FINEOS Claims brings insurance value to life through superior claims handling. With its AI-enhanced workflows and comprehensive management capabilities, insurers can provide interactive and efficient experiences that increase customer satisfaction, produce better outcomes, and reduce costs. The purpose-built design of the FINEOS Claims management system ensures user-friendly interactions every time, resulting in unparalleled levels of service.
Key Features of FINEOS Claims management solution
- End-to-end automation for the entire claims process – from initial notification to final settlement.
- The only platform offering an integrated life event experience that seamlessly combines disability and voluntary benefits.
- Role-based portals for 24×7 self-service.
- Fully integrated functionality across front-end, middle, and back office.
- Accessible on smartphones and tablets.
- AI-powered claims scoring using advanced analytics and real-time decision models, with auto-escalation to trigger additional review or intervention when risk thresholds are met.
- Automated follow-ups, reminders, texts, and integrated email.
- Intuitive, easy-to-use claims reporting wizards.
- Rule-based claims assignments and configurable workflow scripting.
- Natural language processing (NLP) to automatically extract, classify, and act on unstructured information from claimant emails, notes, and document.
FINEOS Claims management solutions are configurable to fit your organization
Service: People and Process Features:
- FINEOS Claims streamlines standard claims and simplifies complex ones
- AI-powered workflows to guide claim processing, streamline task prioritization, and optimize resource allocation.
- Integrated policy and claims information for faster coverage verification
- A single view of customer information with complete claims history
- 24×7 role-based self-service to reduce unnecessary inquiries
- 3rd party integration for improved case management and faster payments
- AI-generated management alerts for proper handling of complex claims
Business: Improve Results:
- Reduce operational costs and improve efficiencies with streamlined, low-touch, no-touch claim processing.
- Measure what matters most in the claims experience with easier access to the right information
- Reduce claims leakage with integrated 3rd party information, auto-escalation, and tighter claims management
- Produce better outcomes with proper case handling, improved coordination of benefits, and accurate information
- Detect potential fraud faster with fully configurable AI-powered alerts to claims management
- Improve return-to-work planning with AI-driven analysis of historical claim data and claimant recovery patterns.
Technology: Flexibility and Usability:
- Configurable to fit your organization. The FINEOS Claims management solution is a SaaS standalone system that can be integrated into any policy administration system, including the FINEOS Platform
- Out-of-the-box accelerators for deployment, including data migration tools, to reduce setup requirements and ensure smooth integration with other systems.
- Highly configurable, scalable platform to support claims service delivery
- APIs that matter to support transactions and customer interactions throughout the entire claims lifecycle
- Trusted and compliant platform to support the most stringent security and regulatory requirements
The FINEOS Claims management solution is supported by FINEOS AdminSuite, the purpose-built solution for the Life, Accident, and Health industry and the Employee Benefits market. Designed to meet the evolving needs of insurers, employers, and employees, FINEOS AdminSuite enables seamless delivery of claims management across the insurance lifecycle. Whether deployed as a comprehensive end-to-end core system or through modular components for incremental transformation, FINEOS Claims leverages secure, scalable SaaS cloud technology and embedded AI capabilities to enhance accuracy, speed, and decision-making.
Contact us today to learn more.
