理赔处理软体市场规模、份额和成长分析（按部署类型、组织规模、产业、类型、功能和地区划分）－2026-2033年产业预测

全球理赔处理软体市场规模预计在 2024 年达到 479.8 亿美元，从 2025 年的 522 亿美元增长到 2033 年的 1025 亿美元，在预测期（2026-2033 年）内复合年增长率为 8.8%。

全球理赔处理软体市场正经历变革，其主要驱动力是人工智慧的进步，人工智慧正在推动诈骗侦测和预测分析的自动化。对自动化需求的不断增长、向云端解决方案的逐步转型以及严格的合规要求，都对该行业产生了显着影响。此外，客户对理赔处理流程中无缝数位化体验的期望，也迫使服务提供者提升自助服务能力并规范处理流程。这些发现表明，市场正在不断发展，以满足技术进步和消费者需求，最终提高理赔处理系统的效率和使用者满意度。

全球理赔处理软体市场驱动因素

全球保险理赔处理软体市场的主要驱动因素之一是保险和医疗保健产业对自动化日益增长的需求。随着各机构努力提高营运效率、减少处理错误并提升客户满意度，采用先进的保险理赔处理解决方案至关重要。这些先进的软体系统能够实现即时追踪、简化工作流程并提高数据准确性，最终加快理赔速度。此外，日益复杂的监管要求和对全面数据分析的需求进一步加速了对创新理赔处理解决方案的需求，使其成为企业在瞬息万变的市场环境中保持竞争力的必备工具。

全球理赔处理软体市场面临的限制因素

全球理赔处理软体市场面临的主要限制因素之一是网路威胁和资料外洩的日益增加。由于保险理赔处理涉及敏感的个人和财务信息，企业必须在网路安全措施方面投入巨资，以防止资料被盗并确保符合监管要求。这些高级安全要求导致营运成本和复杂性增加，这可能会阻碍小规模企业采用先进的理赔处理解决方案。此外，保险和医疗产业缺乏标准化可能会阻碍软体互通性，使整合工作更加复杂，并限制整体市场成长潜力。

全球计费软体市场趋势

全球保险理赔处理软体市场正经历着人工智慧驱动的个人化趋势，这正在重塑保险理赔的管理方式。随着保险公司积极采用先进的人工智慧技术，他们能够为客户提供更个人化的理赔体验。这种个人化服务能够加强沟通，主动指导客户准备所需文件，并根据个人理赔记录、行为分析和风险评估进行主动跟进。转向以客户为中心的预测性生态系统的转变有望显着简化理赔流程，同时提升客户满意度，并将人工智慧定位为理赔管理发展演变的核心要素。

目录

介绍

• 调查目标
• 调查范围
• 定义

调查方法

• 资讯收集
• 二手资料和一手资料方法
• 市场规模预测
• 市场假设与限制

执行摘要

• 全球市场展望
• 供需趋势分析
• 细分市场机会分析

市场动态与展望

• 市场规模
• 市场动态
  • 驱动因素和机会
  • 限制与挑战
• 波特分析

关键市场考察

• 关键成功因素
• 竞争程度
• 关键投资机会
• 市场生态系统
• 市场吸引力指数（2025）
• PESTEL 分析
• 总体经济指标
• 价值链分析
• 定价分析

全球理赔处理软体市场规模（按部署方式及复合年增长率划分）（2026-2033 年）

• 基于云端的
• 本地部署

全球理赔处理软体市场规模（依组织规模及复合年增长率划分）（2026-2033 年）

• 中小企业
• 大公司

全球理赔处理软体市场规模（依垂直产业划分）及复合年增长率（2026-2033 年）

• 保险
• 卫生保健
• 製造业
• 政府
• 运输/物流

全球理赔处理软体市场规模（按类型和复合年增长率划分）（2026-2033 年）

• 产物保险）
• 医疗保险
• 工伤意外赔偿保险

全球理赔处理软体市场规模（按功能和复合年增长率划分）（2026-2033 年）

• 资料管理
• 工作流程管理
• 报告与分析
• 一体化

全球理赔处理软体市场规模及复合年增长率（2026-2033）

• 北美洲
  • 美国
  • 加拿大
• 欧洲
  • 德国
  • 西班牙
  • 法国
  • 英国
  • 义大利
  • 其他欧洲地区
• 亚太地区
  • 中国
  • 印度
  • 日本
  • 韩国
  • 亚太其他地区
• 拉丁美洲
  • 巴西
  • 其他拉丁美洲地区
• 中东和非洲
  • 海湾合作委员会国家
  • 南非
  • 其他中东和非洲地区

竞争资讯

• 前五大公司对比
• 主要企业的市场定位（2025 年）
• 主要市场参与者所采取的策略
• 近期市场趋势
• 公司市占率分析（2025 年）
• 主要企业公司简介
  • 公司详情
  • 产品系列分析
  • 依业务板块进行公司股票分析
  • 2023-2025年营收年比比较

主要企业简介

• Guidewire Software（United States）
• Duck Creek Technologies（United States）
• Sapiens International Corporation NV（Israel）
• FINEOS（Ireland）
• Insurity（United States）
• Pegasystems Inc.（United States）
• OneShield Software（United States）
• Majesco（United States）
• Hyland Software, Inc.（United States）
• EIS（United States）
• LexisNexis（United States）
• Riskonnect（United States）
• Newgen Software Technologies Limited（India）
• BriteCore（United States）
• Snapsheet（United States）
• ClaimVantage（Ireland）
• Origami Risk（United States）
• Oracle Corporation（United States）
• IBM（United States）
• DXC Technology Company（United States）

结论与建议

Global Claims Processing Software Market size was valued at USD 47.98 Billion in 2024 and is poised to grow from USD 52.2 Billion in 2025 to USD 102.5 Billion by 2033, growing at a CAGR of 8.8% during the forecast period (2026-2033).

The global claims processing software market is experiencing transformative changes, primarily driven by advancements in artificial intelligence, which facilitates automation in fraud detection and predictive analytics. The growing need for automation, combined with a progressive transition towards cloud-based solutions and stringent compliance mandates, significantly influences this sector. Furthermore, client expectations for seamless digital experiences throughout the claims process compel providers to improve their self-service functionalities and standardize processing timelines. These insights indicate that the market is evolving to meet both technological advancements and consumer demands, ultimately enhancing efficiency and user satisfaction within claims processing systems.

Top-down and bottom-up approaches were used to estimate and validate the size of the Global Claims Processing Software market and to estimate the size of various other dependent submarkets. The research methodology used to estimate the market size includes the following details: The key players in the market were identified through secondary research, and their market shares in the respective regions were determined through primary and secondary research. This entire procedure includes the study of the annual and financial reports of the top market players and extensive interviews for key insights from industry leaders such as CEOs, VPs, directors, and marketing executives. All percentage shares split, and breakdowns were determined using secondary sources and verified through Primary sources. All possible parameters that affect the markets covered in this research study have been accounted for, viewed in extensive detail, verified through primary research, and analyzed to get the final quantitative and qualitative data.

Global Claims Processing Software Market Segments Analysis

Global Claims Processing Software Market is segmented by Deployment, Organization Size, Industry Vertical, Type, Functionality and region. Based on Deployment, the market is segmented into Cloud-based and On-premises. Based on Organization Size, the market is segmented into Small and Medium Enterprises (SMEs) and Large Enterprises. Based on Industry Vertical, the market is segmented into Insurance, Healthcare, Manufacturing, Government and Transportation and Logistics. Based on Type, the market is segmented into Property and Casualty (P&C), Health and Workers' Compensation. Based on Functionality, the market is segmented into Data Management, Workflow Management, Reporting and Analytics and Integration. Based on region, the market is segmented into North America, Europe, Asia Pacific, Latin America and Middle East & Africa.

Driver of the Global Claims Processing Software Market

One of the key market drivers for the global claims processing software market is the increasing demand for automation in the insurance and healthcare sectors. As organizations seek to enhance operational efficiency, reduce processing errors, and improve customer satisfaction, the adoption of advanced claims processing solutions becomes imperative. These sophisticated software systems enable real-time tracking, streamlined workflows, and enhanced data accuracy, ultimately leading to faster claims resolution. Additionally, the growing complexity of regulatory requirements and the need for comprehensive data analytics further propel the need for innovative claims processing solutions, making them indispensable for organizations aiming to remain competitive in a dynamic market landscape.

Restraints in the Global Claims Processing Software Market

One significant market restraint for the global claims processing software market is the increasing prevalence of cyber threats and data breaches. As claims processing involves sensitive personal and financial information, companies must invest heavily in cybersecurity measures to protect against data theft and ensure compliance with regulations. These heightened security requirements can lead to increased operational costs and complexity, potentially deterring smaller players from adopting advanced claims processing solutions. Furthermore, the lack of standardization across different insurance and healthcare sectors can hinder software interoperability, complicating integration efforts and limiting the market's overall growth potential.

Market Trends of the Global Claims Processing Software Market

The Global Claims Processing Software market is experiencing a notable trend towards AI-driven personalization, reshaping how insurance claims are managed. As insurers increasingly adopt advanced artificial intelligence technologies, they are able to deliver a more tailored claims experience for clients. This personalization allows for enhanced communication, anticipatory guidance on required documentation, and proactive follow-up actions based on individual claimant histories, behavioral insights, and risk assessments. The shift towards a predictive, customer-centric ecosystem is set to streamline claim-processing cycles significantly while simultaneously boosting customer satisfaction, positioning AI as a pivotal component in the evolution of claims management.

Table of Contents

Introduction

• Objectives of the Study
• Scope of the Report
• Definitions

Research Methodology

• Information Procurement
• Secondary & Primary Data Methods
• Market Size Estimation
• Market Assumptions & Limitations

Executive Summary

• Global Market Outlook
• Supply & Demand Trend Analysis
• Segmental Opportunity Analysis

Market Dynamics & Outlook

• Market Overview
• Market Size
• Market Dynamics
  • Drivers & Opportunities
  • Restraints & Challenges
• Porters Analysis
  • Competitive rivalry
  • Threat of substitute
  • Bargaining power of buyers
  • Threat of new entrants
  • Bargaining power of suppliers

Key Market Insights

• Key Success Factors
• Degree of Competition
• Top Investment Pockets
• Market Ecosystem
• Market Attractiveness Index, 2025
• PESTEL Analysis
• Macro-Economic Indicators
• Value Chain Analysis
• Pricing Analysis

Global Claims Processing Software Market Size by Deployment & CAGR (2026-2033)

• Market Overview
• Cloud-based
• On-premises

Global Claims Processing Software Market Size by Organization Size & CAGR (2026-2033)

• Market Overview
• Small and Medium Enterprises (SMEs)
• Large Enterprises

Global Claims Processing Software Market Size by Industry Vertical & CAGR (2026-2033)

• Market Overview
• Insurance
• Healthcare
• Manufacturing
• Government
• Transportation and Logistics

Global Claims Processing Software Market Size by Type & CAGR (2026-2033)

• Market Overview
• Property and Casualty (P&C)
• Health
• Workers' Compensation

Global Claims Processing Software Market Size by Functionality & CAGR (2026-2033)

• Market Overview
• Data Management
• Workflow Management
• Reporting and Analytics
• Integration

Global Claims Processing Software Market Size & CAGR (2026-2033)

• North America (Deployment, Organization Size, Industry Vertical, Type, Functionality)
  • US
  • Canada
• Europe (Deployment, Organization Size, Industry Vertical, Type, Functionality)
  • Germany
  • Spain
  • France
  • UK
  • Italy
  • Rest of Europe
• Asia Pacific (Deployment, Organization Size, Industry Vertical, Type, Functionality)
  • China
  • India
  • Japan
  • South Korea
  • Rest of Asia-Pacific
• Latin America (Deployment, Organization Size, Industry Vertical, Type, Functionality)
  • Brazil
  • Rest of Latin America
• Middle East & Africa (Deployment, Organization Size, Industry Vertical, Type, Functionality)
  • GCC Countries
  • South Africa
  • Rest of Middle East & Africa

Competitive Intelligence

• Top 5 Player Comparison
• Market Positioning of Key Players, 2025
• Strategies Adopted by Key Market Players
• Recent Developments in the Market
• Company Market Share Analysis, 2025
• Company Profiles of All Key Players
  • Company Details
  • Product Portfolio Analysis
  • Company's Segmental Share Analysis
  • Revenue Y-O-Y Comparison (2023-2025)

Key Company Profiles

• Guidewire Software (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Duck Creek Technologies (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Sapiens International Corporation N.V. (Israel)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• FINEOS (Ireland)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Insurity (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Pegasystems Inc. (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• OneShield Software (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Majesco (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Hyland Software, Inc. (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• EIS (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• LexisNexis (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Riskonnect (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Newgen Software Technologies Limited (India)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• BriteCore (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Snapsheet (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• ClaimVantage (Ireland)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Origami Risk (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• Oracle Corporation (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• IBM (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments
• DXC Technology Company (United States)
  • Company Overview
  • Business Segment Overview
  • Financial Updates
  • Key Developments

Conclusion & Recommendations