Enterprise Claims Management for Property & Casualty Carriers and TPAs
The average claim sits in queues for days, not because adjusters aren't working — but because they can't find the police report, the medical authorization is buried in someone's email, and the approval workflow stalled when the manager went on vacation. Regure cuts cycle time in half by eliminating the document hunting.
- CLM-8892AutoRear-end collision · $8.4K est.JRSLA 3h 12m
- CLM-8891AutoMulti-vehicle · fraud reviewMSFlagged
- CLM-8879PropWater damage · $42K settlementTAAwaiting approval
- CLM-8871CasSlip & fall · investigatingKDIn progress
- CLM-8863WCBack strain · $8.5K approvedJRSettled
TPA Claims Software — Reduce Leakage, Accelerate Cycle Times
Insurance carriers and TPAs process thousands of claims monthly — auto, property, health, casualty, workers comp. But average cycle time from FNOL to settlement still averages 12-18 days for routine claims that should settle in 5. The delay isn't assessment time — it's administrative friction.
Adjusters spend 14+ hours per week searching for documents, manually routing claims to supervisors for approval, chasing field adjusters for photos, and waiting for medical records that arrived but nobody classified. Every hour of administrative work is an hour not spent assessing claims and preventing leakage.
Claims leakage — overpayments due to insufficient investigation, duplicate payments, or fraud — costs carriers 5-10% of claim spend. A $500M annual claim spend carrier loses $25-50M to leakage. Fraud alone accounts for 10% of property-casualty claims costs, per the Coalition Against Insurance Fraud.
Regure is claims management software for carriers that eliminates administrative friction: automated FNOL intake, intelligent claim assignment, multi-level approval workflows, and fraud detection on suspicious documents.
Automated FNOL intake and triage that gets claims into adjuster hands in minutes
First Notice of Loss is where cycle time starts — and where most carriers lose days. Regure automates intake from every channel: email, web portal, phone transcription, broker API, field adjuster mobile app. See automation by line: property, auto, workers comp.
Multi-Channel Intake
Claims arrive everywhere: policyholders call the 1-800 number, brokers email loss reports, field adjusters photograph damage, web portals capture FNOL submissions. Regure ingests from all channels and creates unified claim records in 3 minutes average.
FNOL data is classified by loss type (auto, property, liability, health), severity estimated from narrative and loss amount, and priority assigned based on policyholder status and SLA requirements.
Intelligent Triage & Routing
Not all claims need the same handling. Low-severity auto claims under $5K route to junior adjusters. High-severity or complex claims route to senior adjusters. Potentially fraudulent claims flag for SIU review. Configurable workflows ensure the right adjuster gets the right claim.
Routing considers adjuster workload, expertise, geographic location, and current SLA performance — preventing one adjuster from being overloaded while others have capacity.
Missing Document Detection
Claims can't progress without required documentation. Regure identifies what's missing (police report, medical records, photos, repair estimates) and auto-generates requests to the claimant or broker before the adjuster opens the file.
This proactive document collection eliminates back-and-forth that adds 3-5 days to cycle time. Adjusters receive claims with complete documentation, ready for assessment.
SLA Monitoring & Escalation
Claims approaching SLA deadlines auto-escalate to supervisors. Acknowledgment requirements (24-hour in many states), investigation timelines, and settlement deadlines are tracked with automated alerts. No more manual SLA tracking in spreadsheets.
SLA compliance improved from 72% to 97% for carriers implementing automated escalation workflows.
See multi-channel FNOL intake on your own claim mix
Regure ingests from email, portal, phone, broker API, and mobile — creating unified claim records in under 3 minutes on your actual data.
Multi-level approval workflows with settlement thresholds and authority limits
Claims above settlement thresholds require supervisor approval. Regure automates the approval chain: adjuster recommends, supervisor reviews, manager approves — with complete audit trails and SLA tracking.
Most carriers operate with settlement authority limits: junior adjusters approve up to $10K, senior adjusters up to $50K, supervisors up to $250K, and anything above requires claims director approval. These thresholds control risk and ensure appropriate oversight — but they create bottlenecks when approvals happen via email.
An adjuster finishes assessing a $75K property claim, emails the supervisor for approval, and waits. The supervisor is in meetings, on vacation, or handling 15 other approval requests. The claim sits for 2-3 days waiting for a decision that takes 10 minutes to make.
Regure automates approval routing:
- Settlement recommendations auto-route to the appropriate approver based on amount and claim type
- Approvers see all pending approvals in one queue with claim summaries, adjuster recommendations, and supporting documentation
- Approvals happen in-app with timestamped decisions logged in immutable audit trails
- Auto-escalation if approvals aren't completed within SLA (e.g., 24 hours for routine approvals)
- Delegation workflows allow supervisors to delegate approval authority during absence without stopping the approval chain
For catastrophe events when approval volumes surge, temporary authority increases can be configured system-wide, allowing adjusters to approve higher amounts during CAT response without individual authority changes.
Fraud detection that flags suspicious claims before investigation begins
Fraud costs carriers 10% of claim spend. Regure flags fraud indicators at FNOL: duplicate claims, suspicious addresses, inconsistent narratives, known fraud patterns — routing flagged claims to SIU before resources are wasted.
Duplicate Claim Detection
The same loss reported multiple times to different adjusters or under different policy numbers. Regure detects duplicate claims by comparing claimant names, loss dates, loss locations, and descriptions — flagging potential duplicates for SIU review.
Known Fraud Indicators
Addresses associated with prior fraud, claimants with suspicious claim histories, providers with high fraud rates. Regure maintains fraud indicator databases and flags claims involving known bad actors.
Pattern Recognition
Multiple claims filed within short timeframes, claims filed immediately before or after policy cancellation, unusually high claim amounts relative to policy value. AI models identify patterns indicating organized fraud schemes.
Cut claims leakage without a core-system replacement
See fraud detection, smart assignment, and multi-level approvals working alongside your Guidewire, Duck Creek, or Sapiens stack — in 14 days, not 14 months.
What carriers and TPAs ask about Regure
Does Regure integrate with Guidewire or Duck Creek?
Yes. Regure integrates with Guidewire ClaimCenter, Duck Creek Claims, and other core claims systems via bi-directional APIs. The same layered approach applies to policy administration platforms (Guidewire PolicyCenter, Duck Creek Policy, Sapiens, Insurity). FNOL data extracted by Regure flows into your claims system automatically. Claim status updates flow back to Regure for reporting and customer portal display. See Guidewire comparison, Duck Creek comparison, or the top software platforms for P&C insurers 2026 guide.
How does intelligent claim assignment work?
Regure routes claims based on configurable rules: loss type, claim amount, geographic location, adjuster expertise, current workload, and SLA priority. High-severity claims route to senior adjusters. Low-severity claims route to junior adjusters. Potentially fraudulent claims route to SIU. Rules are configurable per your operational needs.
Can Regure handle catastrophe event surge volume?
Yes. Enterprise tier includes CAT event surge capacity that auto-scales infrastructure to handle 5-10x normal FNOL volume. Assignment rules adjust for CAT events to distribute claims across available adjusters, temporary staff, and independent adjusters. Temporary authority increases can be configured system-wide for faster settlements during CAT response.
How does fraud detection work?
Regure flags fraud indicators at FNOL intake: duplicate claims across adjusters/policies, known fraud addresses, suspicious claim patterns, and providers with high fraud rates. Flagged claims route to your SIU automatically with supporting evidence. The system doesn't make fraud determinations — it ensures potential fraud is detected early.
What does pricing look like for a mid-size carrier?
A carrier with 100-200 claims staff (adjusters, supervisors, SIU) would typically run the operations platform, priced on the modules in scope, the products you write and the configuration your operation needs rather than a per-seat list price — including FNOL automation, smart assignment, approval workflows, and fraud detection. See full pricing.
How long does implementation take?
Standard implementation is 14 days for single-line operations. Multi-line carriers (auto, property, health, casualty) typically require 3-4 weeks for full deployment including workflow configuration per line, integration with existing claims systems, and team training. See cycle time reduction case studies.
Is Regure secure enough for regulated insurance data?
Yes. Regure is built as a compliance-ready operations platform for regulated industries, with immutable audit trails logging every approval, status change, and document action. This gives carriers and TPAs a defensible record for regulatory review and internal audits. See Security & Compliance for the full breakdown.
Does Regure work the same way for TPAs as it does for carriers?
Yes. The same platform handles both, since TPAs and carriers face identical bottlenecks around FNOL intake, document collection, approval routing, and fraud flagging. Configuration differs by settlement authority, line of business, and client-specific SLAs, but the underlying automation is shared across both buyer types.
Can approval and routing rules be customized per line of business?
Yes. Assignment and approval rules are configurable independently for auto, property, health, casualty, and workers comp. A multi-line carrier can set different settlement thresholds, adjuster expertise routing, and SLA windows for each line rather than applying one universal ruleset.
What kind of reporting does Regure provide on cycle time and leakage?
Regure surfaces claim status, cycle time, and approval data back into the platform for reporting, since every FNOL, routing, and approval action is timestamped and logged. Claims directors get visibility into where delays are happening by line, adjuster, or claim type without pulling data manually from spreadsheets.
What support is included after implementation?
Carriers get workflow configuration support during the 14-day (or 3-4 week multi-line) rollout, plus ongoing access to adjust routing rules, SLA thresholds, and approval chains as operational needs change. This is distinct from a one-time setup, since claims volume, staffing, and fraud patterns shift over time.
See how Regure handles your carrier workflows
Book a 20-minute demo with your actual claim types. We'll show you FNOL automation, smart assignment, approval workflows, and fraud detection — with your data.