Pegasystems Revolutionizes Insurance Claims Management With Faster Time-to-Value and Reduced Total Claims Costs

Pegasystems Inc. (NASDAQ: PEGA), the leader in business process management (BPM) and a leading provider of customer relationship management (CRM) solutions, today unveiled a new insurance claims solution that revolutionizes the way insurers process claims and deploy claims management functionality across operations. Pega Claims for Property and Casualty Insurers provides greater ease-of-use and faster time to value through a single, unified and strategic platform designed to support the varied claims management needs of insurers.  Pega’s Build for Change® technology delivers rapid deployment and increased flexibility without compromising rich "out-of-the-box" functionality.

The Pega Claims solution features market-leading case management capabilities which free up claims operations from manual, inefficient tasks by automating work activities and guiding support staff to the next best action, for better decision making and outcomes throughout the life cycle of the claim. These advanced capabilities foster best practices across operations and support all the components of a claim case by actively monitoring and managing the various roles and processes associated with case components. This approach also streamlines claims handling and improves quality by providing complete visibility into claim activities, status, service level agreements (SLAs) and financials for each occurrence. Insurers benefit from a more effective way to both increase customer satisfaction and control claim costs.

The solution also leverages decision management to improve claim adjudication. The dynamic, intelligent decisioning approach to claims management helps insurers reduce claim costs and mitigate claim leakage.  Insurers also benefit from a lower total cost of ownership; they can leverage existing investments in legacy systems to achieve enhanced claims functionality in 90 days or less. The extensible and configurable nature of the solution with built-in support for multi-channel servicing means business users can adapt quickly to changing market or business needs. The results are optimal claims outcomes and a reduced total cost of risk.

Pega Claims Highlights

This new insurance solution dramatically improves claims operations by:

  • Rapidly implementing configurable, end-to-end claims processes for general liability, personal and commercial auto.
  • Improving retention with a consistent and efficient customer service experience. 
  • Controlling total claims costs with effective investigation, reserving, settlement and subrogation best practices.
  • Integrating content management into the claims process.
  • Delivering real-time insight and management reports on process and operational performance.

Supporting Quotes:

Karen Pauli, Research Director, Tower Group:

"Carriers must adopt claims technology that can facilitate straight through processing for routine claims as well as complex case management with multiple elements. With the proliferation of channels and multiple stake holders in individual claims, carriers cannot relegate management to manual processes and static, inflexible rules. Leaders in the claims space recognize that technology that assesses dynamic claim characteristics and supports decisions by multiple claim workers will make the difference in bottom-line results. TowerGroup research shows that customer satisfaction and expense reduction are of equal importance to claims executives. Technology that can rapidly propel a carrier to meet both goals will be a competitive differentiator."

David Carlon, Director of Insurance Industry Solutions, Pegasystems:

"Property and casualty insurers need a claims solution that is easier to use, but with significantly faster time to business value. Frankly, the insurance market should not have to tolerate slow deployments and lengthy IT efforts.Insurers need a new kind of solution that is designed by and for insurance business users, with intelligent automation of industry best practices. Pegasystems’ new solution dramatically reduces complexity, accelerates business value, and lowers claim servicing cost because, unlike legacy approaches, it delivers full end-to-end claims process capabilities on a single, unified and open platform."

Supporting Resources:

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About Pegasystems

Pegasystems (NASDAQ: PEGA) develops strategic applications for marketing, sales, service, and operations. Pega’s applications streamline critical business operations, connect enterprises to their customers seamlessly in real-time across channels, and adapt to meet rapidly changing requirements. Pega’s Global 3000 customers include many of the world’s most sophisticated and successful enterprises. Pega’s applications, available in the cloud or on-premises, are built on its unified Pega 7 platform, which uses visual tools to easily extend and change applications to meet clients’ strategic business needs. Pega’s clients report that Pega gives them the fastest time to value, extremely rapid deployment, efficient re-use, and global scale. For more information, please visit us at

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The information contained in this press release is not a commitment, promise, or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described remains at the sole discretion of Pegasystems, Pegasystems specifically disclaims any liability with respect to this information.


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