Core Software

Majesco Claims for L&AH – Claims Management Software for L&AH Insurance

Smarter, Faster Claims Management for the AI Era

Transform claims into a smarter, faster experience with L&AH claims management software. Majesco Claims for L&AH delivers end-to-end lifecycle management with embedded intelligence that reduces manual effort and improves responsiveness. Agentic AI brings a new level of autonomy to claims, enabling hands-off processing, proactive exception handling, and more consistent outcomes across every step of the journey.

Quickly change the name on a policy in less than 30 seconds compared to the 3 minutes it takes in a traditional UI.

Flexible, Simplified Claims

Automate and streamline the entire claims process, including eligibility checks, benefit applicability, claims summary, and post-submission claim form editing for a wide range of insurance products such as dental, life, vision, accident, long-term care, disability, critical illness, hospitalization, and more. Benefit from a flexible, simplified, STP-first, and automated claims operating environment that offers extensive calculation and payout options for benefit amounts, payment schedules, adjustments, overpayments, delayed claim interest, and OFAC checks.

Leverage Advanced Claims Management

Utilize end-to-end insurance claims management capabilities, from intake to settlement and payment. With Majesco DocScribe, claim-related documents — from physician statements to policy forms — are automatically ingested, reviewed, and converted into structured data for faster adjudication and compliance. Automate prior claim analysis and cut decision time by up to 70% with AI-driven adjudication. Access a comprehensive 360-degree dashboard for each claim, providing a cross-LOB view, discrepancy management to align claim data with policy, and an event center to track timelines and action plans.

Deliver Exceptional Customer Experiences

Exceed policyholder expectations with end-to-end digitally enabled claims handling. Enable case-driven straight-through processing, exception workflow, and support for various engagement channels. Empower claims adjusters with a highly configurable and business rules-driven platform to meet the demanding expectations of customers.

L&AH Core Suite Solutions

Policy for L&AH

Maximize business growth and cater to your customers’ life journey with our powerful single platform designed for individual, group, and voluntary benefits. Experience the seamless integration and advanced capabilities of our platform to drive success in the L&AH industry.

Billing for L&AH

Transform your billing processes into a key enabler for exceptional customer experience and business success with our cutting-edge platform. Seamlessly integrate advanced features and functionalities to optimize billing operations and improve customer satisfaction. Stay ahead of the competition with our innovative solution, designed to maximize your business’s growth and success.

Illustrations for L&AH

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Exceptional Claims Management from Intake to Settlement

Deliver responsiveness, customer value, and business process improvements with claims that stay in sync with a more modern, flexible underwriting experience across rating, decisions, renewals, and analytics.

  • Leverage AI agents to accelerate claims intake and routing, reducing manual touchpoints.
  • Manage intake, settlement, payment, appeals, reopen, hold/release, void, resubmit, and archiving processes.
  • Integrate systems to enhance the flow of information across departments.
  • Store everything electronically on one central platform, eliminating paper files.
  • Provide support for Short-Term Disability (STD), Long-Term Disability (LTD), Life (Whole, Term, and Universal), Accidental Death and Dismemberment (AD&D), Life Waiver of Premium Critical Illness, Hospital Indemnity, Accident, and Cancer.

Case-Driven Management with Straight Through Processing

Automate and streamline case management through always-on processing.

  • Utilize a flexible, simplified, STP-first, and automated claims operating environment.
  • Automate and streamline claims from eligibility check, benefit applicability, and claims summary to post-submission.
  • Configure workflows and tasks to ensure your team focuses on complex decision-making rather than manual administrative duties.
  • Gain better insights to make data-driven decisions.

Better Claims Outcomes

Utilize built-in, rules-based best practices, workflows, and third-party integrations.

  • Assign the right claims to the right people at the right time to improve claim outcomes.
  • Improve the accuracy and timeliness of claim decisions.
  • Manage discrepancies, monitor timelines, and create action plans.
  • Monitor claims timelines and action plans through the event center.

FAQ

What is claims management software?

L&AH claims management software facilitates and automates the processing of claims for insurance companies. This process begins at First Notice of Loss (FNOL) and continues until final adjudication. This is where a claim is paid or in some cases denied. Claims management software is designed to streamline each of an insurance company’s internal processes within this workflow, allowing staff to be more productive while making better claims determinations.

How does a Cloud solution streamline the process?

Cloud solutions allow carriers to access their data and solution from anywhere at any time. In addition, Cloud solutions help to automate manual processes, help businesses keep up with technological changes, and simplify disaster recovery.

What does comprehensive claims management include?

For a solution to be considered comprehensive it should at a minimum have features for document management, process/workflow automation, and claims settlement. Top-tier providers include additional features that further improve the user experience and productivity.

The Future Starts With Majesco