By Brynne Ramella, Content Marketing Manager, ProNavigator

Getting reimbursed for claims is a high priority for your policyholders. That puts a lot of pressure on your adjusters. Traditional insurance claims processing involves adjusters dealing with large volumes of paperwork. Relying on those manual processes or legacy software can lead to improper claims, incorrect quotes, or lost documents.

If your organization is starting to experience these issues, it’s time to upgrade your claims management software. In this article, we’ll break down the business needs to consider and the features to prioritize before purchasing a new solution.

What to consider before buying claims management software

Claims management solutions are not a one-size-fits-all technology. You need to make sure that you select a tool that is tailored to the unique needs of your business. Before you start investigating software solutions, ask your internal stakeholders the following questions. The answers you get can help dictate the claims management software you look for.

Do you need on-premises or cloud software?

On-premises software is installed directly on your internal IT system. Cloud-based software is stored, managed, and accessed through the cloud. There are benefits to both options.

On-premises systems are often more customizable, and cloud-based software requires fewer IT resources. Talk to your IT department and see which option is most compatible with your current software setup.

What systems do you need to integrate?

Consider additional software solutions your claims department uses on a daily basis, such as your insurance knowledge management system. Make sure your new solution integrates with these existing tools. A claims management tool might look perfect on paper. But if you don’t integrate with the tools your claims adjusters use, you’re making your job more challenging.

What are your growth plans?

Make sure you are aware of any plans to grow the claims department in the coming months. If your department plans to hire a few additional fitters, select a software solution that can accommodate more users.

What insurance plans do you offer?

The lines of insurance you provide may dictate the claims management solution you choose. Some vendors will offer customizable solutions, but others may have a narrower focus on specific lines. Talk to the providers you’re considering and make sure they’re compatible with your company’s insurance offerings.

What features should you look for in claims management software?

Considering your specific business goals and needs is the first step in finding the right claims management solution for your business. The next step is to make sure that the tool you select can work in the exact way you need it to. Here are some general features to look for in a claims management solution.

First Efficient Loss Notification (FNOL)

The purpose of a claims management solution is to make the entire claims workflow run faster and smoother. One way to speed up the process is by selecting a solution with a feature of FNOL. These solutions can determine the probable total losses in the FNOL with only photographic data. Adjusters can quickly determine the next steps in a claims process with a feature like this.

Easy claims filing process

Customers expect digital experiences: the insurance customer experience is no different Your policyholders want to be able to easily file their claims. Prioritize tool selection with an intuitive, mobile-friendly customer portal that makes this process easy for users.

Risk assessment and fraud detection

This is a critical function in a claims management solution. Fraud detection and risk assessment features enable adjusters to perform comprehensive risk analysis and manage fraudulent claims by verifying details from various sources of information. That will allow your customers to get reimbursed faster.

Automated workflow

Go with a solution that automates the spreadsheets and manual work associated with traditional claims processing. An AI-powered automated claims management solution can speed up the document processing schedule for current cases. Adjusters will also be able to review information from a previous claim, all in one secure location.

Enhanced reporting capabilities

Claims administration and management is a data intensive process for your adjusters. But with the right software, you can use that information to your advantage. Select a tool that provides comprehensive reporting and analysis that you can take advantage of to improve processing time, customer service and business results.

Claims tracking

A claims tracking feature allows you to standardize data workflow management for all incoming claims. You’ll be able to track the description and cause of loss, define claim types, and offer customer-specific data fields. When you have a solid understanding of claims data, you’ll have a better picture of the risk your organization faces.

processing payment

While the insurance industry as a whole faces pressure to go digital, there is no department more affected than claims. Insurance consumers want the ability to be reimbursed for your claims digitally. Look for a system that offers multiple payment options and has top-notch security features. Train your call center agents on the platform so they can provide a human point of contact to claimants when needed.

Improve employee experience and customer satisfaction with claims management software

At ProNavigator, we believe in the power of technology to improve the customer experience and daily operations of insurance companies. The right claims management software will streamline your adjusters’ workflows and lead to faster resolutions for claimants. A smoother claims handling process will lead to a positive customer experience and productive employees.

visit our blog to learn more about the benefits of enhancing your company’s technology stack.

About ProNavigator

ProNavigator provides a knowledge sharing platform, Ask Sage, used by some of the largest insurance organizations in North America to save time, provide superior service, and realize revenue opportunities. The platform leverages the latest advances in artificial intelligence and natural language understanding to instantly, automatically, and accurately retrieve answers to employee questions. For more information please visit

SOURCE: ProNavigator

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