Next Generation Claims Systems

Decision Management delivers next generation claims systems that act immediately, increase agility, consistency and accuracy, improve customer satisfaction, speed response and reduce costs. Insurers can achieve significant speed-to-market gains, reduce fraud and create innovative new claims processes.

Today’s insurance claims systems deliver value to insurers by increasing efficiency through business process automation and workflow. The use of manual decision points within these processes and systems, however, creates bottlenecks and under-utilizes company expertise. Insight gained from data mining and analytics is restricted to the back office and IT resources cannot be freed up from legacy systems maintenance. Leading insurers are implementing a new generation of Decision Management claims systems.

  • Next generation claims systems with Decision Management recognize decisions as reusable assets and replace decision points like claim adjudication or fraud detection with Decision Services.
  • These use business rules to eliminate manual reviews, increase agility and put business users in control. Data mining and analytic insights feed back into these Decision Services to improve the accuracy and effectiveness of these decisions while ongoing Decision Analysis creates a process for continuous improvement.
  • Insurers are adopting Decision Management to build next generation claims systems that improve claims processes. Decision Management leverages modern IT architecture to build on existing IT systems, avoiding costly rip and replace initiatives.

“Our business rules were locked up in code and this led to a lack of agility. Changes we needed urgently were taking 12-plus weeks to implement.”
– VP Business Systems Implementation

“With predictive analytics, we can fast track valid claims or flag possible counterfeit claims for further review, saving our customers time and money.”
– SVP of Claims

Download our free white paper to learn more, or schedule a free consultation.

Next Generation Claims Systems