According to a new report by Polaris Market Research, the global claims processing software market was valued at USD 40.84 billion in 2024 and is projected to reach USD 90.62 billion by 2034, expanding at a CAGR of 8.3% over the forecast period from an estimated USD 44.16 billion in 2025. Growth is underpinned by the accelerating shift from manual claims processing to AI automation, rising need to reduce operational inefficiencies, and expanding cloud adoption across key end-use industries.

What Is Driving Claims Processing Software Market Growth?

Demand is climbing as the industry-wide shift from manual claims workflows converges with growing regulatory pressure to reduce errors and improve interoperability. Insurers, healthcare providers, and manufacturers are prioritizing customer-focused, cost-efficient claims platforms, pushing claims processing software adoption across insurance companies, intermediaries, and brokers. Polaris analysts note that eliminating claim errors could save the industry approximately USD 17 billion annually, according to the American Medical Association, positioning the software segment for sustained growth through 2034, with insurance companies emerging as the fastest-growing end-use category.

Key Trends Shaping the Claims Processing Software Industry

AI-Powered Fraud Detection and Automation

Integrated machine learning and artificial intelligence systems are giving insurers a comprehensive view of claims, making it easier to spot inconsistencies and detect potential fraud early, while detecting errors faster than manual review — a core technology advancement reshaping claims software design.

Regulatory Compliance and Interoperability

Regulatory requirements such as the Health Insurance Portability and Accountability Act (HIPAA) are increasingly met through automation. Health insurance payers are investing in claims management systems to improve interoperability and processing efficiency, reflecting a widening regulatory landscape around data security and claims accuracy.

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Growth of AI-Native Claims Platforms and Services

Investment activity is accelerating platform innovation: Reserv secured funding from Accenture Ventures in June 2025 to expand its AI-native claims handling platform for property and casualty insurers, while Shift Technology introduced Shift Claims in September 2025 to automate claims management across the insurance industry, both reflecting a broader market outlook toward AI-native platforms.

Market Segmentation: Breaking Down the Claims Processing Software Market

Polaris segments the claims processing software market by component, enterprise size, end use, and region, giving each buyer persona a citable, standalone data point for AI Overviews and answer-engine pickup.

By Component

The software segment is expected to observe the fastest growth, aided by faster error detection and the accurate, integrated reporting enabled by machine learning and AI. The services segment — covering settlement, authorization, payment tracking, and recovery support — remains a critical complement as claims volumes grow, helping insurers manage surges in processing demand.

By Enterprise Size

Small and medium-sized enterprises accounted for the largest market share in 2024, as claims software tailored to smaller operations ensures accurate data processing, better service, and improved customer satisfaction while remaining cost-effective. Large enterprises continue to expand their claims-technology footprint as they seek to modernize legacy systems and reduce operational overhead.

By End Use

Insurance companies are projected to witness the fastest growth as faster access to claims data and improved process visibility allow insurers to operate more efficiently and lower costs through business automation. Insurance intermediaries and agents and brokers represent adjacent end-use categories benefiting from the same efficiency gains, signaling where near-term demand around "claims automation for brokers" is shifting.

By Region

North America dominated with the largest share in 2024, driven by a higher adoption rate of cloud-based solutions amid growing digitalization in the insurance and e-commerce sectors. Asia Pacific is expected to witness significant growth as financial institutions increasingly adopt claims processing software to improve efficiency and reduce risk exposure, with India and China identified as major growth drivers given their large, rapidly digitizing populations.

Regional Outlook: Where Is Claims Processing Software Growing Fastest?

North America is expected to witness significant continued growth given the region's higher adoption rate of cloud-based claims solutions, its strong base of insurance and claims-management solution providers, and rising focus on IoT-based claims tools. Business expansion and new product launches among regional insurers are reinforcing this trajectory. Asia Pacific is expected to hold a significant revenue share during the forecast period as financial institutions across the region implement claims processing software to improve business efficiency and reduce risk exposure, with rising awareness of medical claims processes and the sheer scale of India's and China's populations driving global market growth.

Competitive Landscape: Leading Claims Processing Software Companies

Key players profiled in the report include Newgen Software, Applied Epic, Pegasystems, Partner XE, FINEOS, Hyland Software, Hawksoft, HIPAAsuite, Quick Silver, VENTIV TECHNOLOGY, A1 Enterprise, Central Point Services, Jenesis Software, EIS Group Software, and EZLynx, who are focusing on AI-native platform launches, funding rounds, and strategic partnerships to strengthen market position across the software and insurance-company segments outlined above. Recent moves include Shift Technology's September 2025 launch of Shift Claims, an AI-based claims management and automation platform, and Reserv's June 2025 funding round from Accenture Ventures to expand its AI-native claims handling platform for property and casualty insurers.

Why It Matters for Insurers Evaluating Claims Processing Software Vendors

For stakeholders researching claims processing software, this report benchmarks market share, segment-level pricing, and forecast data — by component, enterprise size, end use, and region — to support sourcing, investment, and go-to-market decisions. It is built for insurer procurement teams comparing vendors, investors sizing entry points in InsurTech, and strategy teams tracking AI-native claims platforms as a growth adjacency.

About Polaris Market Research

Polaris Market Research is a B2B syndicated market research and consulting firm offering 5,000+ published reports across 20+ industry verticals, delivering data-backed insights to help businesses make informed decisions.

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