ClaimCore

Bring flexibility, accuracy, and exceptional customer service to the core of your claim processes.

ClaimCore® is a comprehensive, easily configurable, and extendable insurance claims management solution that enables today’s insurers to drive the claims process from end to end with great speed, responsiveness, customer focus, and oversight.

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Elevate all facets of your claims processing.

With unprecedented capabilities for insurers, ClaimCore gives your claims organizations the power and agility to process claims in less time, streamline payment processing, and enhance fraud detection. ClaimCore is available as a self-contained product that integrates with third-party systems and is also a foundational component of the unified EIS Suite™.

  • Speed claims handling and improve compliance with a rules-based, customer-centered workflow
  • Enhance the quality and consistency of claims experiences for all customers
  • Adjust and resolve more claims, more accurately in less time
  • Enable greater self-sufficiency and self-service for customers and claims teams
  • Automatically infuse your claims processes with industry best practices

ClaimCore for Benefits

Transform claims processing across your benefits business.

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Enable better customer experiences.

Increase customer retention with faster, more satisfying service for individual policyholders and plan administrators. Give all customers convenient self-service and omnichannel communication options, including mobile. Empower claims teams with direct access to eligibility information in the workflow.

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Enhance fraud detection.

Protect your bottom line by simplifying fraud detection processes across your operations. ClaimCore provides an integrated rules engine that integrates with third-party solutions to automate key activities in fraud detection. Speed response times by automatically flagging and routing suspect claims to investigation teams.

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Increase operational efficiencies.

Process higher claim volumes with greater ease and accuracy. ClaimCore streamlines and automates time-consuming task generation and management activities. Configurable workflows give claims teams the flexibility to design and manage the claims process from beginning to end for both adjuster-managed and auto-adjudicated claims.

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Improve claims outcomes.

Optimize the effectiveness of your entire claims operation. Capitalize on built-in integrations that make the most of third-party asset retention programs. Automate compliance with ERISA, statutory requirements, and SLAs. And employ rule-based best practices and workflows to better manage benefit calculations.

ClaimCore for P&C

Turn claims processing into a competitive advantage.

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Increase policyholder satisfaction.

Easily enable faster, more satisfying claim experiences. Empower customers to send first notice of loss (FNOL) by the means they prefer, including web portals and mobile apps. Improve customer interactions by giving your teams a trusted, real-time view of every claimant throughout the lifecycle.

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Detect fraud faster.

Prevent revenue leakage by catching fraudulent claims sooner. ClaimCore automates the identification of potential fraud, integrates with third-party tools, and ensures that suspicious claims are automatically flagged and routed for review.

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Improve operational efficiencies.

Handle higher claim volumes faster and more accurately. With ClaimCore’s rules-based automated assignment, you can assign the right claims to the right adjusters every time. Manage claims from the field using mobile apps. And ease adjuster burdens with streamlined workflows for claims approvals, payments, and vendor interactions.

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Manage cash reserves painlessly.

Tighten your control over cash flow and ensure that payments are timely and correct. Smartly manage all claims activities, track reserves, and trigger reserve authorizations. Plus, with real-time dashboards and reporting you’ll always know the impact of claims activity on your reserves.

Make a Digital Connection

With the EIS® Digital Experience Platform™ (DXP™), everyone has access to a rich set of mobile information, personalized for their needs. Remove the veil and keep everyone in the know with easy, always-on access to claim status and history. Provide a modern experience with mobile initiation of FNOL.  Make it seamless to capture claim information with easy upload of photos, reports, and documents. Keep everyone, including your producers, updated on important topics with custom bulletins and alerts.

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EIS platform power speeds your success.

ClaimCore is powered by the EIS Platform which comes with a full range of common business services and tools that increase business velocity in every phase of the claim cycle. Stay on top of your claims with real-time monitoring, analytics, and reporting. Easily configure rules and automate your processes with workflow. Go paperless with digital document management services.

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Customer spotlight

Transformation Success at IAAH

IAAH shares how aging technology and outdated processes were hindering their ability to expand market share and improve customer service. Partnering with EIS Group, they successfully replaced their legacy system and within 24 months implemented new processes and migrated 15 products onto the EIS Suite insurance platform.

Achieve more with the Suite advantage.

Available as a standalone application, ClaimCore is also part of the fully unified, customer-centered EIS Core Insurance Suite™ that combines a digital-ready platform with robust applications for the full insurance lifecycle. Get the suite advantage. Minimize your integration burden. Gain a true 360° view of your customers over the lifetime of interactions—from policy to billing to claims.  Innovate freely and create the differentiation you need to compete in an environment of intensive change.

Explore the EIS Suite