Claims Processing Software

Pega Claims Processing Software Delivers Intelligent Automation

Insurers need claims processing operations that are customer-focused, cost-effective, and adaptable. Claims processing software from Pegasystems helps many of the world’s largest insurance companies achieve these objectives, under the most demanding conditions. Powered by our industry-leading business process management (BPM) platform, Pega claims processing software enables insurers to build and deploy automated end-to-end claims processes that are:

  • Highly intelligent. Automated processes can only be as intelligent as the business rules that drive them, and the Pega BPM platform delivers business rules functionality that far surpasses competing solutions in sophistication and flexibility. With Pega BPM powering your insurance claims software, you can 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 company’s best thinking consistently across the organization.
  • Agile. More than any other process management solution, Pega BPM empowers business users to create new automated processes and services with minimal reliance on IT staff. With Pega’s patented Build For Change® technology, you can quickly adapt your claims processing software and other insurance software solutions to keep up with changes in business objectives or the marketplace.
  • Ready to deliver ROI. Pega BPM integrates seamlessly with your existing enterprise systems, to facilitate rapid deployment. And our solution frameworks for claims processing software and other types of insurance policy management software provide a foundation of industry best practices upon which you can quickly create your own customized applications.

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Feature-Rich Claims Processing Software

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.

In addition to powering intelligent, agile claims processing software, Pega BPM is the ideal platform for other types of insurance management software, including compliance management software, claims management software and fraud case management applications. With comprehensive solutions that meet the insurance industry’s most pressing business needs, it’s no wonder that seven of the top ten insurance companies use Pega software.

Learn more about Pega insurance solutions.