Alternatives to ClaimScore
Compare ClaimScore alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to ClaimScore in 2026. Compare features, ratings, user reviews, pricing, and more from ClaimScore competitors and alternatives in order to make an informed decision for your business.
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1
Cloud Claims
APP Tech
Improve claim outcomes with streamlined First Notice of Loss (FNOL), claim processing and flexible reporting. INCIDENT BASED CLAIMS MANAGEMENT Effective claims management is about more than simply managing claims outcomes. It is about having an automated process that ensures efficiency and accuracy across the organization, getting timely notice of losses, and taking swift action are keys to success. The incident-based approach of Cloud Claims covers all accidents and losses, delivering a complete picture of loss to executives and claims managers. Cloud Claims by APP Tech is an integrated solution that is highly configurable, with actionable reports to guide decision-making and a friendly UI so you can get work done faster and more confidently. Cloud Claims runs in the cloud, so there’s minimal IT burden and no installation required — just simple configuration, effortless system upgrades, best-in-class security, and the ability to scale quickly.Starting Price: $2,500 per month -
2
Virtual Examiner
PCG Software
Virtual Examiner®, PCG Software’s flagship product, monitors the internal claims process of an organization to trend provider data for fraudulent and abusive billing patterns, and maximizes financial recoveries. PCG Software’s Virtual Examiner® allows healthcare organizations to enhance their current claims adjudication system with more than 31 million edits per claim. The software solution monitors an organization’s internal claims process to identify unclean claims and reduce payment for improper or erroneous coding to conserve premium dollars. Virtual Examiner® is more than a claims review solution with a focus on code combinations. It is a cost containment solution that evaluates the claim not only for abusive billing patterns but also identifies those claims that may involve third-party liability/coordination of benefits, case management opportunities, physician billing education and many other cost recovery reports. -
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
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. -
5
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 -
6
MotionsCloud
MotionsCloud
All in one mobile & AI solution to reduce insurance claim cost and claim cycle time from days to hours. The value of the damages are estimated in real-time through the MotionsCloud estimation engine. The evidence collected is of the highest quality and in various kinds of media forms, including text, audio, photo and video. All evidence is stored in a high graded security standard, eliminating the possibility of fraudulent. Claims expert working closely with customer remotely through voice & video communication to complete the claim settlement. Improve customer satisfaction via smooth and efficient process. A great claims experience helps to retain clients and convert claimants. -
7
eOxegen
eOxegen
eOxegen is an AI-powered claims management system designed to streamline and enhance the efficiency of health insurance operations. Automating claims processing through a Straight Through Process (STP), reduces manual intervention, leading to faster claim settlements and improved accuracy. It incorporates advanced fraud detection capabilities, utilizing AI algorithms to identify and flag potentially fraudulent activities early in the process. Additionally, eOxegen offers features such as provider contracting and empanelment, pre-authorization management and adjudication, and robust reporting with business intelligence analytics dashboards. Its AI-driven workflow automation ensures consistent task completion, minimizes repetitive activities, and enhances overall productivity. By integrating these functionalities, eOxegen empowers insurance companies and third-party administrators to optimize their claims management processes, and reduce operational costs. -
8
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. -
9
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. -
10
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. -
11
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. -
12
LexisNexis Claims Compass
LexisNexis
Automate with confidence and improve efficiency by embedding timely, reliable insights directly into your claims management system. Embed timely, reliable insights directly into your claims management system through Claims Compass, a scalable, system-to-system multi-solution platform. Improve cycle time and streamline the claims handling process while reducing your costs with a platform that delivers robust data and analytics. Streamline workflows and more easily apply powerful analytics to gain insightful intelligence that drives better decisions at every step of the claims handling process. Help reduce fraud through a more efficient way of receiving predictive analytics, sophisticated investigation and medical provider management tools. Make customers whole again faster with a claims management system that taps unparalleled processing power. -
13
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. -
14
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. -
15
Dragonfile
Dragonfile
Dragonfile – The Smarter Way to Manage Claims. Dragonfile is a powerful, intuitive claims management solution designed specifically for adjusters and adjustment companies. Built by industry experts, Dragonfile streamlines workflows, automates updates, and organizes files—helping adjusters save time, reduce stress, and focus on resolving claims efficiently. ✅ Centralized File Management – Keep all claim documents in one secure place. ✅ Automated Notifications & Reminders – Never miss a deadline again. ✅ Seamless Accessibility – Work from desktop, tablet, or mobile—anytime, anywhere. ✅ Zero to Minimal Training Required – Simple, user-friendly interface built for adjusters. ✅ Customizable Workflows – Adapt to your process and work smarter, not harder. Whether you’re managing P&C or Flood claims, Dragonfile simplifies the process, eliminates manual work, and enhances productivity. -
16
ClaimXperience
Xactware
Now claims representatives can truly collaborate with policyholders. Involving the policyholder more deeply in the claims process can help improve customer satisfaction and reduce claims-handling costs. Policyholders today expect a high level of service that works around their schedule, not yours. Policyholders who are closely involved in the claims process from start to finish are more likely to be more satisfied with the experience. Gain the advantage of “eyes-on-site”—right from the desk. ClaimXperience video collaboration helps you effectively triage the claim and assess the severity of damage. With greater accuracy, you can directly settle more claims, saving the cost of an on-site visit. And when an onsite visit is needed, you can send the right person the first time. -
17
Veritable
314e Corporation
Veritable accelerates patient insurance eligibility verification and claims-status checks by providing instantaneous results in a clean, intuitive interface. It supports real-time, batch uploading of patient lists to verify eligibility across more than 1,000 payers (including national Medicare and all state Medicaid) and multiple service types. It also enables tracking of claims status, from submission through reimbursement, so practices and billing companies can proactively identify issues to reduce payment delays and denials. Key benefits include automating eligibility and claims workflows to reduce manual entry and phone calls, improving front-desk patient experience by validating coverage and copayments at check-in, and offering seamless integration for both technical and non-technical users with strong data-security controls. It includes a “Code Explorer” for instant lookup of ICD-10-CM, ICD-10-PCS, HCPCS Level II, and CPT codes.Starting Price: $50 per month -
18
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. -
19
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. -
20
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. -
21
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 -
22
Sprout.ai
Sprout.ai
Our AI-powered technology helps you deliver fast and accurate claims decisions, enabling you to better serve your customers. However, by adapting certain features and data sources, we have developed a solution that’s configurable for every insurance line, from health and life insurance to motor and property. Sprout.ai provides fast and accurate claims decisions whatever the sector. From handwritten doctor’s notes, to call transcripts and prescriptions, our technology extracts all the relevant information from any type of claim document. The claim is validated with external data points such as treatment codes, provider network policies, or medication information, and then checked against policy documents. Deep learning AI algorithms predict the best next step for a claim and pair it with a clear justification. -
23
ClickClaims
E-Claim.com
ClickClaims is ideally suited for small to mid-size property and casualty insurance carriers, independent claims adjusting firms, and third party administrators who need the advanced technologies that drive a competitive market. ClickClaims SaaS model allows for rapid deployment, unlimited scalability, performance, security and versatility that legacy systems cannot match, at a fraction of the cost. Built to evolve as technologies emerge, your investment appreciates over time. -
24
ARNIE
Yarris
ARNIE is a motor claims management platform that streamlines the motor claims process by integrating the people and the systems behind the scenes to make handling simple. Claims handlers use ARNIE to get the right information at the right time. Assessors use ARNIE and it’s mobile solutions to capture and complete vehicle assessments in the palm of their hand. Repairers use ARNIE to be able to effectively work with insurers to get the job done. We are excited to be working on simple AI and ML solutions, as well as being the support you need to integrate them into your business and your technology ecosystems. We believe that small improvements over time will change the world of motor claims, but we also like to dream big and realize the future is not that far away. -
25
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. -
26
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. -
27
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 -
28
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. -
29
AI Insurance
AI Insurance
AI Insurance is a modern, cloud-based, AI-powered insurance management platform designed to streamline and automate workflows for program managers, captives, third-party administrators, and risk retention groups. The platform consolidates various functions into a single interface, including claims management, financials, digital portals, and application processes, premium billing, policy issuance and signature, rating engine, and data management. Key features include AI-backed automation for tasks such as invoice auditing, where defense counsel invoices are parsed and audited against guidelines to prevent unauthorized legal fees, and application parsing, which extracts data from received applications to populate forms automatically. Additionally, the platform offers indemnity prediction capabilities, claiming to be 25% more accurate than adjusters after a year of usage, providing cost predictions and recommendations for claims.Starting Price: $1,089 per year -
30
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. -
31
ScoutWorks
ScoutWorks
ScoutWorks is a next-generation service platform that enables users to access, manage, and track a wide array of solutions, ranging from field inspections to AI-driven claims processing. The platform offers over 30 different types of services, including field inspections and appraisals for auto services, heavy equipment, specialty services, and property services. It also provides photo inspections through tools like Scout and Scout Snap, virtual inspections and appraisals, underwriter inspections, and on-demand desk adjusters for tasks such as desk reviews, subrogation reviews, and claim analysis. ScoutWorks integrates technology solutions with a nationwide professional workforce, delivering services across all 50 states and Canada. With over 20 years of operational experience, the platform emphasizes transparency, accountability, and consistency in claim management and outsourcing solutions. -
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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. -
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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
Claimable
Claimable
Claimable is claims management software for businesses that removes the headache of managing insurance claims. Increase your claims handling capacity by spending less time on admin. Stop searching shared folders and inboxes. Your claims data is just a few clicks away! Your data is securely stored in the cloud and is accessible from anywhere. No more paper! Be ready for an audit with a complete history of each claim at your fingertips. Keep track of your documents and access them whenever and wherever you need! Filter and report on your claims data, to drive productivity and stay informed. Label your claims to categorize and organize them to suit your workflow. Keep detailed notes on each claim and collaborate and share with your team. Assign tasks to your team and see at a glance which are due or completed. Build and manage your claims contact database, and find contacts in an instant.Starting Price: $79 per month -
35
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. -
36
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. -
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Curacel
Curacel
Curacel’s AI powered platform enables insurers track fraud and automate claims seamlessly. Collect your claims from your Providers in real-time and easily auto-vet the claims. Curacel Detection helps you detect and curb fraud, waste and abuse in the Claims Process. Collect claims from their providers and prevent fraud, waste and abuse in the claims process. We studied the Health Insurance industry to understand where the most value is lost by Insurers. This was identified to be the Claims Process. The Process is mostly manual and is fraught with a lot of fraud, waste and abuse. Our solution, driven by AI, helps to curb wastage and make the Insurer more efficient, thereby making them unlock hidden value. ravel insurance is peculiar in that it is built on on-demand policies that cover relatively short periods of time. Should a policy holder want to make a Claim, both the insurer and the insured want claim settlement to be as efficient and accurate as possible. -
38
ClaimBook
Attune Technologies
ClaimBook enables faster settlement of insurance claims, improved accountability and fewer rejections. It is well equipped with the features to address every part of the claims and evidence submission. ClaimBook supports international patient treatment with dedicated workflows, therefore enabling medical tourism. A built-in Rules Engine that disallows incomplete submissions, and knows what information and documents need to be submitted. This results in error-free submissions that are complete and guarantees that it is pre-authorized. ClaimBook's Smart Data Extraction can read documents uploaded to extract relevant data from the Hospital's Information System (if integrated with ClaimBook) to prevent the need for manual entries. ClaimBook also features Integrated Emailing by creating a virtual inbox in your dashboard. Withing the dashboard, emails can be composed, the design feature is similar to Microsoft Outlook. -
39
Vitesse
Vitesse
Streamline your claims payouts, achieve real-time visibility and control, and reduce capital requirements. Whether you're involved in underwriting risks, selling insurance products, handling claims settlements, or any combination thereof, our solutions deliver substantial value to your operations. Our platform seamlessly integrates with strategic tier-1 bank partners, providing a secure infrastructure for protecting and controlling your claim funds, even when delegated to third parties. By pooling and streamlining claim funds with Vitesse, you can unlock up to 80% of your capital tied up in claims operations, redirecting it to other areas of your business to generate new revenues. Our platform enables fast, full-value payments across 180+ countries and currencies using versatile methods such as bank transfers, checks, pay-to-card, and more. Our solutions are designed to empower each stakeholder, providing a competitive edge in claim funds management and operational efficiency. -
40
Reimbursify
Reimbursify
Reimbursify is the first and only mobile-enabled, software platform delivering a truly innovative solution empowering patients, serving practitioners, and enabling digital partners to easily file out-of-network reimbursement claims for medical and mental health services. Reimbursify is the fast, easy way to file out-of-network (OON) reimbursement claims from your health insurance company! Our intelligent app takes the pain and trouble out of claim filing to make sure you get all the money coming to you. Fast, streamlined registration for primary insured, spouse & dependents. Smart dashboard manages all your claims and keeps track of money you’re on track to collect. Proprietary Rejection Resolution Pathway to help resolve rejected claims fast. Provider search function that auto-populates provider information.Starting Price: Free -
41
SSI Claims Director
SSI Group
Elevate your claims management process and decrease denials through unmatched edits and an industry-leading clean claim rate. Health systems require access to technology that facilitates accurate claim submission and rapid reimbursement. Claims Director, SSI’s claims management solution, streamlines billing practices and provides visibility by guiding users through the electronic claim submission and reconciliation process from beginning to end. As payers change or modify reimbursement criteria for services, the system actively monitors and incorporates these changes and requirements. And with a comprehensive mix of edits at the industry, payer and provider levels, the solution aids organizations in making the most of reimbursement efforts. -
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Oracle's Digital Insurance Platform empowers insurance providers to deliver innovative solutions and exceptional digital customer experiences. This comprehensive insurance management system streamlines operations from sales channels to back-office processes, enabling rapid deployment of new offerings and seamless implementation of necessary changes. With real-time analytics, insurers gain valuable insights into their business, facilitating informed decision-making. The platform supports both individual and group life and annuity insurance, consolidating underwriting, policy processing, billing, and claims into a single, efficient system. Health insurers benefit from simplified enrollments, premium billing, and claims adjudication, enhancing member satisfaction through transparent and personalized services. Additionally, the platform accelerates the bancassurance lifecycle by providing real-time connectivity between banks and insurers, ensuring speed, consistency, and reliability.
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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. -
44
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. -
45
Openkoda
Openkoda
Openkoda is an application development platform purpose‑built for the needs of the insurance sector. It lets carriers, insurtech, MGAs, insurtech start‑ups and service vendors stand up full‑featured web apps, APIs and internal tools in a fraction of the time traditional development requires - while still giving the team full ownership of the source code. The platform is built upon an open‑source stack which guarantees freedom from vendor lock‑in. A modular architecture with pre‑built templates accelerates common insurance flows - policy issuance, claims, endorsements, renewals, yet everything runs in containerised environments that scale horizontally and charge no per‑user fees. Openkoda ships with domain‑specific accelerators: an AI‑ready policy‑administration core, claims workbenches, embedded‑insurance checkout components, and underwriter dashboards that can pull external risk data or trigger machine‑learning models.Starting Price: $4000/month -
46
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. -
47
DRILLER
DGTAL
DRILLER is a powerful deep analytics tool that enables digitization and drilling into insurance portfolios by analyzing structured and unstructured data. Improved understanding and full durability of the portfolio and claim composition. Faster reserve release, to lower solvency capital requirements and cost of capital. The tool is powered by artificial intelligence models that support the analysis of a portfolio and claim and predict potential adverse development of a claim (severity score). Earlier identification of potential under or over-reserved claims. Full searchable documents and claims with a detailed understanding of portfolio composition. Identification of characters, numbers, and sentiment, classification of documents, and identification of claim characteristics. Review and prioritization of critical claims that require immediate action, with a full automated analysis of the portfolio. -
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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. -
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KGiSL n-sure
KGiSL
NSURE is the first ever AI-powered comprehensive and modern insurance management system designed for core operations, policy administration, claims administration, and operational automation for both Life and Non-Life insurance businesses. This fully integrated, web-based application enables customers and agents to generate policies online while leveraging automation to enhance business performance, efficiency, and productivity through digital solutions. -
50
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.
