Claims Processing Software

How Claims Processing Software Works

Claims processing operations are required to be customer-focused, cost-effective, and adaptable. Claims processing systems help many of the world’s largest insurance companies achieve these objectives under the most demanding conditions.

Claims processing software for insurance, healthcare, manufacturing, and other industries should enable organizations to develop automated end-to-end processes that are highly intelligent, agile, and ready to deliver ROI. These software solutions should also allow agents to easily create intelligent, dynamic business rules that fully capture company objectives and best practices, and use those rules to drive automated processes that apply the best thinking consistently across organizations.


Build For Change: Omni-Channel UX

Pega’s Omni-Channel UX delivers an optimized and consistent user experience in every channel.


Claims Management for Life Insurance

Improve claim accuracy and consistency while reducing costs.

Feature-Rich Claims Management Solutions

Pega’s solution framework for claims processing software is rich with built-in features including:

  • Intelligent data capture for FNOL, NOL, and FROI, with dynamic flows and forms that respond to the customer’s needs
  • Support for multi-channel claims entry via mail, fax, contact center, Internet, or email
  • Data integration for all types of information including databases, flat files, images, PDF, and major APIs
  • Comprehensive case management tools, with built-in SLA performance tracking
  • Early detection and alerting for patterns indicating potential fraud
  • Self-documenting processes that simplify auditing and compliance reporting

Additionally Pega BPM integrates seamlessly with your existing enterprise systems, to facilitate rapid deployment. Pega’s claims processing software, and other types of insurance policy management software, provides a foundation of industry best practices upon which your business can quickly create its own customized applications.

Additional Resources