Claims Management Software Development

FNOL intake form capturing the incident details, the claimant's information, the insured's policy reference, and the initial description of the loss through a web form, a handler-assisted phone intake, or an automated feed from a third-party aggregator. Policy verification at the point of FNOL confirming that the policy is in force, the loss date is within the policy period, and the coverage type matches the reported incident before the claim is registered -- catching coverage issues at the point of notification rather than after investigation has begun. Duplicate claim detection checking the new notification against the existing claims database to identify whether the same incident has already been reported under a different policy or by a different party. Initial claim triage routing the claim to the correct team and handler based on the line of business, the estimated loss severity, and any special handling flags set in the policy record. FNOL acknowledgement sent to the claimant confirming receipt of the notification, the claim reference, and the contact details for the assigned handler.

Claim assignment to handlers based on line of business, geographic territory, claim type, or workload distribution rules configured to your team's structure, with the assignment recorded against the claim record with the effective date and the assigning manager's identity. Task list for each claim showing the actions required at each stage -- the coverage investigation, the liability assessment, the quantum investigation, the reserve review, and the settlement authority request -- with due dates and completion recording against each task. Diary management allowing handlers to set review reminders on claims that are waiting for information, waiting for a legal milestone, or reserved pending a survey or medical report, with the diary entries visible to supervisors alongside the handler's active workload. Instruction management recording every instruction sent to a solicitor, loss adjuster, medical expert, or repair network with the instruction date, the instructed party, and the response received linked to the claim. Claim transfer workflow for claims that need to move between handlers or teams -- for example, claims that breach a severity threshold and move to a specialist unit -- with the transfer reason, the transferring handler, and the transfer date recorded in the claim history.

Reserve setting at claim registration with the initial reserve based on the handler's initial assessment of the likely ultimate cost, or on a system-calculated initial reserve based on the claim type and reported loss description. Reserve movement recording every change to the indemnity, defence costs, and third-party reserves with the date, the amount, the reason for the movement, and the identity of the handler who made the change -- the complete financial history of the claim visible from the reserve summary. Authority level controls preventing reserve changes above the handler's delegated authority limit without escalation to the appropriate authority level, with the escalation request and the approver's decision recorded in the claim. Bulk reserve review tools for actuarial and claims management teams to review and update reserves across a portfolio segment -- all claims of a given type, age, or development status -- without processing each claim individually. Reserve adequacy reporting comparing the current reserve position against the claim's development history and the portfolio's historical development factors.

Payment processing for indemnity payments, defence costs, and third-party settlements with the payment request subject to the handler's settlement authority and escalated to the appropriate authority level for amounts exceeding the limit. Payee management maintaining a register of approved payees -- claimants, solicitors, medical experts, and repair suppliers -- with bank account details verified before the first payment and stored for subsequent payments on the same or related claims. Payment instruction generation producing the payment data in the format required by your accounts payable system or bank payment platform, with the claim reference and payment type included for reconciliation. Excess and deductible recovery calculation identifying the amount recoverable from the insured or a contributing insurer under excess-of-loss arrangements and tracking the recovery status through to collection. Settlement and closure workflow capturing the settlement terms, the release obtained from the claimant, and the payment confirmation before the claim is moved to closed status and the final reserve is written off.

Subrogation identification flagging claims where a recovery opportunity exists -- third-party liability, product defect, or negligent party -- at the point of settlement rather than as an afterthought after the claim has been closed and the recovery opportunity has expired. Recovery action tracking recording every step in the recovery process: the letter of claim, the liability response, the negotiation, the settlement, and the collection against the claim record with the recovery amount and the recovery costs recorded separately. Recovery reserve tracking the expected recovery amount as a credit against the net claim cost, with the recovery reserve updated as the recovery progresses and the final recovery applied to the claim's net ultimate cost. Third-party capture for claims where the insured's insurer has a right of action against a third party on the insured's behalf, with the action managed within the claims system rather than tracked separately. Recovery reporting showing the total recoveries collected in the period, the recovery rate against claims with identified recovery potential, and the outstanding recovery pipeline by claim and recovery stage.

Claims MI dashboard showing the portfolio's development across the key metrics the claims director needs: claim count by line, status, and handler; average cost of settlement by claim type and cause; reserve development against initial reserve by accident year and reporting year; handler productivity showing claims closed, average settlement time, and average settlement cost. Actuarial data export producing the structured triangle data -- paid losses, incurred losses, claim counts by accident year and development period -- in the format your actuarial team uses for reserving and pricing analysis. Large loss register tracking claims above the reporting threshold for reinsurance notification, board-level reporting, and Lloyd's syndicate reporting. Regulatory reporting producing the claims data required for FCA, Lloyd's, or local market regulatory returns from the live claims data rather than from a manual data assembly exercise. Exception reporting identifying claims that have exceeded their diary date without action, claims where the incurred cost exceeds the reserve, and claims approaching the large loss notification threshold before the threshold is breached.