The claims processing software market was estimated at USD 40.84 billion in 2024, the base year, and USD 44.16 billion in 2025, when the forecast period begins. It is projected to reach USD 90.62 billion by 2034, growing at a CAGR of 8.3% from 2025 to 2034. North America was the largest market in 2024. Key companies include Newgen Software Technologies Limited, Pegasystems Inc., FINEOS, and Duck Creek Technologies. Polaris Market Research links growth to the shift away from manual processing.

AI Automation Replaces Manual Processing

The report states that the transition from manual processing to AI automation is fueling market growth. Claims management software provides data collection, settlement, authorization, payment tracking, recovery, communications management, and monitoring. By managing all aspects of a claim within a single system, it allows easier access to consumer data and improved workflow, while reducing errors, saving time, and improving data accuracy. In September 2025, Shift Technology introduced Shift Claims, an AI-based software designed to improve claims management and automate processes in the insurance industry.

Fraud Detection and Error Reduction

A comprehensive view of claims makes it easier to spot inconsistencies and supports early fraud detection. The report notes that the software can detect errors faster than the human eye, and attributes the accurate information in reports and complete status overviews to integrated artificial intelligence capabilities. In February 2025, Hawaii Employers' Mutual Insurance Company partnered with EvolutionIQ to use its AI-driven Claims Guidance and MedHub solutions, aiming to speed claims processing through automated medical summaries and case prioritization.

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Cloud-Based Solutions Strengthen North America

North America held the largest share in 2024 because of its higher adoption of cloud-based solutions, supported by growing digitalization in the insurance and e-commerce sectors. The region also has a strong presence of insurance and claims management solution providers, and business expansion and product launches are driving demand. In September 2025, BriteCore launched cloud-based claims processing software to help insurers improve team visibility, streamline workflows, and reduce processing time. Asia Pacific is expected to hold a significant revenue share as financial institutions implement the software to improve efficiency and reduce risk exposure.

Small and Medium-Sized Enterprises Lead by Enterprise Size

Small and medium-sized enterprises accounted for the largest share in 2024. Software for small and medium-sized enterprises ensures accurate data processing, which leads to better service and higher customer satisfaction, and its cost-effectiveness is credited for the segment's rapid growth. The software also reduces time, allowing organizations to use it for other purposes. Large enterprises form the other segment in the enterprise size category.

Insurance Companies as the Fastest-Growing End-Use

The insurance companies segment is projected to witness the fastest growth. Faster access to claims data helps them operate efficiently, and tracking claim process performance improves process visibility. Business automation lowers costs, which insurance companies use to gain a competitive advantage, and it helps employees save time and increase productivity. Other end-use groups include insurance intermediaries and agents and brokers. Data security concerns and high implementation cost continue to limit growth.

Key Players in the Market

•       Newgen Software Technologies Limited

•       Applied Epic

•       Pegasystems Inc.

•       Partner XE

•       Duck Creek Technologies

•       FINEOS

•       Hyland Software, Inc.

•       HawkSoft, Inc.

•       HIPPAsuite

•       Quick Silver

•       VENTIV TECHNOLOGY

•       a1 enterprise, inc.

•       Central Point Services Limited

•       Jenesis Software

•       EIS Group Software Limited

•       EZLynx

Conclusion

The claims processing software market is projected to rise from USD 44.16 billion in 2025 to USD 90.62 billion by 2034 at a CAGR of 8.3%. AI automation, stronger fraud detection, wider use of cloud-based solutions, and demand from small and medium-sized enterprises and insurance companies define the current direction. Vendors that manage security and implementation cost will be better placed to capture this demand.

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