Claims Management Market Size, Share & Industry Analysis, By Type (Health Insurance Claims, Property and Casualty Insurance Claims, Life Insurance Claims, Workers’ Compensation Claims, and Disability Insurance Claims), By Deployment (On-premises and Cloud), By Technology (AI & ML, Blockchain, Robotic Process Automation, and Internet of Things), By Enterprise Type (Small & Medium Enterprises (SMEs) and Large Enterprises), By End-user (Healthcare Providers, Insurance Companies, Third-Party Administrators (TPAs), and Government Agencies), and Regional Forecast, 2024-2032

The global claims management market size was valued at USD 4.60 billion in 2023 and is projected to grow from USD 5.15 billion in 2024 to USD 13.95 billion by 2032, exhibiting a CAGR of 13.3% during the forecast period. North America dominated the global claims management market with a share of 45.65% in 2023.

Claims management helps insurers manage their claims processes more efficiently. These solutions can automate various aspects, including data collection, processing, validation, and analysis. By implementing technologies, such as machine learning, artificial intelligence, and data analytics, insurers can increase detailed insights into their claims data. Furthermore they can optimize their claims processes, speeding up claims processing times, reducing the need for manual effort, and improving accuracy and consistency.

The outbreak of the COVID-19 pandemic played a major role in driving the market growth. There was a surge in claims due to disruptions in business operations, health-related issues, and economic challenges. This overwhelmed many claims management systems and required adjustments to handle the increased volume. Overall, while the pandemic posed challenges, it drove innovation and improvements in the sector.

Claims Management Market Trends

Integration of Technologies, such as Artificial Intelligence (AI) and Automation, to Drive Market Growth

The market is currently witnessing a transformation driven by technological advancements and an increasing focus on efficiency in the insurance industry. With the rising adoption of artificial intelligence and automation, companies are relying on innovative solutions to improve and streamline their processes. This trend reflects the broader industry push toward digitization, which is driving faster, more accurate claims processing. As more technologies become connected, the need for claims management is expected to increase.

• As per Aon Plc, organizations that invest in claims AI solutions give claims talent the time and support to grow, learn, and develop claims-related solutions.

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Claims Management Market Growth Factors

Increased Claims Related Customer Service and Remote Work to Boost Market Growth

Managing customer expectations has become more difficult due to delays and complications caused by the pandemic. Companies are focusing on improving communication and transparency with applicants, which is driving the claims management market growth. Additionally, the shift to remote work has posed challenges in effectively managing and processing requests. As a result, organizations have had to adapt their systems and processes to ensure rapid continuity. For instance,

• According to Upwork, by 2025, about 32.6 million Americans will work remotely, equivalent to about 22% of the workforce. This forecast shows a continued and gradual shift toward remote working arrangements.

RESTRAINING FACTORS

Data Security Concerns and High Cost of Claims Solution Hamper Market Growth

Ensuring the security and privacy of sensitive claim data is crucial, and breaches can lead to major financial and reputational damage. The cost of managing claims effectively, including hiring skilled professionals and maintaining robust systems, can be a barrier for some companies.

Claims Management Market Segmentation Analysis

By Type Analysis

Growing Awareness About Life Insurance Benefits to Dominate Life Insurance Claim Market

Based on type, the market is segmented into health insurance claims, property and casualty insurance claims, life insurance claims, workers’ compensation claims, and disability insurance claims.

Among these, life insurance claims held the largest market share in 2023 due to growing awareness about life insurance benefits, which will encourage more people to purchase policies, potentially leading to more life insurance claims. It is expected to contribute 30.2% of global market share in 2025. Additionally, life insurance premiums are increasingly adopted by major people in countries such as India, China, and the U.S. For instance,

• As per industry analysis, life insurance premiums in India increased by 9.63%, whereas global life insurance premiums increased by 1.18% in 2023.

Health insurance claims are expected to grow at the highest CAGR during the forecast period of 2024-2032 due to the increased expense of healthcare, which demands purchasing insurance coverage to cover potential costs for medical treatments, hospital stays, and prescription medication costs.

By Deployment Analysis

Increased Partnership to Adopt Cloud Solution Contributing to Segmental Growth

Based on deployment, the market is studied into cloud and on-premises.

The cloud segment held a major market share in 2023 and is expected to grow at the highest rate in the forecast period. Cloud solutions reduce the need for expensive on-premises infrastructure and maintenance, lowering overall operational costs. Many companies are entering into partnerships to adopt cloud-based benefits and stay competitive in the market. For instance,

• In February 2024, AdvantageGo announced a strategic alliance with DOCOsoft, a claims management system provider. DOCOsoft’s cloud-based claims management solutions can maximize performance by automating routine tasks.

On-premises segment will grow considerably owing to customer focusing on user friendly process and timely communication to improve customer satisfaction and retention. It is estimated to reach a value of USD 1,023.6 million in 2025.

By Enterprise Type Analysis

Implementation of Advanced Technologies in Large Enterprises Contributing to Segmental Growth

Based on enterprise type, the market is studied into SMEs and large enterprises.

Large enterprises hold a major market share in 2023. These enterprises implement advanced technologies to enhance claim procedures. These technologies help to enhance operational efficiency, improve customer satisfaction, and streamline processes, but specific needs differ based on the nature of claims and regulatory requirements they address.

SMEs are expected to grow at the highest rate in the forecast period. An increasing number of small enterprises are realizing the benefits of automating key processes - reduced costs, less time spent on data entry, and greater transparency for customers.

By Technology Analysis

IoT-based Claim Management Contributing to Segmental Growth

Based on technology, the market is studied in terms of AI & ML, blockchain, robotic process automation, and Internet of Things.

IoT held a major market share in 2023 as IoT devices make the claims process more accurate and faster, improving customer satisfaction and reducing costs by providing real-time data. These changes help insurers improve their business models and offer better services.

Blockchain is expected to witness the highest growth during the forecast period. By leveraging blockchain for claims processing, insurance companies can streamline the claims processing process from start to finish. Smart contracts can be executed to reduce claim management costs, reduce fraud, and automate claim verification.

By End-User Analysis

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Rapid Usage of Wireless Devices in Healthcare Industry Contributing to Segmental Growth

Based on end-user, the market is studied into healthcare providers, insurance companies, third-party administrators (TPAS), and government agencies.

Insurance companies gained a major claims management market share in 2023 and are expected to witness the highest CAGR during the forecast period. These solutions help insurers manage their claims processes more efficiently. These solutions include customer self-service portals, digital document management, mobile claims, and fraud detection and prevention, which can help insurers reduce costs, improve customer service, and prevent fraudulent claims. Overall, claims management helps insurers streamline their operations and provide better customer service.

Healthcare provider holds second largest share in the market as users are implementing advanced claims management software and electronic health record system that improves efficiency, accuracy, and tracking claims.

REGIONAL INSIGHTS

Based on geography, the market is studied across North America, Europe, Asia Pacific, the Middle East & Africa, and South America.

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North America holds the highest market share with high adoption rates due to its advanced technology infrastructure and a significant number of insurers. For instance:

• According to the Insurance Information Institute 2024, New Mexico had approximately 3,000 insurers in 2023.

Additionally, companies in North America can effectively navigate the complexities of claims management and position themselves for growth in an evolving healthcare landscape.

Europe holds a significant market share, driven by stringent regulatory standards and increasing attention to digital transformation in the insurance sector. Europe is projected to exhibit a CAGR of 11.3%.

Asia Pacific is expected to grow at the fastest CAGR from 2024 to 2032. The market in India is expected to grow at a steady CAGR of 22%. Increasing insurance penetration and a growing middle class are driving the demand for claims management solutions in Asia Pacific. The claims management market in Japan is expected to reach an estimated value of USD 294.3 million in 2025.

South America and the Middle East & Africa have become increasingly popular in recent years due to the growing awareness of efficient claims handling and the need to streamline operations. These regions have observed increased demand due to the expansion of the insurance market and the desire to modernize claims management operations. Each region’s sub-segmentation differs based on local regulatory requirements, technology adoption rates, and market maturity, which influence the overall demand and growth of claims management software solutions.

KEY INDUSTRY PLAYERS

Key Players to Emphasize on Advanced UPS to Strengthen their Positions

The prominent players in the market, such as Salesforce and DWK, are expected to dominate the market. These players are focused on offering claims management options to cater to the changing user requirements. Similarly, these players are adopting various strategies, such as partnerships and investments, to continue their dominance in the upcoming years.

LIST OF TOP CLAIMS MANAGEMENT COMPANIES:

• Salesforce, Inc. (U.S.)
• Guidewire Software (U.S.)
• Aclaimant (U.S.)
• BriteCore (U.S.)
• Claimable Ltd. (U.K.)
• Duck Creek Claims (U.S.)
• DWF (U.K.)
• EIS ClaimCore (U.S.)
• DXC Technology Company (U.S.)
• ProcurementIQ (U.S.)

KEY INDUSTRY DEVELOPMENTS:

• May 2024: InsurTech Optalitix partnered with Pool Re to implement a new, complete treaty and claims management system with enhanced reporting and full auditability.
• May 2024: Tego Partners with Five Sigma to revolutionize claims management in Australia. This partnership highlights the need for claims management systems to improve efficiency and handle the growing complexity and volume of claims.
• March 2024: EIS launched ClaimSmart, a cloud solution aimed to redefine the claims management landscape. ClaimSmart enables insurers to decrease the cost of claims while considerably growing the quality of the customer experience.
• April 2023: Swiss Re Reinsurance and Des Moines-based insurtech Benekiva partnered to improve an Integrated Claims Management Platform that merges Benekiva's state-of-the-art claims administration system with Swiss Re's Claims Automated Rules Engine and deep expertise in risk management.
• October 2023: InsureMO and Mendix entered into a partnership to help insurance companies accelerate claim management and digital transformation initiatives.

REPORT COVERAGE

The study on the market includes prominent areas globally to help the user get a better knowledge of the industry. Additionally, the research provides insights into the most recent market trends and an analysis of technologies that are being adopted quickly. It also emphasizes some of the growth-stimulating factors and restrictions, allowing the reader to obtain a thorough understanding of the market.

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REPORT SCOPE & SEGMENTATION