Claims Workspace
Cotality
Claims Workspace is a comprehensive solution designed to streamline property claims management by integrating data, automation, and collaboration tools. It simplifies workflows, enabling better outcomes for insurers and restoration professionals. Claims Workspace offers seamless integration with various data sources, providing real-time access to property information, damage assessments, and repair estimates. Automation features reduce manual tasks, accelerating claim processing and improving accuracy. Collaboration tools facilitate communication between all stakeholders, ensuring transparency and efficiency throughout the claims lifecycle. By leveraging advanced analytics and intuitive interfaces, Claims Workspace empowers users to make informed decisions, enhance customer satisfaction, and optimize operational performance. -
42
ClaimScape
DataGenix
Emerged in the year 2000, DataGenix is strongly resolved to provide TPAs, adjusters, and insurance companies with modern claims processing solutions. We understand that claims processing and health benefits management can include several complications. So that your business does not suffer any losses, our experts have created the advanced ClaimScape software that can automate the entire adjudication process. The goal of our business and the Claims software is to resolve the perplexities that hinder the reach of unmatched customer experience for your clientele network. Keeping in mind the modern trends and requirements, we can assure your business's optimum growth with our software products. We have won the trust of top TPAs of the nation and are willing to serve more. -
43
Crunchwork
Codafication
Crunchwork is for insurers who want to gain a competitive edge with a fast, customer-centric claims process. Crunchwork is a cloud-based insurance claim management software that has everything you and your supply chain need to triage, process, and complete claims. In one platform. It’s the simpler way to transform your entire claim lifecycle. Unlike typical claim management platforms, Crunchwork is both flexible and powerful enough to operate your entire business however you work best. -
44
Inovalon Claims Management Pro
Inovalon
Keep revenue flowing with a powerful tool that speeds up reimbursements with eligibility checks, claims status tracking, audits and appeals, and remittance management for government and commercial claims, all in a single system. Leverage an advanced rules engine that immediately scrubs claims against the most up-to-date CMS and commercial payer rules, allowing you to correct errors before claims go out the door. Verify eligibility across all payers during claim upload and see flagged errors so claims can be edited before submission. Decrease days in A/R with automated workflows for audit responses, appeal submissions, and ADR tracking. Customize staff workflow assignments based on the type of claim and action needed. Automate secondary claims submissions to stop timely filing write-offs. Increase claims revenue with automated workflows for faster, more successful audits and appeals. -
45
Gradient AI
Gradient AI
Gradient AI is a leading provider of proven artificial intelligence solutions for the insurance industry. Our solutions improve loss ratios and profitability by predicting underwriting and claim risks with greater accuracy, as well as reducing quote turnaround times and claim expenses through intelligent automation. AI solutions for the insurance industry built on key differentiators that enable your organization to grow profitably. Look through the lens of Gradient AI to see a new picture of risk and probability, a picture that grows sharper the more it learns. A more complete and in-depth picture of risk providing enhanced underwriting capabilities. Price policies more accurately and with deeper insights, to compete more effectively and win more business while improving loss ratios. Accelerate expansion into a new geography, new line of business, or a new industry sector, leveraging data to gain a deeper understanding of risk in new markets. -
46
Majesco ClaimVantage
Majesco
Digital technologies are having a significant impact on insurance, and those keeping pace with this evolution are on track to maintain a competitive advantage. Traditional claim management tools, involving multiple systems, paper files and manual processes, are being replaced with cloud-native enterprise claim management platforms. The Majesco ClaimVantage Claims Management Software for L&H platform streamlines the claims process through the full life cycle of a claim, from intake through payment calculation, integrating multiple systems to improve the flow of information across your business. Improve the customer experience and drive operational effectiveness with accurate and timely claim decisions. Built on the Salesforce Lightning Platform, Majesco ClaimVantage Claims Management Software for L&H enables insurance companies and TPAs to modernize and optimize their claims operations today and into the future. -
47
MediConCen
MediConCen
The ultimate insurance claim automation solution powered by patented blockchain technology. Claims are the moment of truth for all insurance, and with our solutions, everything has been craftily designed to automate insurance claims for insured and insurers with unbeatable accuracy and speed, from claim estimation before a claim occurs, to making the right claim decision and settling the payments. MediConCen is a leading insurance technology that automates insurance claims and makes insurance usable for insurance companies, medical networks, and clinics using Hyperledger Fabric blockchain. We empower claim assessors with powerful AI models and expert knowledge decision rule engines so that fraud and abuse can be spotted instantly and clean cases can be approved right away for consistently perfect claim cost management and unbeatable efficiency. Be in the know with powerful claim analytics that simply work for underwriting and product development. -
48
Practo Insura
Practo Insura
Practo Insura is a modular P&C insurance platform that supports the full policy, billing and claims lifecycle for carriers, MGAs and reinsurers. The platform helps teams launch new products faster, modernize legacy processes and maintain state-by-state compliance while reducing manual work and operational friction. Core Features/Modules • Policy administration (full lifecycle from issuance to renewal) • Billing & payments (premium billing, collections – describe as implemented) • Claims management (FNOL to settlement in one system) • Rating engine & quote management • Insured / policyholder portal and consumer POS • Agent portal & quote-to-bind tools • Compliance & filing workflows (state expansion, rate/form governance) • Reporting & operational analyticsStarting Price: $50,000/year -
49
CLAIMSplus
Addiox Technologies
Expedited claims. Multiple interfaces sync with your corporate brand. Digitized data environment that can be accessed from anywhere, at any time. Health and Life processing via faster systems that aligns with your processing needs. Speeding up the claims life cycle to match the influx of your claims—while reconciling and resolving the more complicated claims at record velocity. It’s in. It’s out. No interruptions or claims processing delays. CLAIMSplus moves claims faster, working with employers, TPAs and insurers with robust in-the-cloud processing platforms. CLAIMSplusis in the business of optimizing processes and expediting medical claims through secure, reliable and efficient electronic claims management. More to the point, our technology—first and foremost—manages claims quickly and efficiently. We’ve asked our clients, and the timescale of the claim is the most important element for claims processing. -
50
Applied Epic
Applied Systems
The management system is the backbone of your agency so you need a system with the capabilities to manage your entire business and the flexibility to grow as you do. Applied Epic® is the world’s most widely used management platform. It allows you to manage and maintain a clear picture of your entire agency across all roles, locations and lines of business, including both P&C and benefits. Our Applied Epic software is browser-native so your team is able to easily access data, minimize software management and more quickly realize the value of new capabilities. Build your agency on a system that automates back office operations, keeps your front office sales team connected, and integrates with customer service and insurer connectivity technologies. Give employees a simple, intuitive user experience. In just a few clicks, they can view account and policy details, complete a quote, file a claim, and remarket a renewal.
