FINEOS Claims

FINEOS Claims is the claims management part of the FINEOS Platform, a SaaS insurance system for life, accident and health insurers. The company describes it as a rules-driven, case-based and customer-centred claims product within a wider enterprise suite. It serves insurers that run employee benefits and government schemes.

Main features

• Claims management: rules-driven, case-based and customer-centred claims handling.
• Absence management: manages absence within the AdminSuite.
• Billing and payments: billing and payments handled within the AdminSuite.
• Policy administration: policy administration, provider management, new business and underwriting.
• FINEOS Engage: machine-learning digital engagement pathways for customers.
• FINEOS Insight: predictive analytics and reporting across the business.

Who it works with

Life, accident and health insurers, including employee benefits insurers and government insurance schemes in North America, Europe and Asia Pacific.

Key facts

• Customers: 7 of the 10 largest employee benefits insurers in the US.
• Market share: 70% of group insurance in Australia.