Insurance providers need an efficient way to handle the entire claims management process from end-to-end—from the first notice of loss to setting up a claim, processing and settling.
When the insurer is first notified, the claims processing life cycle is kicked off. During this workflow, insurance professionals need to track the claims in a way that reduces costs, avoids fraud and improves customer service and communication.
This guide is designed to help insurance providers and agencies searching for a claims management system. In it, we look at common features, types of buyers, costs and trends that may impact your business.
Here's what we'll cover:
What Is Claims Management Software?
Common Claims Management Software Features
Benefits of Claims Management Software
Key Considerations When Purchasing Claims Management Software
How Much Does Insurance Software Cost?
Recent Events You Should Know About
Claims management software offers tools to streamline the process of moving a claim through the initial contact all the way to a resolution that is satisfying to the customer and your company.
A view of claims being tracked in Insly
Throughout this task, users can leverage external sources to verify information, manage important documents, track customer details and utilize reporting tools to spot trends in operations.
Claims management systems potentially include several features designed to guide users through the full workflow. These can include:
|Claims tracking and workflows||Provides core claim workflows to standardize the majority of incoming claims. Many systems also offer the ability to modify existing or customize new workflows to fit the service provider's needs.|
|Electronic claims||Enables the filing of claims from customers electronically.|
|EDI data exchange integrations||Helps manage a large number of claims at once, importing from multiple insurance carriers.|
|Fraud management||Allows insurers to identify and manage cases of fraudulent claims by tapping into various sources of information and verifying details. Sources may include other claims the customer has submitted, publicly available information or social media.|
|Document management||Assists companies with the many paper and electronic documents necessary in the claims management process by storing and organizing them.|
|Customer portals||Allow customers to submit and view claims information online, increasing convenience.|
|CRM||Provides for integration with a customer relationship management (CRM) module so customer details can be easily reviewed during the claims management process.|
|Reporting||Claims processing data can be analyzed to reveal areas of improvement, which may involve processing times or specific details about claims that can highlight trends.|
The customizable workflows and tracking capabilities available in claims management systems result in some significant benefits for agencies:
For any software purchase, there are some important factors to consider that can impact the success of the investment. Some are universal, and some are specific to your particular type of business:
On-premise or cloud-based deployment? Insurance and claims management software are offered via two different types of deployments—on-premise or cloud-based. On-premise is the traditional method of installing a system on the buyer's computers, while cloud-based software (also called Software-as-a-Service, or SaaS) is accessible through a web browser.
On-premise is usually a more customizable option, but requires more IT resources. And cloud-based systems don't typically include a large upfront cost to get started. Evaluate these options for each vendor to determine the best fit.
What integrations do you need? Some types of software, such as CRM, accounting or advanced business intelligence systems, are used by a wide variety of industries. You may want these systems to connect with the claims management functionality. It's important to discuss integration options with any vendor you decide to work with.
What type of insurance do you offer? Based on whether you provide property and casualty (P&C), life and annuities (L&A) or health insurance, some claims management software vendors can offer workflows for different types of claims. Ask whether vendors can customize aspects of the system so your daily tasks are as streamlined as possible.
Unlike some other software types, claims and insurance software vendors don't often list this information online, for a reason. Usually, it's because they want you to call for more details, so they can sell you on other software features.
Most insurance systems are offered on a subscription pricing plan, and you're likely to find a stand-alone claims management system for a few hundred to $1,500 per month.
Some subscription costs may also include specific parameters, such as a price per user. Keep your budget in mind when evaluating pricing plans to find one that makes the most sense for your needs.
Current world events can have a significant impact on claims management. Here are some recent happenings that could impact your software search:
Growing advancements in technology enhance fraud detection. For years, fraudulent claims were simply a part of the insurance world, but technology is changing that. Predictive and machine learning capabilities in software are allowing insurance providers and agencies to identify fraudulent claims before they are paid out, saving time spent trying to reclaim losses.
Modern vendors are helping to make these tools feasible for smaller agencies. You can ask vendors about their product road map to see if these capabilities are planned for a future release.
2017 was the most expensive year to date for agencies, due to natural disasters. Damages from the 2017 Atlantic hurricane season topped more than $200 billion in damages with 17 major storms, including Harvey, Irma and Ophelia.
These types of disasters cause a surge of claims for insurers, so proper automation is necessary to handle this increase, and software is capable of processing a large volume of claims during catastrophes.
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