Claims Module
Streamline the Entire Claims Lifecycle
ISI Core’s Claims module brings every stage of claims handling from intake to resolution into one connected, automated environment. Real-time coverage validation, built-in workflows, and integrated financials help carriers manage complex claims efficiently, reduce leakage, and deliver faster outcomes for policyholders.
Key Capabilities That Strengthen Daily Operations
Rules-Based and Adaptive Claims Workflows
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Automate notifications, task creation, and approvals to accelerate intake and settlement.
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Validate coverage, limits, and deductibles instantly across policies and versions using point in time checks based on the reported date or date of loss.
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Handle multi-party, multi-loss, and catastrophe claims in one file with configurable workflows and support for multiple examiners assigned to the same claim.
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Manage litigation, subrogation, salvage, and SIU workflows in dedicated work areas for better control.
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Create and search claims faster using customizable intake screens and user-specific filters.
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System-driven claim status logic automatically updates Incident, Open, Closed, or Reopened stages for consistent lifecycle tracking.
Gain Complete Financial Oversight
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Manage reserves, payments, and recoveries directly within ISI Core for real-time financial visibility.
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Set or adjust reserves with authority-based approval paths and full audit tracking.
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Integrate seamlessly with Accounting and Reinsurance modules for end-to-end transaction oversight.
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Support bulk processing, bordereau intake, and batch settlements for high-volume events.
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Reverse or reapply payments automatically while preserving compliance through detailed transaction histories and level-specific summaries for claims, claimants, and coverages.
Deliver Insight-Driven Decision Making
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Drill down into real-time claim performance metrics to identify trends, loss ratio drivers, and examiner productivity.
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Leverage natural language queries with Analytics powered by AWS-powered Quick Suite to instantly build real-time dashboards, KPI reports, and trend visualizations.
Simplify Communications and Documentation
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Generate claim letters using configurable templates with auto-merged claim and policy data.
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Track all notes, documents, and correspondence at any claim level for complete transparency.
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Enable paperless collaboration across departments with built-in audit trails and secure access controls.
Business Outcomes You’ll Achieve
With ISI Core’s Claims module, carriers improve accuracy, agility, and customer satisfaction through automation, integrated financials, and real-time insights.
- Reduce claim cycle times and administrative effort with configurable workflows and automated tasks.
- Enhance accuracy and compliance through system-driven validation, audit trails, and role-based controls.
- Gain full lifecycle visibility across intake, reserves, recoveries, and payments to support better oversight.
- Access real-time reporting for team management and loss control to monitor performance, trends, and operational health.
- Scale confidently during CAT or multi-claim events with built-in batch processing and bulk settlements.
See Other Core Modules
Policy Administration
Enhanced Precision and Team Performance
- Rules-Based Controls for Enhanced Underwriting
- Simplify Workflows for Every Policy Task
- Make Data Driven Decisions Based on a Unified View
- Adapt Quickly to Market Shifts
Risk Management & Assessment
Strengthen Underwriting and Loss Control
- Centralize Risk Assessments with Repeatable Workflows
- Strengthen Underwriting Decisions with Consistent Risk Scoring
- Improve Visibility Across the Risk Control Process
- Take Targeted Action to Help Reduce Loss Ratios
Billing
Real-Time Control for Every Policy, Payment, and Process
- Flexible Billing for Every Business Model
- Automated Workflows for Accuracy and Efficiency
- Real-Time Financial Oversight and Control
- Data-Driven Insights for Better Decision Making
Accounting
Real-Time Financial Control Across Every Entity and Ledger
- Unified Financial Management Across All Modules
- Flexible Configuration and Compliance Support
- Automated Workflows for Accuracy and Efficiency
- Actionable Reporting and Financial Insights
Reinsurance
Enhance Risk Sharing Through Automation and Visibility
- Complete Treaty and Facultative Management
- Seamless Integration Across Every Step and Module
- Automation and Controls That Reduce Risk
- Analytics and Partner Oversight
Policy Administration
Enhanced Precision and Team Performance
- Rules-Based Controls for Enhanced Underwriting
- Simplify Workflows for Every Policy Task
- Make Data Driven Decisions Based on a Unified View
- Adapt Quickly to Market Shifts
Risk Management & Assessment
Strengthen Underwriting and Loss Control
- Centralize Risk Assessments with Repeatable Workflows
- Strengthen Underwriting Decisions with Consistent Risk Scoring
- Improve Visibility Across the Risk Control Process
- Take Targeted Action to Help Reduce Loss Ratios
Billing
Real-Time Control for Every Policy, Payment, and Process
- Flexible Billing for Every Business Model
- Automated Workflows for Accuracy and Efficiency
- Real-Time Financial Oversight and Control
- Data-Driven Insights for Better Decision Making
Accounting
Real-Time Financial Control Across Every Entity and Ledger
- Unified Financial Management Across All Modules
- Flexible Configuration and Compliance Support
- Automated Workflows for Accuracy and Efficiency
- Actionable Reporting and Financial Insights
Reinsurance
Enhance Risk Sharing Through Automation and Visibility
- Complete Treaty and Facultative Management
- Seamless Integration Across Every Step and Module
- Automation and Controls That Reduce Risk
- Analytics and Partner Oversight
Supporting Modules
FAQs
What functionality does the ISI Claims module provide?
The ISI Claims module supports the complete claims lifecycle from FNOL intake through assignment, investigation, adjudication, payments, reserves, recoveries, and reporting. It includes workflow automation, rules-based approvals, diary and task management, and integrated document handling to streamline claims processing.
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Does the module support multi-party claims and subrogation?
Yes. ISI Core can manage multi-party losses, multi-claimant events, subrogation recoveries, salvage tracking, and litigation workflows. All related parties and events are linked for accurate tracking and reporting.
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Can we configure claim types, coverages, and rules?
Absolutely. Claim types, coverage triggers, workflow rules, validations, assignment logic, and authority levels can be configured without custom development. This allows carriers to tailor claim processing to their internal policies and regulatory requirements.
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How does the system support claims reporting and KPIs?
Claims data is updated in real time and integrates with ISI Analytics to support dashboards for loss ratios, reserve development, adjuster performance, workload, and potential fraud indicators. Reports can be filtered by product, jurisdiction, or other attributes.
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Does ISI Claims integrate with ISI Portal and external TPAs?
Yes. FNOL can be submitted by brokers or policyholders through ISI Portal. External adjusters or TPAs can be assigned and managed through configured partner workflows using ISI Connect.
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Are reserve and payment audit trails maintained?
Yes. All reserve changes, payments, recoveries, and approvals are captured with timestamps, user details, and full audit history to support compliance and financial accuracy.
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Can the Claims module be implemented as a standalone component?
Yes. The Claims module can be deployed independently or as part of the full ISI Core suite, giving carriers flexibility in modernizing one function at a time.
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Can insurers define custom approval workflows?
Yes. Approval rules can be configured by role or authority level, with automated routing for exceptions, escalations, and supervisory review. These workflows help carriers maintain control and consistency across claims operations.
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What automation features exist in claims?
ISI supports straight-through claims processing, automated assignment, fraud detection flags, and configurable workflows to accelerate claims resolution.
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How does ISI support regulatory compliance for claims?
The Claims module aligns with Canadian OSFI and U.S. NAIC requirements. Audit trails, data validation, and configurable reporting ensure compliance with jurisdictional regulations.
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