Claims admin
The system of record for claims from FNOL through settlement.
Vendors by generation
AI-native (3)
- CLARA Analytics
AI-native claims intelligence platform for workers' compensation, auto, and general liability. Predictive models for triage, provider scoring, litigation risk, and fraud detection across the full claims lifecycle.
- Five Sigma
AI-native claims management platform for P&C insurers, MGAs, TPAs, and self-insurers. Ships Clive™, an AI claims adjuster that sits on top of any CMS; Five Sigma's own cloud CMS is available as the underlying rails.
- Sprout.ai
AI-native software suite for personal and commercial claims automation and fraud detection. Automates triage, coverage checks, and document review, accelerating settlement times while flagging fraud signals.
Modern SaaS (4)
- Duck Creek Claims
Modern P&C claims-administration platform covering the full claims lifecycle from FNOL to closure. Duck Creek's structural alternative to Guidewire InsuranceSuite; acquired by Vista Equity Partners for $2.6B in 2023.
Parent: Vista Equity Partners - FINEOS
Cloud-based core administration platform for group and individual life, accident and health insurers, covering policy, billing, claims, absence, new business and underwriting on a single SaaS suite.
- Guidewire ClaimCenter
The incumbent modern claims-administration system for global P&C insurers. Part of Guidewire InsuranceSuite with PolicyCenter and BillingCenter. ClaimCenter governs the full claims lifecycle from intake through closure.
NYSE: GWRE - TriZetto Facets
Core administration platform used by US health payers to run enrollment, premium billing, benefits configuration, and claims adjudication on a single system of record.
Parent: Cognizant Technology Solutions
Legacy
No tools on this generation yet.
Carriers named on this layer
Every carrier publicly cited by any vendor on the Claims admin layer. Appearance here means the carrier is named in at least one fiche on this layer with a source.
- Alfa Insurance
- Amerisure
- AmTrust
- Arch Insurance
- Ascot US
- Berkshire Hathaway Homestate Companies
- Berkshire Hathaway Specialty Insurance
- BlueCross BlueShield of Tennessee
- CareFirst BlueCross BlueShield
- Fast Cover
- Geisinger Health Plan
- Guardian Life
- Hollard Insurance
- L+M Development Partners
- Liberty Mutual
- MetLife Chile
- Mutual of Omaha
- New Ireland Assurance
- New York Life Group Benefit Solutions
- Northbridge Financial Corporation
- Partners Life
- QBE Insurance
- Securian Canada
- Tokio Marine
- Zurich
About this layer
Phidea classifies every tool into one of 16 canonical US insurance stack layers, chosen by the tool’s centre of gravity rather than its newest feature. This page is the single URL for everything on the claims adminlayer — the vendors, the carriers that use them, and the news that’s moved the category recently. Generation classification (legacy, modern saas, ai-native) is defined on the methodology page.