Claims Module
Greater Accuracy and Control from First Notice of Loss to Final Payment
Streamline Claims Management
With Connected Insights
ISI Core’s Claims module helps P&C insurers and MGAs manage claims within one connected environment. As part of a comprehensive insurance claims management system, the module brings together real-time coverage validation, configurable workflows, integrated financials, and claims insights to help teams manage complexity, improve oversight, and support 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 FNOL intake, review, and settlement.
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Validate coverage, limits, and deductibles instantly across policies and versions using point-in-time checks based on 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 greater control.
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Create and search claims faster using customizable intake screens and user-specific filters.
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Use system-driven claim status logic to update Incident, Open, Closed, or Reopened stages for consistent lifecycle tracking.
Gain Complete Financial Oversight
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Manage reserves, payments, recoveries, and related claim transactions directly within ISI Core for real-time financial visibility.
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Set or adjust reserves with authority-based approval paths, full audit tracking, and access to available reserve lines within a subfile.
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Streamline claim payment processing with support for multiple invoices, split payments to a single payee, and creation of new reserve lines when needed.
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Support bulk processing, claims bordereau intake, and batch settlements for high-volume or MGA-managed claims and transactions.
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Connect with Accounting and Reinsurance modules for end-to-end transaction oversight, financial reporting, and reconciliation support.
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Reverse or reapply payments while preserving compliance through detailed transaction histories and level-specific summaries for claims, claimants, and coverages.
Turn Claims Analytics Into Actionable Insights
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Drill down into real-time claims data and analytics dashboards to identify trends, loss ratio drivers, and examiner productivity.
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Use embedded analytics powered by Amazon Quick to build dashboards, KPI reports, and trend visualizations for claims leadership and operational teams.
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, insurers and MGAs 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 stronger oversight.
- Use real-time claims data and analytics to monitor team performance, identify trends, and support stronger claims oversight and loss control.
- Scale during CAT or multi-claim events with batch processing, bordereau intake, 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
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
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 is the ISI Core Claims Module?
The ISI Core claims module is a comprehensive insurance claims management system designed to handle the full claims lifecycle for P&C insurers and MGAs. It supports everything from FNOL intake through investigation, adjudication, payments, reserves, recoveries, and reporting within a single connected platform, without requiring separate tools for each stage.
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What claims workflows can ISI Core support and automate?
ISI Core supports claims processes from FNOL intake through assignment, investigation, adjudication, payments, reserves, recoveries, and reporting. It includes configurable automation for claim notifications, task creation, assignment logic, approvals, document generation, payment workflows, diary management, and status updates. Straight-through processing can also be supported for eligible claims or transactions based on configured rules, authority levels, and operational requirements.
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Does the ISI Core Claims module support multi-party claims and subrogation?
Yes. ISI Core’s Claims module can manage multi-party losses, multi-claimant events, subrogation recoveries, salvage tracking, and litigation workflows. Related parties, claim events, payments, and recoveries can be linked for accurate tracking and reporting.
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Can insurers and MGAs configure claim types, coverages, and rules?
Yes. Claim types, coverage triggers, workflow rules, validations, assignment logic, and authority levels can be configured without custom development. This allows insurers and MGAs to tailor claims processing to internal policies, authority structures, and regulatory requirements.
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How does the ISI Core Claims Module 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, claim type, or other attributes.
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Does the ISI Core Claims module 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, financial accuracy, and governance.
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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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How does ISI Core 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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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 giving P&C insurers and MGAs flexibility to modernize one function at a time.
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Why should insurers and MGAs choose ISI Core for claims management?
ISI Core helps P&C insurers and MGAs manage claims through a configurable platform that connects FNOL, workflows, coverage validation, reserves, payments, recoveries, documents, reporting, and related core operations. With integrated financials, audit trails, claims insights, and connection across the broader ISI Core suite, teams can improve oversight, reduce manual effort, and manage claims with greater control.
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