Claims Management Software

Riskonnect’s Claims Management software streamlines the claims process from intake to final settlement.

Track all claim details in one place. Seamlessly integrate people, systems, and data from multiple sources.

Reduce costs. Streamline workflows, automate routine tasks, and facilitate collaboration among stakeholders to shorten the claim lifecycle.

Resolve even the most complex claims quickly, easily, and fairly. Move every claim through the system with maximum efficiency.

Claims Management Software dashboard on laptop screen

Claims Management Software

Product Highlights

  • Intake
    Streamline your claim and incident entry with intuitive mobile forms, automatic alerts, real-time access to data, and instant data validation.
  • Electronic Report
    of Injury
    Complete and send complex electronic filings for First Report of Injury (FROI) and Subsequent Report of Injury (SROI) to keep you compliant with state workers’ compensation requirements.
  • Assignment
    Triage claims for quicker, more efficient handling based on adjuster experience, workload, location, and other criteria.
  • Reserve
    Management
    Create and maintain indemnity benefit schedules with full reserving functionality while capturing an audit trail of all recorded changes.
  • Adjudication
    Streamline adjuster tasks and notifications using configurable data-entry screens, rules, and forms.
  • Settlement
    Efficiently manage and process recurring payments, multiple pay parties, and garnishments.
  • Subrogation
    and Recovery
    Quickly identify recovery opportunities and simplify the subrogation lifecycle.
  • Return to Work
    Manage the complete return-to-work process using insights from official disability guidelines and extensive collaboration capabilities to get ill or injured employees back to work quickly and safely.
  • Closure
    Log every step of a claim to gauge progress, ensure compliance, and confirm all required activities are completed before closure.
  • Intelligent Claims
    Processing
    Embed predictive models and AI capabilities into claims workflows to automate tasks and augment claims adjuster expertise to drive faster, smarter decisions.
  • Risk Analytics
    and Insights
    Easily customize your reporting and dashboards to tell your story and inform decisions. Learn More.
  • Data Transformation
    Services
    Transform – and simultaneously validate – data from more than 900 external systems used by major carriers and TPAs.
  • Regulatory
    Compliance
    Proactively monitor current and potential regulations, manage relationships with external entities, and execute documentation to ensure regulatory compliance.

Claims Management Demo Video

IHG Hotels & Resorts

Trey Braden at Randstad

Riskonnect is helping us in terms of achieving financial accuracy for payments for insurers, which is great. We have full visibility of what’s going on in terms of claims management from start to end.”

Marcela Siera, Insurance Systems Manager, IHG® Hotels & Resorts

Reimagined Parking

Anybody in the claims industry knows that the longer a claim is open, the more costly it is,” says Hauf. “With Riskonnect we now have a more efficient claims intake process and quicker triaging, helping to reduce claims duration and expenses.”

Jeff Hauf, Senior Director of Claims, Reimagined Parking

McLane Company

Riskonnect gives us one platform to house all claims data from the cargo standpoint to the liability standpoint. If you want to get accurate information, you need accurate data. And to access that in one platform and be able to utilize that to mitigate, minimize, or prevent accidents, it’s critical to get it all under one roof.”

Rocky Coe, McLane Company

IHG
Reimagined Parking
McLane Company

Streamline, Automate,

and Close Claims Faster

How much are lingering claims costing you? Riskonnect’s Claims Management software automates tasks, reduces clicks, and adds efficiency to every step of the process to save you both time and money.

  • Customize checklists, standards, workflows, and scoring methodologies according to regulatory requirements or your own best practices.
  • Attach notes, images, files, and more directly to the claim.
  • Eliminate duplicate work and improve data accuracy with survey-style intake questionnaires and automatic data validation.
  • Automatically assign adjusters based on workload and expertise.
  • Speed up response time with real-time access to critical information from the moment something happens.
               

Put Your Claims Data
to Good Use

Are you squeezing all the intelligence possible from your claims data? Riskonnect’s Claims Management software offers machine learning and AI capabilities to help you respond faster, allocate resources better, and even prevent similar claims in the future.

  • Ingest structured and unstructured data to automate routine tasks, notifications, and alerts.
  • Identify litigation propensity, subrogation likelihood, and estimate claims duration with AI-based predictive analytics models.
  • Detect potential problems – including so-called sleeper claims – for early intervention.
  • Customize dashboards to surface important details of each claim.
  • Assess the performance of your claims management process and compare it to others in your industry.

Work Together –

and Achieve Better Outcomes

Are claims languishing while your adjusters chase down the information they need? Riskonnect’s Claims Management software offers real-time collaboration between internal and external parties to keep the process moving toward a speedy resolution while delivering the best experience.

  • Seamlessly integrate with third parties, including ISO and Official Disability guidelines.
  • See outstanding action items, approaching due dates, and expected costs.
  • Show collaborators relevant information, not necessarily the entire claim record.
  • Easily create reports using templates and dynamic workflows.
  • Automatically distribute reports to key stakeholders.
  • Streamline communications with claimants via a dedicated portal and texting services.

Get Started with These Helpful Resources

Claims Administration Software resource guide
EBOOK
The Complete Guide to Claims Administration Software
Whether you manage your own claims or manage claims on behalf of others, this ebook will give you the information you need to evaluate claims management software and decide what is right for you.
EBOOK
Your Guide to Adding Intelligence to Claims Processing
AI gives claims professionals the power to resolve claims faster than ever, unlock insight from any type of data, and deliver the kind of experience that keeps customers loyal. Download this ebook to understand what AI can do for the claims process.
Claims management RFP template
RFP TEMPLATE
Starting an RFP process for claims management software?
Download Riskonnect’s list of the most critical claims management software-related questions and customize it to suit your needs.

Customers with

Enhanced Claims Management Programs

Also Use

Enterprise Risk Management
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Billing
Streamline the insurance payment process to efficiently service your policyholders and agents.
Policy Administration
Manage the insurance policy lifecycle, from inception through renewals.

Start anywhere. Expand everywhere.

Industry Recognition for Riskonnect

Redhand Advisors Forrester Wheelhouse Advisor

Start partnering with Riskonnect today.
Find out how Riskonnect can transform the way you view risk.

Quick Answers to Your Claims Management Software Question

Claims management software is a platform for managing, analyzing, and reporting on claims information. The software integrates people, data, systems, correspondence, and more into one place. It saves time and money by automating tasks, streamlining workflows, and closing claims faster. The software can also help you identify fraud, litigation potential, and severe loss potential and reduce the workload and stress on adjusters.

Claims software offers a variety of applications – like intake, document management, electronic report of injury, regulatory compliance, and data transformation services – to close even the most complex claims quickly, easily, and fairly.

The answer to this question depends on the number and complexity of your claims. Companies with a limited number of straightforward claims might find spreadsheets a perfectly adequate tool. As the volume and severity of your claims grows, however, so does the amount of data and reporting needed to effectively manage costs.

You will likely benefit from claims management technology if you have multiple carriers or TPAs, are struggling to identify potential problem claims, or are unable to easily determine how well your claims program is performing. Claims management software helps you respond faster, allocate resources better, and even prevent similar claims altogether.

Riskonnect’s flexible model allows you to start anywhere and go everywhere. You can build a solution that fits your needs today – and easily add and upgrade as your business grows and changes.

Riskonnect is designed to seamlessly connect claims data from multiple sources inside and outside your organization. The software can handle vast amounts of data from numerous insurers/TPAs in multiple formats and currencies. We also offer APIs (application programming interface) to easily import and export data and out-of-the-box integrations with specialized partners to help you get the most from your data as efficiently as possible. And you can easily incorporate that data into your enterprise-level risk analysis.

Pricing depends on the size and complexity of the project and how much customization you require. We offer three industry-leading implementation options at different price points to fit your budget, while achieving your business objectives as quickly as possible.

The claims lifecycle is the end-to-end process a claim goes through from the moment a loss event occurs to final closure. The key stages are: incident capture — recording the event at the source before it becomes a formal claim; first notice of loss (FNOL) — the initial claim report that triggers the formal process; assignment — triaging the claim and routing it to the right adjuster based on workload, expertise, and claim type; investigation and adjudication — gathering information, evaluating liability, and determining the appropriate resolution; reserving — establishing and maintaining financial reserves based on estimated exposure; payment and settlement — processing payments to claimants and other parties; subrogation and recovery — identifying and pursuing recovery opportunities from responsible third parties; and closure — confirming all required actions are completed before closing the file. Leading claims management software supports every stage with automation, workflows, and documentation — reducing the manual effort and elapsed time at each handoff. For a comprehensive treatment, see Successful Claims Management.

FNOL — First Notice of Loss — is the initial report of a claim, the point at which the insured or claimant first notifies the insurer or risk manager that a loss has occurred. It’s one of the most consequential moments in the claims process: claims that are reported quickly and captured accurately have significantly better outcomes than those that are delayed or poorly documented at intake. Good claims management software streamlines FNOL with mobile-friendly intake forms, automatic data validation, and real-time routing to the appropriate adjuster. Riskonnect also supports electronic filing of First Report of Injury (FROI) and Subsequent Report of Injury (SROI) for workers’ compensation claims, keeping organizations compliant with state-specific reporting requirements from the moment a claim enters the system.

Subrogation is the process by which an insurer or self-insured organization recovers claim costs from the third party responsible for the loss — for example, pursuing a negligent contractor after paying a property damage claim they caused. Subrogation opportunities are frequently missed or underpursued because identifying them requires careful review of claim details during a period when adjusters are focused on resolution. Claims management software helps by using AI-based analytics to flag claims with subrogation potential early in the process — before the statute of limitations or recovery window closes — and providing dedicated workflow support for managing the subrogation lifecycle through to recovery. Recovering even a fraction of subrogation opportunities that would otherwise be missed can meaningfully reduce an organization’s total cost of risk.

Reserves are the financial estimates an insurer or self-insured organization sets aside to cover the expected cost of open claims. Accurate reserving is critical both for financial reporting and for understanding true loss exposure at any point in time — under-reserving creates financial surprises; over-reserving ties up capital unnecessarily. Claims management software supports reserve management by providing structured workflows for setting and adjusting reserves as claims develop, maintaining a complete audit trail of all reserve changes for regulatory and financial reporting purposes, and surfacing predictive analytics that inform more accurate initial reserve estimates. Riskonnect’s platform includes full reserving functionality, including the ability to create and maintain indemnity benefit schedules with complete audit trail documentation.

AI is transforming claims management in several concrete ways across the claims lifecycle. At intake, AI can process unstructured data — photos, documents, text — to automatically populate claim fields and flag potential issues. During adjudication, predictive models can assess litigation propensity, estimate claim duration, and identify subrogation likelihood — helping adjusters prioritize their attention on the claims that need it most rather than treating every file the same. AI can also surface “sleeper claims” — cases that appear straightforward but have indicators of future complexity — for early intervention before costs escalate. And at the reporting level, AI-powered document summarization can instantly condense lengthy claim files into concise summaries, saving adjusters significant time on routine review. Riskonnect’s Intelligent Claims Processing capability embeds these AI models directly into the claims workflow rather than requiring adjusters to use separate tools.

The terms are often used interchangeably, but there’s a useful distinction. Claims administration tends to refer to the operational execution of claims handling — intake, assignment, payment processing, regulatory filings, and compliance — and is typically associated with TPAs and insurers who handle claims on behalf of others. Claims management is the broader discipline that encompasses administration but also includes the analytical and strategic functions: identifying trends, managing reserves, optimizing the claims portfolio, and using data to improve outcomes over time. The best claims management platforms handle both — giving organizations the operational efficiency of claims administration software alongside the analytical depth that transforms claims data into strategic insight. The Claims Management Definitive Guide covers this distinction and the full scope of modern claims management in detail.

Claims management is one of the most heavily regulated functions in insurance and risk management. Workers’ compensation in the United States requires state-specific FROI and SROI filings with strict timing requirements — failure to comply results in penalties. Payment and settlement processes are subject to prompt payment laws that vary by state and line of business. Data privacy regulations including GDPR and CCPA govern how claimant personal data is collected, stored, and shared. And organizations managing claims across multiple jurisdictions face the additional complexity of staying current as regulatory requirements change. Riskonnect’s Claims Management software includes proactive regulatory compliance monitoring — tracking current and anticipated regulatory changes, managing compliance documentation, and providing the electronic filing capabilities needed to meet state workers’ compensation requirements. Riskonnect also offers dedicated Claims Regulatory Compliance Services for organizations that need hands-on support navigating this landscape.

Claims management software is used across a broad range of organizations involved in insurance and risk management. Insurance carriers use it to manage claims on behalf of policyholders across property, casualty, liability, and workers’ compensation lines. TPAs (Third-Party Administrators) use it to administer claims on behalf of self-insured employers, captives, and smaller insurers. MGAs (Managing General Agents) use it to manage claims within their delegated authority. Self-insured employers — particularly large corporations, healthcare systems, municipalities, and educational institutions — use it to manage their retained losses internally. The common thread is volume and complexity: any organization handling more claims than a spreadsheet can manage effectively — or whose claims data needs to inform broader risk and insurance program decisions — benefits from a dedicated claims management platform.

Claims data is the most operationally rich and financially significant data in any insurable risk program — and it’s most valuable when it’s connected to the rest of the risk picture rather than isolated in a standalone system. When claims management software is integrated with a full risk management information system, claims data feeds directly into loss trend analysis, cost allocation, insurance program optimization, and renewal preparation. Risk managers can see how claims experience is affecting premium spend, which business units or locations are driving losses, and where risk control investments would have the greatest return. Riskonnect’s platform is built for this integration — claims management and RMIS share the same environment, so neither function requires manual data export and reconciliation to tell the complete risk story.

The evaluation should start with a clear understanding of your claims volume, lines of business, and the specific pain points in your current process — whether that’s slow intake, poor adjuster productivity, limited analytical capability, or difficulty meeting regulatory filing requirements. Key selection criteria for leading claims management software include: depth of workflow automation across the full claims lifecycle; quality of AI and predictive analytics capabilities; flexibility of configuration for different lines of business and jurisdictions; strength of data transformation capabilities for ingesting carrier and TPA data; regulatory compliance monitoring and electronic filing support; and integration with your RMIS and broader risk platform. Riskonnect’s Claims Management RFP template provides a structured set of evaluation questions designed to surface meaningful differences between top claims management software vendors and platforms — and help you make a decision based on operational reality rather than feature lists.