Transform your Claim Management
Transform your business
With unrivalled speed to market, our solution eliminates legacy software issues, reduces implementation costs by over 60%, and transforms the way you process claims, today, and into the future.
Get Your Claims in the Cloud
Our claim management software solution is state-of-the-art and designed to process both group, individual, and worksite life and health products on one digital platform. Supporting a broad range of policy benefits, the software leverages a claimant-centric approach to help you deliver a superior customer experience with efficiency and accuracy.
Our cloud-native claims solution is hosted on the secure Salesforce Lightning Platform, and has a user-friendly interface, with deep functionality built by industry experts that will change the way you process claims today and into the future.
Claim Management Software
Our Claim Management Software supports the full life cycle of a claim, from intake through to payment calculation. This claimant-centric process drives accurate and timely claim decisions. Designed with efficiency and usability in mind, our solutions minimise the number of screens a user needs to navigate to process a claim.
Claim Management Software
One Central Platform
To manage individual, group,
and worksite benefits
No More Manual
- Death Cover
- Income Protection
- Critical Illness
- Long Term Disability Income
- Waiver of Premium
Learn More About
Our claim management software
The claim intake ‘wizard’ guides the user with reflexive questioning to ensure the necessary data is collected to create a claim. This process can be configured to meet your specific business needs.
Once created, a claim can be manually or automatically assigned to a user or team on pre-defined criteria such as geographical location, or team structure.
Introduce automated workflows to auto-adjudicate claims based on specific rules. These rules can be configured to process claims based on a number of fields, including the benefit type, eligibility status, or payment specification. Introduce assignment rules with due dates to keep claim durations on track. All auto-adjudication rules and workflows can be configured, depending on the level of automation you would like to introduce to your claims.
- Automate your communication workflows using auto-adjudication.
- Auto-generate tasks to help your team manage their work.
- Create and send timely letters, emails, and SMS to policyholders.
The case management journal is the ‘heartbeat’ of the claim. Based on the traditional paper file, the journal is divided into several categories for easy access to various sections, such as benefits, policy, and claim information, where claim assessors can:
- View benefit claimed details.
- Initiate an approval process when the benefit claimed status changes.
- Write a detailed synopsis.
- Document an action plan and next steps.
- Review and re-run eligibility rules.
- Attach forms and documents.
- Add and review notes in various categories.
- Document and view information in many sub-categories.
- View claim status and metrics.
All information in the journal can also be easily exported in PDF format.
Payments are calculated based on the claim, policy, and benefits information provided. Whether you want to consolidate payments, set up automated scheduling, or make a lump sum payment, the software can be configured to meet your needs. Depending on your business process, the payment calculation options can be configured to allow claim level or beneficiary payments.
Take A Look At Our Case Studies
We’ve helped global insurance carriers, TPAs, and large employers to digitally transform their benefits administration; by introducing digital files stored on one central platform, integrating external systems to improve the flow of information, and introducing auto-adjudication to improve operational efficiency