Alternatives to CLARA Analytics

Guidewire ClaimCenter stands out as a premier claims management platform aimed at optimizing the complete claims lifecycle for property and casualty (P&C) insurers. It encompasses a wide array of functionalities, spanning from the initial claim intake phase to final resolution, which empowers insurers to handle claims both swiftly and with precision. Among its notable features are automated workflows, integrated analytics, real-time performance tracking, and fraud detection capabilities, all of which work together to enhance operational effectiveness while boosting customer satisfaction levels. ClaimCenter caters to multiple insurance sectors, such as personal, commercial, and workers' compensation, and can be utilized independently or as a component of the Guidewire InsuranceSuite. By utilizing ClaimCenter, insurers not only expedite the claims process but also gain insights for informed decision-making and remain agile in response to shifting market conditions. Its implementation can lead to significant improvements in both efficiency and overall service delivery for insurers.

APP Tech pioneered the incident-based approach to claims and risk management. Since 2003, we’ve delivered integrated technology solutions to hundreds of customers across North America — to improve claims-management efficiency and scalability, increase visibility, shorten response times, lower premiums, and prevent risk events. Cloud Claims by APP Tech is a top-rated risk management and claims software solution. IMS is a purpose-built software solution for self-insureds, TPAs, and companies who want to track their claims and losses. It helps users manage the entire claim lifecycle, from the initial incident report to issuing payments and collections. It offers a variety of features that allow users to have complete control over their claims, as well as risk information. These include incident management and claims management, workgroup tools as well as reporting, insurance tracking, and many other features. We’re proud of our 100 percent implementation-success rate and excellent customer-retention rate, a result of our commitment to understanding our clients’ needs and rolling out solutions that work for them.

Introducing a cutting-edge and efficient method for managing and settling insurance claims. This comprehensive, all-in-one solution caters to various types of insurance, including property, liability, and workers’ compensation. ClaimRuler™ is a state-of-the-art cloud-based claims management platform crafted specifically for Independent Adjusters, Third-Party Administrators, CAT Adjusters, Insurance Carriers, Self-Insured entities, and Municipalities. The system facilitates seamless claims processing with integrated guided workflows, extensive reporting features, and an automated diary system that enhances the efficiency of the claims settlement process. Designed with the real-world needs of industry professionals in mind, ClaimRuler™ offers a user-friendly and functional interface, making it easier to manage forms, lists, documents, and images. Whether you are part of an I/A firm, a TPA, an insurance carrier, or a municipality, ClaimRuler™ is flexible and scalable to grow alongside your organization. This adaptability ensures that users can navigate the platform with ease while meeting the evolving demands of the insurance landscape.

Duck Creek Claims offers a robust solution for managing the claims process, aimed at optimizing each stage of the lifecycle for insurance providers. It automates workflows from the first report through to the final settlement, while also simplifying data analysis via integrated analytics and ensuring compatibility with current systems. Notable features encompass advanced first notice of loss (FNOL) capabilities, automated assignments that consider adjuster expertise and current workloads, immediate access to policy and coverage information, and streamlined workflows for adjusters. This innovative platform significantly boosts operational efficiency and minimizes manual tasks, thus facilitating quicker claims resolutions and enhancing customer satisfaction, all while adhering to the latest regulatory standards. With its comprehensive tools and features, Duck Creek Claims positions insurers to effectively respond to the evolving demands of the insurance landscape.

Claims and Litigation Management Software for Captive or Risk Retention Group property or casualty claims. Direct Claim Solution provides a complete system that manages vendor, claims, and policy management for Self-Insured programs, Captive programs, or Risk Pool programs. This tool provides industry-specific tools for analyzing and investigating law. Modules for litigation management, subrogation, loss recovery and document management are included. The Merge feature allows for easy email or letter creation. The robust report screen allows management to query multiple conditions of claims by date ranges, state of loss and exposure type. External service providers can access the system and populate the fields as required to speed up reporting and collaborative analysis. See our website at www.directclaimsolution.com

Enhancing the claims process from start to finish. Our approach is technology-oriented, focused on people, and grounded in integrity. We offer a comprehensive claims service interaction platform tailored for insurance carriers, managing general agents, captives, and self-insured organizations. With easy access to deployments, claims management, and advanced file organization, efficiency is just a click away. At Beagle, we recognize the specific hurdles that insurance service providers and independent adjusters encounter in claims management. Our foundational software features are crafted to optimize the claims process, minimize expenses, and ensure swift responses to your claims. By integrating our technology, we enhance efficiency and bring professional insight to each phase of the adjustment process. Our services include expedited claims and inspection feedback, which not only mitigate liability but also promote operational efficiency. We address new policy inspections, policy renewals, and daily loss assessments seamlessly. Beagle was designed to manage the routine processes that arise each day, ensuring that claims handling is streamlined through the utilization of cutting-edge technologies for quicker resolutions. In this way, we empower our clients to navigate the complexities of claims with ease and confidence.

Sapiens ClaimsPro is an all-encompassing claims management system tailored for Property & Casualty (P&C) insurers, featuring auditable, customizable, and AI-enhanced automation applicable across various business lines. The software's intelligent, rules-based workflows expedite claims processing, thereby reducing both costs and the time to settle claims. Its user-friendly interface allows adjusters to access essential features with just a single click, significantly improving their overall experience. Additionally, a centralized repository provides a comprehensive view of claims, policies, and accounts, which enhances customer service and streamlines vendor management. ClaimsPro also empowers insurers to swiftly adapt to evolving business needs, manage intricate claims with advanced case management tools, detect and mitigate fraud, and proactively address exposure in response to catastrophic incidents, ensuring timely service delivery. Thus, this software not only optimizes operational efficiency but also strengthens the insurer's capacity to respond effectively to unprecedented challenges.

The Sapiens Platform for Property & Casualty offers a comprehensive, cloud-based or on-premise suite of software solutions equipped with cutting-edge digital functionalities. This platform can be deployed either as an integrated system or as independent modules. Its wide-ranging offerings cater to the diverse requirements of P&C carriers, supporting various lines of business and distribution channels while providing an extensive array of digital tools. The Sapiens CoreSuite for Property & Casualty features several key components, including Sapiens PolicyPro for Property & Casualty, which oversees the entire policy administration process from the initial quote to rating and policy issuance; Sapiens BillingPro for Property & Casualty, which guarantees the accurate collection of premiums, management of claims payments, and processing of agent commissions; and Sapiens ClaimsPro for Property & Casualty, which manages claims processing and the settlement procedures. Additionally, the platform encompasses a reinsurance solution, enhancing its robustness and functionality. This comprehensive approach ensures that carriers can efficiently streamline their operations and improve overall service delivery.

Our innovative solutions lead to reduced loss costs, minimized expenses, and improved customer satisfaction, demonstrating their effectiveness with top-tier carriers. EvolutionIQ is at the forefront of revolutionizing the claims handling process for intricate coverage lines, fostering a robust collaboration between adept professional adjusters and a uniquely designed predictive guidance system. By providing clear prioritization, proactive claim alerts, and comprehensive context, empowered adjusters are able to lower losses and costs while enhancing the experience for claimants. This approach also mitigates unnecessary variability in the claims process by implementing a consistent and scalable guidance system. Additionally, it optimizes the deployment of adjuster resources, leading to fewer redundant claim reviews and facilitating targeted investigations that help avoid litigation and ensure timely settlements. Our claims AI systematically gathers and utilizes data to offer the strategic guidance necessary for your team’s success. Furthermore, EvolutionIQ integrates both structured and unstructured data from carriers alongside our exclusive third-party data, enhancing overall operational efficiency and effectiveness. This synergy not only streamlines processes but also positions your organization for greater success in the claims landscape.

Venue ™ Claims Management for Independent Adjusters offers a complete solution for overseeing the entire claims processing workflow. This system is suitable for various entities, including adjustment firms, third-party administrators, insurance carriers, and self-insured organizations. Users can enjoy a highly customizable interface, enabling significant self-modification of the claims management system to meet their specific needs. The platform includes a built-in web service interface, facilitating real-time or batch data imports, updates, and exports to nearly any external data-sharing source concerning all claim-related information. Furthermore, seamless integration with policy and billing systems ensures real-time synchronization of all policy-related details, which may encompass essential policy dates and alerts, such as ongoing fraud investigations and assumed policies. The system provides thorough capabilities for every dimension of claims processing—spanning claim payments, recovery processes, reserves tracking, contact management, trust accounts, forms templates, and extensive reporting functionalities. Overall, Venue ™ empowers organizations to enhance their claims management efficiency and effectiveness.

CaseworksPro is a cost-effective online claims management system tailored to meet diverse claims processing needs. Created by Insurance Technology Solutions, this platform is specifically designed for the claims departments of insurance carriers, self-insured retentions (SIRs), and third-party administrators (TPAs). With its user-friendly interface, CaseworksPro incorporates a variety of functionalities, such as workflows centered around SIR clients, the ability to capture policy data, options for both one-off and scheduled payments, customizable user access permissions, check printing capabilities, electronic reporting features, and the ability to capture NCCI and ISO statistical codes. Additionally, its comprehensive approach ensures that all stakeholders can efficiently manage claims while maintaining compliance with regulatory standards. This makes CaseworksPro an invaluable tool in the claims administration landscape.

ALYCE is tailor-made for self-insured entities, municipalities, and small third-party administrators managing claims related to Workers' Compensation, Auto Liability, Auto Property, General Liability, and Property. Its user-friendly interface prominently features essential data points on the primary claim page, showcasing the financial summary alongside other critical information that can be accessed quickly with a simple scroll or a click. Additionally, it offers a multi-tiered structure for employer reporting obligations that vary by location and department. The system also facilitates recoveries through salvage, subrogation, and payments from excess carriers. Users benefit from automated scheduling for recurring payments, complete with diary alerts to enhance organization. Furthermore, diaries are automatically generated based on significant events, timelines, and financial activities, ensuring nothing is overlooked. The system also creates form letters automatically for claimants, attorneys, and various stakeholders involved in the claims process, streamlining communication and documentation. This comprehensive approach not only improves efficiency but also fosters clearer communication among all parties involved.

Claims Manager is a complete, integrated RIMS system that streamlines your process from FNOL through settlement. Unique, configurable business rules engine automates workflow. It reduces duplicate and manual work, saves time, improves outcomes, and increases the value for all parties. Claims Manager's integrated solutions simplify workflow by allowing you to manage, adjust, and report on your property and casualty insurance claims. Claims Manager is an easy-to-use Risk Management Information System that provides tomorrow's solutions. Its intuitive interface seamlessly integrates into an automated workflow that can be accessed from any device, anytime, anywhere. It allows you to easily capture, benchmark and administer claims for all lines property and casualty insurance.

ClickClaims is ideal for small to medium-sized property and casualty insurers, independent claims adjusters firms, and third-party administrators who require advanced technologies to drive a competitive market. ClickClaims SaaS model is fast and cost-effective. It offers a scalable, flexible, secure, and performance that legacy systems simply cannot match. Your investment will appreciate over time because it is built to adapt to new technologies.

Five Sigma embarked on a quest to empower claims organizations to embrace innovation. Their collection of claims management tools and distinctive platform equips insurers with what is necessary to adapt their claims operations to an ever-evolving environment. By offering a suite of Claims-First Cloud-Native and User-Centric products, Five Sigma enhances the capabilities of adjusters, enabling them to manage claims more effectively and swiftly. Through the automation of routine administrative tasks, adjusters can concentrate on making informed decisions while the system efficiently manages the rest. Introducing Clive™ by Five Sigma, the first AI-driven claims adjuster in the industry, is revolutionizing the claims processing landscape for insurers, MGAs, and TPAs. By harnessing cutting-edge AI and automation, Clive optimizes the entire claims lifecycle, from the First Notice of Loss (FNOL) to the final settlement. This AI agent not only boosts the efficiency of claims handling but also improves accuracy and reduces costs by automating various tasks, ultimately leading to a more streamlined and effective process for all stakeholders involved. In this way, Five Sigma is setting a new standard for the future of claims management.

Our data prediction system is powered by a sophisticated artificial intelligence framework that utilizes exclusive algorithms and machine learning techniques to detect and forecast potential risks associated with significant losses, extensive litigation, and other financial burdens. By harnessing machine learning alongside statistical modeling approaches, we analyze client data and complement it with external sources to enable the AI to accurately assess risk. Our comprehensive product offerings can function independently or be seamlessly integrated into existing business intelligence platforms like Board, Tableau, or Microsoft BI. Whether it's managing worker’s compensation claims or processing general liability issues, our solutions can align with your insurance provider, third-party administrator, or your internal systems if you are self-insured. By utilizing our services, you can mitigate your risk through precise and thorough defense documentation, diminished settlement expenses, expedited resolutions, and proactive measures aimed at risk reduction. We also offer tools for predicting costs associated with general liability or worker’s compensation claims, facilitating swift settlements and providing more precise premium calculations, ultimately enhancing your operational efficiency in risk management. Our commitment is to deliver innovative solutions that not only meet but exceed your risk management needs.

360Globalnet's acclaimed no-code digital claims platform, 360SiteView, empowers insurers to seamlessly manage and automate the complete claims journey from the First Notice of Loss (FNOL) to the final settlement. This comprehensive digital solution enables customers to submit and track their claims through an intuitive, incident-specific template available on a website, app, or via a contact center. By leveraging video, images, and documents, the platform optimizes the claims process, which leads to reduced lifecycle times and improved customer satisfaction. A fully automated customer portal ensures that clients receive updates on their claim status without needing to remember extra logins or passwords. With nearly complete configurability, 360SiteView allows operational teams to create and implement digital workflows without requiring technical skills. It accommodates a diverse range of claim types, including but not limited to motor, property, casualty, travel, pet, warranty, commercial, engineering, aviation, and marine, making it a versatile solution for insurers. Furthermore, its user-friendly design and adaptability mean that it can evolve with the changing needs of the insurance industry.

A risk management solution for property and casualty. All-in-one benchmarking and claims management system that simplifies claims-related processes and makes adjusters' lives more simple. TerraClaim provides two tools to simplify claims-related operations. These tools are powerful enough on their own, but even more so when combined. An innovative cross-industry data analytics and claims benchmarking solution that compares your claims performance to industry peers. This helps you set better goals, manage risk reserves, and improve claim outcomes. The world's best property and casualty claims management software that streamlines your internal processes, improves productivity, drives desired results, and prevents fraud.

Our cloud-based offerings encompass a diverse range of standalone, subscription, and As-a-Service products, featuring top-tier policy management, billing, claims processing, rating, product configuration, business intelligence, and advanced analytics. OneShield's solutions cater to all sectors and are meticulously crafted for mid to large-sized property and casualty insurers, as well as specialty markets, providing essential technology for policy, billing, claims, rating, and business analytics. Tailored specifically for the property and casualty insurance industry, this enterprise-grade solution prepares your organization for upcoming challenges and opportunities. It has been designed to fulfill the particular requirements of niche financial service sectors, such as Managing General Agents (MGAs), Third Party Administrators (TPAs), regional insurers, workers’ compensation, and risk pools. In this rapidly evolving landscape, the millennial generation stands out, as their unique purchasing behaviors and interactions with companies prompt insurers to rethink their strategies and embrace transformation. Understanding the impact of millennials on the insurance sector is crucial for driving innovation and staying competitive.

At Resilience, we present an innovative solution for the middle market in cyber insurance, supported by a highly-rated insurer and a dedicated in-house claims team. Our offerings include comprehensive insurance coverage at the point of binding, loss mitigation services after binding, and tailored ongoing security solutions that span the entire duration of the policy, ensuring your cyber resilience remains our priority. We integrate a complete ecosystem of security, insurance, and claims, all underpinned by exceptional data collection and analytics, allowing us to deliver customized protection, coverage, and assistance specifically designed for mid-market enterprises. As businesses increasingly adopt remote work models, we assist in navigating the growing dependence on cloud infrastructures and the associated risks, which range from misconfigured services to vulnerable home network security. Our goal is to empower organizations with the tools they need to thrive in this evolving digital landscape.

The Insurance Data Network (IDN) represents a groundbreaking approach to data sharing among insurance providers, offering real-time insights that significantly bolster fraud detection and risk management throughout the claims process, leading to greater operational efficiency and minimized financial losses. By promoting visibility across different insurance carriers, the IDN allows insurers to identify patterns and trends in fraudulent activities and claims behavior, thereby supporting better-informed decision-making and effective strategies for risk reduction. Utilizing AI-enhanced data mapping and entity resolution techniques, the IDN provides precise, actionable insights that seamlessly integrate into the workflows of insurers. It automates the conversion of raw data into useful intelligence, which removes the necessity for manual data analysis and simplifies the decision-making process. Additionally, IDN prioritizes the ownership and control of data for both insurers and their clients, ensuring transparency in how the data is utilized. This innovative platform not only streamlines operations but also fosters a collaborative environment that empowers insurers to combat fraud more effectively.

The process of filing claims is intricate and essential. Over 60% of individuals refrain from submitting complex claims due to the involved procedures and the time they require. Artivatic offers a specialized claims platform tailored to various insurance sectors, empowering companies to facilitate digital claims experiences, enable self-processing, automate evaluations, and implement risk and fraud intelligence alongside claims payouts. A SINGLE PLATFORM TO ADDRESS ALL YOUR CLAIMS REQUIREMENTS. Comprehensive Automation and Assessment for Claims. AUTO CLAIMS – HEALTH CLAIMS – TRAVEL CLAIMS – ACCIDENTAL CLAIMS – DEATH CLAIMS – FIRE CLAIMS – SME CLAIMS – BUSINESS CLAIMS – COMMERCIAL CLAIMS – EVERY CLAIM MATTERS.

The FIS Reinsurance Manager is an innovative reinsurance solution that operates independently of any specific source, aiming to boost both operational efficiency and transparency within the insurance sector. This system offers a centralized, secure, and auditable framework that automates intricate reinsurance workflows, minimizing dependence on outdated spreadsheets and legacy platforms. Among its notable features are automation for accounts payable and receivable, monitoring of open balances, and capabilities for standardized reporting. The platform effortlessly integrates with current policy and claims management systems, as well as general ledger solutions, making contract maintenance, billing, and thorough financial and statutory reporting more efficient. By centralizing and automating reinsurance tasks, the FIS Reinsurance Manager empowers insurers to navigate complex contracts with greater effectiveness, enhances accounting and claims oversight, and guarantees timely and precise reporting. Ultimately, this results in a more streamlined operational process for insurers, allowing them to focus on their core business objectives.

Our goal is digitization of data exchange between all claim handling participants: insurers and brokers, their customers and loss adjusters. Our platform allows you to account and share your cases or connect your claims system with our API hub to integrate with your partners. To exchange data with your partners, connect your claims system to the API hub. Direct integration of all claims systems cannot be achieved, so information must be exchanged manually. This slows down the process and increases costs. It also complicates claims process automation. ClaimsControl's purpose is to allow digital data exchange between all participants in the insurance claims handling process. Let's discuss any claims management solutions you may have. We can help you exchange data with other systems, or provide our users with your solution.

The rise in total loss claims has reached a concerning 20 percent of all collision and liability losses within the auto insurance sector. Unfortunately, many insurance providers still struggle with disjointed total loss operations, which can result in higher expenses, unhappy customers, and limited oversight. Introducing Total Loss Pro™ from Vemark: this innovative solution is designed to turn the cumbersome total loss claims process into a streamlined and efficient system that can adapt to rapid industry changes. With this tool, you can ensure quicker settlements that enhance policyholder satisfaction. Additionally, it boosts employee morale by minimizing frustration associated with cumbersome processes. This platform also offers improved visibility and transparency, enabling data-driven decision-making. Given the complexities involved in total loss auto claims compared to standard repair claims, Total Loss Pro serves as a cloud-based solution that optimizes every stage of the intricate salvage vehicle workflow, ultimately benefiting both insurers and their clients. Moreover, by implementing this comprehensive tool, carriers can foster a more proactive approach to managing claims, ensuring a smoother experience for all parties involved.

An all-encompassing general insurance software solution tailored for insurance firms managing both personal and commercial lines of business. Each module within the system utilizes a unified database and a centralized repository of business rules for data management. This application encompasses a wide range of essential insurance functions, such as client administration, underwriting procedures, policy and endorsement creation, claims processing, and the handling of co-insurance and reinsurance tasks. Additionally, it facilitates billing, payment collection, cash handling, agency and commission oversight, production workflows, and comprehensive management reporting, all within a versatile system that supports multiple companies, currencies, and languages. Moreover, it incorporates reinsurance accounting, automated underwriting systems, an Insurance Products Generator, and a rating tool for enhanced efficiency. This robust software also streamlines policy administration and agent commission management, making it a vital tool for modern insurance operations.

SohamLife is an entirely web-based platform that facilitates the entire insurance operation life cycle, encompassing everything from the initial proposal registration to the conclusive settlement of claims, whether related to death or maturity. This solution is designed to be user-friendly, offering insurers essential flexibility and scalability while ensuring a swift implementation and deployment process. Users, including both agents and policyholders, can easily check the status of proposals, policies, and claims through a straightforward interface. By allowing seamless integration among the Underwriting, Claims, Reinsurance, and Accounting departments, it effectively eliminates data redundancy. Additionally, the system meets both international and country-specific operational processing and reporting needs. SohamLife supports multiple currencies and languages, enhancing its accessibility and functionality across diverse markets. This comprehensive and integrated component-based solution streamlines core business processes, ensuring that data entered in one area is reflected across all components.

CoreLogic revolutionizes the global property and casualty insurance sector by offering adaptable, collaborative, and secure technologies for claims estimation. We focus on delivering exceptional experiences that enhance business operations and positively impact lives. With Claims Connect™ from CoreLogic®, the claims process is streamlined for all stakeholders through a cohesive digital ecosystem. Transform your workflow to ensure that your customers’ claims are addressed with greater efficiency and precision. All relevant information is securely consolidated within a single platform, making it easily accessible to everyone involved in the claim. Say goodbye to the hassle of toggling between various software applications to modify and review claims data. You can create estimates or implement changes directly in Claims Connect, which immediately updates the information, ensuring that everyone has real-time access to the latest details. By keeping all participants in the claims process informed with timely information, you will facilitate simpler, quicker, and more effective resolutions to claims issues. This innovative approach not only improves operational efficiency but also enhances customer satisfaction throughout the claims experience.

EIS offers a cutting-edge, cloud-native, API-first SaaS platform tailored for the insurance industry, empowering dynamic insurers to innovate with the agility of a technology firm. Their comprehensive platform accommodates various lines of business, such as group benefits, property and casualty, life and annuities, and protection. With an architecture that is open, event-driven, and responsive in real time, EIS enables insurers to enhance their agility and operational efficiency, facilitating swift innovation, quicker product launches, and the creation of new revenue streams while fostering customer-focused insurance solutions. The platform comprises essential core systems, including PolicyCore for managing policies, BillingCore for overseeing billing processes, ClaimCore for claims management, and CustomerCore for managing customer relationships. These components can function independently or as an integrated suite, ensuring seamless end-to-end support across the entire insurance lifecycle, which encompasses policy management, underwriting, claims processing, billing, and customer engagement. By leveraging this robust platform, insurers can effectively respond to market demands and enhance their overall service delivery.

Shift Subrogation is a software-as-a-service (SaaS) solution enhanced by artificial intelligence that autonomously detects, evaluates, and highlights subrogation recovery prospects for insurance firms, particularly in the Property & Casualty (P&C) sector. By integrating structured data like policy information and claims with unstructured text such as loss descriptions and adjuster comments, the platform employs generative AI and various analytical models to evaluate liability, apply pertinent state and negligence laws, compare exposures, consider statute limitations and jurisdictional regulations, and reference external information sources like product recalls. It provides alerts complete with scores and explanations for each recovery opportunity, allowing claims handlers to understand not only which cases to pursue but also the reasoning behind each recommendation. Furthermore, the system offers ongoing monitoring of claims as they develop, adjusting alerts as new information becomes available or as recoverability assessments change over time. This ensures that the insurance companies remain informed and proactive in their recovery efforts.

eOxegen is an innovative claims management system powered by artificial intelligence, aimed at improving the efficiency of health insurance operations. By automating the claims process through a Straight Through Process (STP), it minimizes the need for manual intervention, resulting in quicker claim settlements and higher accuracy. The system features sophisticated fraud detection capabilities, leveraging AI algorithms to detect and flag potentially fraudulent activities at an early stage. Furthermore, eOxegen includes functionalities such as provider contracting and empanelment, management of pre-authorizations and adjudication, as well as comprehensive reporting through business intelligence analytics dashboards. Its AI-driven workflow automation guarantees consistent task execution, reduces repetitive activities, and boosts overall productivity. In integrating these diverse functionalities, eOxegen enables insurance providers and third-party administrators to refine their claims management processes while also lowering operational costs. Ultimately, the platform serves as a transformative tool for the health insurance industry, fostering a more efficient and reliable claims handling environment.

Claims Signal™ represents a revolutionary open claims quality solution developed by Aon and Athenium Analytics, designed to help insurers detect high-risk claims at an earlier stage. By improving the experience for policyholders, this platform can lead to a significant enhancement in claims indemnity and expenses, estimated between 4% to 6%. In today's fast-paced insurance environment, claims teams face mounting pressure to elevate customer satisfaction, streamline operations, and minimize financial leakage. While routine quality audits can effectively highlight root causes and deviations from optimal practices, the feedback from these audits may not be accessible for weeks or even months post-claim closure. Imagine having the ability to continuously monitor open claims and resolve quality concerns before they negatively impact results. The Claims Signal platform leverages advanced artificial intelligence to scrutinize open claims, identify potential problems, and send immediate alerts, empowering front-line managers to take action before a claim reaches conclusion. With the integration of predictive analytics and timely alerts, insurers can achieve a reduction in claims leakage of up to 4%, ultimately transforming the claims management process. This proactive approach not only enhances operational efficiency but also fosters a culture of continuous improvement within claims teams.

Prima XL, previously known as WebXL, is a robust and user-friendly cloud-based software designed for the reinsurance industry, enabling insurers, reinsurers, and brokers to gather, centralize, and analyze all relevant data effectively. This platform meticulously monitors all aspects of your reinsurance agreements, encompassing treaties, facultative policies, claims, incidents, accounting and technical data, as well as various financial details. Users can effortlessly oversee their policies, managing everything from underwriting processes to switches and renewals. Prima XL is designed with flexibility in mind, accommodating international enterprises that work with multiple currencies and adhere to various GAAP standards. By consolidating all reinsurance policies within a single platform, Prima XL enhances data visibility and security, streamlining data management. Furthermore, the software adeptly manages a wide array of contracts, including treaties, facultative reinsurance, proportional and non-proportional agreements, excess loss, stop loss, and quota share arrangements, ensuring comprehensive coverage for all reinsurance needs. With its powerful analytical tools, Prima XL empowers organizations to make informed decisions based on real-time data insights.

Sapiens ReinsurancePro is an all-encompassing platform tailored to streamline the underwriting and management of various forms of reinsurance, including treaty and facultative, as well as ceded, assumed, and retroceded types. This platform boasts strong accounting features that ensure adherence to auditing standards and statutory obligations, alongside automated billing that facilitates one-click Schedule F generation. By integrating seamlessly with policy and claims management systems, it automates the identification and computation of cessions, thus boosting operational efficiency. The automation embedded in contracts, calculations, and processes grants comprehensive financial oversight while minimizing the risk of claims leakage. Emphasizing a cloud-first strategy, ReinsurancePro presents adaptable deployment options and a scalable framework that can efficiently manage substantial data volumes with speed and reliability. Its rapid input/output capabilities and swift transaction processing further enhance the system's overall performance, making it a pivotal tool for reinsurance professionals. Additionally, the platform's user-friendly interface ensures that users can easily navigate its features and maximize its potential.

Streamline the complete claims process by automating steps from the initial loss notification and fraud detection through to adjudication and final settlement. Enjoy the capability to handle various claim types distinctively, such as death claims and maturity claims, while enhancing adherence to regulations and avoiding penalties for non-compliance. Achieve more efficient and precise processing with features for data collection, payment oversight, salvage and recovery management, legal case processing, and comprehensive monitoring. Ensure effective registration, adjudication, tracking, and oversight of all claim submissions. Utilize integrated and detailed business rules that enable claims to be categorized automatically into “fast track” or “non-fast track” categories. Additionally, you have the option to easily add or adjust stakeholders involved in the process, including garages, assessors, loss adjusters, surveyors, investigators, and claims officers, to further enhance operational efficiency. This comprehensive approach not only simplifies workflows but also fosters collaboration among all parties involved in the claims journey.

FileHandler Enterprise helps TPAs, insurance carriers, public entities and self-insured organizations automate processes and improve efficiency. Our software keeps you on track with automation and customization, creating a standard claims management process for your business. From implementation to continuous, dedicated support through our Quality Assurance and Implementation Team Members, our goal is to deliver our client partners an effective business management tool, empowering them to automate workflows and increase productivity throughout their business cycle. FileHandler Enterprise allows businesses to facilitate integration with several third-party applications. We ensure that our software works well with preexisting systems in an essential part of our goal at JW Software; helping create customized third-party integrations for your preexisting ISOs, state systems, insurance systems, and much more. 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.

Sapiens ReinsuranceMaster serves as an all-encompassing platform tailored for extensive and global reinsurance initiatives, delivering complete control over finances and adaptability for various business sectors. By automating intricate programs with customizable workflows and procedures, it guarantees adherence to auditing standards and statutory regulations, while accommodating operations in multiple countries and currencies. The system significantly improves financial precision with accurate premium calculations, enhanced claim recovery features, and meticulous process monitoring to mitigate financial losses. Integrated analytics provide a unified perspective on liabilities and risks, leveraging a rich data warehouse and crucial KPIs to facilitate strategic decision-making. Additionally, its integration features support standard connections to policy and claims management systems, seamless incorporation with document management tools, and comprehensive management of workflows and activities across different business functions, ensuring a streamlined operational experience. This holistic approach not only optimizes efficiency but also empowers organizations to navigate the complexities of the reinsurance landscape with confidence.

Recordables offers advanced software solutions for managing liability claims, encompassing areas such as General Liability, Auto, Property, and various incidents. Their liability insurance tracking software streamlines the organization of incidents and claims associated with auto, property, and general liability policies. With TrackAbility, users can monitor all liability and risk incidents comprehensively, benefitting from a seamless process that handles injury liability claims from the initial incident to final resolution. The platform allows for the creation of customizable liability claim types based on user-defined criteria, enhancing flexibility and usability. Additionally, safety professionals and field personnel can work together on claims and reports, with the capability to continuously upload images and videos related to incidents or claims. Users gain a thorough perspective of the financial aspects vital for effective claims management, including payments and losses that can be analyzed by individual cases, specific locations, policy details, and other relevant information. This integrated approach not only improves efficiency but also fosters better collaboration and communication among stakeholders involved in the claims process.

Pivot Point is a comprehensive reinsurance transaction platform created by CATEX, aimed at transforming the way brokers and general agents handle reinsurance data. This all-in-one system consolidates placement, contracts, accounting, claims, and reporting functions into a single interface, guaranteeing uniform access and reporting across various business lines. Among its standout features is company management, which maintains critical contact details and relationships; contract management, which offers oversight of a range of contract types with intricate terms; and claims management, which accurately correlates claims data to specific contracts. Additionally, it comprises accounting and settlement functionalities to automate the generation of statements and payment schedules, alongside management reporting and analytics, which leverage built-in dashboards powered by Power BI for superior reporting capabilities. By integrating these diverse functions, Pivot Point not only streamlines operational processes but also minimizes manual workloads and significantly improves data precision. Ultimately, this innovative platform serves as a pivotal tool for enhancing efficiency and effectiveness within the reinsurance sector.

An automated claims platform that operates seamlessly from start to finish, leveraging AI-driven decision models for tasks such as data collection, policy and coverage verification, medical coding, and consistency assessments. Our advanced AI models are designed to minimize losses and enhance your loss ratios by effectively detecting fraud, waste, and abuse in health and life insurance sectors. Qantev empowers insurers globally by improving operational efficiency, curbing losses, and elevating client satisfaction. By integrating artificial intelligence with deep medical knowledge, our dedicated team of data scientists and engineers has created cutting-edge solutions that streamline the claims management process while identifying fraudulent activities. Our specialized AI tools are adept at capturing, cleansing, enhancing, and digitizing data from a variety of claims documents in multiple languages. Additionally, we bolster the performance of your medical provider network with automated insights, identifying pricing gaps, recommending strategies, simulating different scenarios, and much more to optimize outcomes. This holistic approach ensures that insurers not only respond to claims effectively but also proactively prevent potential issues before they arise.

The flagship claims processing solution from Acrometis provides exceptional workflow management by utilizing a configurable rules engine to automatically route documents. This system is built around various elements such as claim assessment scoring, matching body parts to claim compensability, adhering to jurisdictional directives, and scoring relatedness, all aimed at minimizing both the duration and costs associated with claims. Notably, CLAIMExpert can autonomously process 65 percent of incoming medical bills and non-medical documents without requiring any user intervention. Documents that need adjuster review are efficiently flagged and organized to facilitate straightforward decision-making, ensuring that the process remains streamlined. With no need for adjuster involvement for the initial processing, clients often experience an improvement ranging from 11 to 23 points in medical loss within the first year. Furthermore, CLAIMExpert is equipped with rules addressing over 190 different document types, enabling it to swiftly manage whitemail and any other documentation that may arrive at an adjuster’s desk. This comprehensive approach not only enhances efficiency but also significantly impacts the overall claims handling process.

BRMS excels in the efficient and precise processing of all Medical, Dental, Vision, and Retiree claims, ensuring a swift turnaround time. We seamlessly update eligibility each night through our MyHealthBenefits system, maintaining up-to-date information. Our expertise in PPO negotiations allows us to effectively lower costs for employers regarding claims. We oversee the full spectrum of claims administration, from initial receipt and eligibility verification to negotiation and final payment. By centralizing all operations in-house, including claims processing, medical management, PPO network oversight, and billing, we offer a responsive and personalized service experience. For self-insured entities, BRMS serves as an invaluable partner in handling Medical, Dental, and Vision claims with exceptional accuracy and efficiency. Our commitment to quality and customer satisfaction sets us apart in the industry.

The influence of digital technologies on the insurance sector is profound, with those adapting to these changes set to gain a strong competitive edge. Outdated claim management systems that rely on numerous platforms, physical documents, and labor-intensive procedures are now being supplanted by cloud-based enterprise claim management solutions. The Majesco ClaimVantage Claims Management Software for Life and Health simplifies the entire claims process, encompassing every stage from initial intake to payment calculations, while seamlessly integrating various systems to enhance information flow throughout the organization. By ensuring precise and prompt claim decisions, businesses can elevate customer satisfaction and boost operational efficiency. Additionally, built on the Salesforce Lightning Platform, Majesco ClaimVantage Claims Management Software for L&H empowers insurance firms and third-party administrators to not only modernize their claims handling but also to position themselves for future advancements in the industry. As the landscape evolves, embracing such innovative solutions will be crucial for sustained success.

Introducing the revolutionary insurance claim automation system, which is enhanced by innovative blockchain technology. The claims process represents a critical juncture for insurance providers, and our solution is meticulously engineered to streamline claims for both policyholders and insurers, ensuring unparalleled precision and rapid processing—from pre-claim assessments to final payment settlements. MediConCen stands at the forefront of insurance technology, leveraging Hyperledger Fabric blockchain to transform the claims landscape for insurance firms, medical networks, and healthcare facilities. Our platform equips claims adjusters with sophisticated AI algorithms and advanced decision-making tools to swiftly identify fraudulent activities while allowing legitimate claims to be processed without delay, ensuring optimal management of claim costs and remarkable operational efficiency. Additionally, we provide insightful analytics that enhance underwriting processes and drive product innovation, empowering stakeholders with the information they need to succeed in a competitive marketplace. This comprehensive approach not only simplifies the claims experience but also fosters trust and reliability in the insurance industry.

Verisk's A-PLUS™ Personal Lines Loss History Solutions equip insurers with tailored tools that grant access to up to seven years of claims and loss data, facilitating precise underwriting and rating choices. The solutions come with versatile options, such as comprehensive reports that comply with the Fair Credit Reporting Act (FCRA) and the Claims Activity Profiler (CAP), which highlights claims activity during the quoting process. By incorporating A-PLUS into their operations, insurers can improve the accuracy of initial quotes, minimize unforeseen premium fluctuations at the time of binding, and enhance the overall experience for customers. The proprietary algorithm of the system guarantees thorough claim documentation with minimal input required, thus optimizing the underwriting workflow. Furthermore, A-PLUS includes valuable features like access to over 300 million crash records, which help to fill in gaps in loss history reports, ultimately offering a more holistic perspective on an applicant's risk profile. This comprehensive approach not only aids in better decision-making but also fosters stronger relationships between insurers and their clients.