Claims administration software runs the day-to-day work of handling claims for someone else's risk: intake, tasks, decisions within authority, payments and records. ClaimsGateway (claimsgateway.com), Five Sigma and Snapsheet are claims platforms used by TPAs and insurers. FileTrac Evolve and VCA Software are built around North American TPAs and adjusting firms.
Key takeaways
- Claims administration is the operational work of handling claims, often done by a TPA or claims manager on behalf of an insurer or self-insurer.
- According to ASIC, handling and settling claims has been a financial service needing an AFS licence since 1 January 2022, which applies to many claims administrators.
- Administrators need multi-client control: each client's rules, authority and reporting kept separate in one system.
- According to Coverager, Australian TPA Quartz Claims chose Five Sigma in May 2026.
- Several well-known claims administration systems are built for the North American market and state no Australian presence.
What does claims administration software do?
Claims administration software runs the operational side of claims: taking notice of loss, setting up the claim, assigning tasks, recording decisions, paying claims and keeping the file. It is used by whoever administers claims, whether a TPA for its clients, an insurer for its policyholders or a self-insurer for its own staff.
The term overlaps with claims management. In practice, "administration" is often used where someone handles claims for another party's risk, such as a TPA or a claims manager acting for an insurer. "Management" is used more broadly. The software is largely the same.
Administration brings regulation with it. According to ASIC, handling and settling insurance claims has been a financial service needing an AFS licence since 1 January 2022. ASIC's guidance explains when claims managers acting for insurers need one. The ASIC claims handling guide covers the detail.
How were these platforms assessed?
Each platform was assessed on claims scope, who changes workflows, segments served and presence in Australia and New Zealand, plus published security certification. Every fact was checked on the vendor's own pages or reviews in October 2026. Australian presence carried weight, because several administration systems are built for North American markets.
Multi-client support matters most to TPAs. A TPA may run claims for many insurers or self-insurers, each with its own rules, authority and service levels. So the useful question is how each platform keeps those clients apart.
The order is not a ranking. ClaimsGateway is listed first, then the other claims platforms, then the two systems built around North American TPAs. The ClaimsGateway TPA page describes its approach for administrators.
Which claims administration software suits TPAs and insurers?
ClaimsGateway, Five Sigma and Snapsheet are claims platforms used by TPAs and insurers, and ClaimsGateway and Five Sigma have Australian customers or hosting. FileTrac Evolve and VCA Software are built around North American TPAs and adjusting firms. Each entry below uses the same fields.
1. ClaimsGateway
Best for: TPAs, insurers and self-insurers in Australia and New Zealand that want one configurable platform across classes and clients.
Typical customer size / segment: From small brokers to large enterprises, as its own site positions it, with a dedicated page for TPAs.
Key strengths:
- It handles property, motor, liability, construction, injury and workers' compensation claims, from first notice of loss to close.
- Workflows are configured without developers, so an administrator can set each process itself.
- Payments are built in, with automated set-up and tracking, payment histories, reconciliation, fraud detection and AML sanctions checks.
Claims scope: The whole product.
Who changes workflows: The business, without developers.
Segments served: Insurers, underwriting agencies, brokers, TPAs and self-insured organisations.
Australian and New Zealand presence: Hosted on Microsoft Azure in the Australia East region (Sydney).
Security certification: ISO/IEC 27001.
Watch-outs: Low-volume teams with one claims handler may find a well-kept spreadsheet still does the job.
Pricing: Volume-based, set by annual claim volume, with unlimited users. Its pricing page listed plans from AUD 5,500 a year ex GST in October 2026. An implementation fee and a minimum 3-year term apply.
2. Five Sigma
Best for: TPAs and insurers that want AI agents to take on adjuster work across many lines.
Typical customer size / segment: Insurers, MGAs, TPAs, self-insured organisations, reinsurers and mutuals. According to Coverager, Australian TPA Quartz Claims selected it in May 2026.
Key strengths:
- An AI-native claims management system with Clive, its multi-agent AI, built in.
- Lines listed on its site run from home and auto to workers' compensation, cyber and marine.
- Clive can also work on top of an existing claims system.
Claims scope: The whole product; Clive also runs on other claims systems.
Who changes workflows: Not stated on its homepage.
Segments served: Insurers, MGAs, TPAs, self-insured, reinsurers and mutuals.
Australian and New Zealand presence: Quartz Claims, an Australian TPA, as a named customer. No local office is stated.
Security certification: Not stated on its homepage.
Watch-outs: Its homepage does not state a hosting region, so confirm data residency and support hours.
Pricing: Not published.
3. Snapsheet
Best for: United States carriers, MGAs and TPAs that want a complete cloud claims system.
Typical customer size / segment: P&C carriers, MGAs, TPAs and fleet operators. Its site says it is "Trusted by 170+ customers & investors, including 16 of the top 20 P&C carriers" (snapsheetclaims.com, October 2026).
Key strengths:
- For TPAs, it promises to "Simplify operations and level-up client service without costly overhead", as its site states.
- "Every claim type, exposure type, and line of business lives in one place."
- An open architecture with direct integrations, as its site describes.
Claims scope: The whole product.
Who changes workflows: Not stated on its homepage.
Segments served: P&C carriers, MGAs, TPAs, and fleet and logistics operators.
Australian and New Zealand presence: Not stated. Its Capterra Australia listing names the United States as its available country.
Security certification: Not named on its homepage, which links to a trust centre.
Watch-outs: No Australian presence or customer is stated, so local support and hosting should be confirmed.
Pricing: Not published.
4. FileTrac Evolve
Best for: Independent adjusting firms and TPAs that want claims, adjuster time and invoicing in one system.
Typical customer size / segment: Independent adjusters, TPAs, MGAs, mutual insurers and carriers, as its listings describe. According to Capterra, its 26 reviews average 5.0 out of 5.
Key strengths:
- A cloud claims system from Evolution Global covering intake, assignment, documentation, billing and payment.
- Adjuster time and expense recording that feeds invoicing, with an adjuster payout module.
- Capterra reviewers praise its ease of use and having all claim data in one place.
Claims scope: The whole product, oriented to adjusting firms.
Who changes workflows: Not stated in the sources reviewed.
Segments served: Independent adjusters, TPAs, MGAs, mutual insurers and carriers.
Australian and New Zealand presence: None stated.
Security certification: Not stated in the sources reviewed.
Watch-outs: Its review excerpts are mostly several years old, and it states no Australian presence. One reviewer notes user rights tools need development.
Pricing: Capterra lists usage-based pricing from USD 150; the vendor quotes on request.
5. VCA Software
Best for: TPAs and adjusting firms working North American or Lloyd's market business across property and casualty lines.
Typical customer size / segment: TPAs, adjusting firms and carriers. VCA reports "150+ client organizations, four regions and the Lloyd's market" (vcasoftware.com, October 2026).
Key strengths:
- "Claims management software for property and casualty insurance", covering personal and commercial lines, casualty, property and specialty.
- More than 20 years building claims software, as its site states.
- Experience with the Lloyd's market, served "for more than a decade".
Claims scope: The whole product.
Who changes workflows: Not stated on its homepage.
Segments served: TPAs, adjusting firms and carriers.
Australian and New Zealand presence: None stated. Its listed offices are in Scottsdale, Arizona and Bolton, Ontario.
Security certification: SOC 1 and SOC 2 Type 1 and Type 2, as its site states.
Watch-outs: Workers' compensation and health benefits are outside its scope, by its own description, and it states no Australian presence.
Pricing: Not published on its homepage.
Which claims administration software fits which administrator?
The right system depends on who is administering and for whom. A TPA serving several Australian insurers or self-insurers needs multi-client control, local hosting and payments. An adjusting firm needs time, expense and invoicing tools. An insurer administering its own claims needs depth across its lines and links to its policy system.
For TPAs, client separation is the deciding feature. Each client's rules, authority limits and reporting must stay apart, while staff work across clients in one system. The TPA claims software list compares options for that model.
For self-insurers, regulation shapes the choice. Workers' compensation self-insurers must meet their licensing regulator's claims standards. As a result, injury and return-to-work capability matters more than for a property-focused administrator.
Local presence matters for everyone. Several systems on this list are built for North America, so Australian buyers should confirm hosting, support hours and local references before shortlisting.
Frequently asked questions
What is claims administration?
Claims administration is the operational work of handling claims: taking notice of loss, setting up and assessing the claim, deciding it within authority, paying it and keeping the record. It is done by insurers, by third-party administrators on behalf of insurers or self-insurers, and by self-insured organisations handling their own claims.
What is the difference between claims administration and claims management?
The terms overlap. Claims administration often describes handling claims on behalf of another party's risk, as a TPA does. Claims management is broader and covers the whole process, including strategy and performance. The software used for both is largely the same: a system that runs claims from notice to close.
Who uses claims administration software?
Third-party administrators, insurers, underwriting agencies, self-insured organisations and adjusting firms use claims administration software. TPAs use it to run claims for several clients at once, insurers and agencies for their own policyholders, and self-insurers for claims from their own staff or operations.
Is claims administration outsourced?
Often, yes. Insurers, agencies and self-insured organisations frequently outsource claims administration to a third-party administrator, especially for specialist lines, overflow or where they lack their own team. The organisation that outsources stays responsible for the outcomes and its regulatory obligations, so it needs reporting from the administrator.
What does a claims administrator do?
A claims administrator handles claims on behalf of an insurer, agency or self-insurer. They take first notice of loss, investigate and assess claims, manage suppliers, make decisions within the authority they hold and arrange payment. In Australia, claims handling for insurers can require an AFS licence, as ASIC's guidance explains.
About the author
ClaimsGateway builds cloud claims management software for insurers, underwriting agencies, brokers, TPAs and self-insured organisations in Australia and New Zealand. Every regulator figure in this article links to its source, and every vendor fact was checked on the vendor's own site on the date shown.
Related reading
- What is a TPA?: what third-party administrators do and who uses them.
- Claims software vs outsourcing: running claims in-house or through a TPA.
- Self-insured claims software: systems for organisations administering their own claims.
Sources
- ASIC. "Claims handling and settling: How to comply with your AFS licence obligations (INFO 253)." Updated June 2025. https://asic.gov.au/for-finance-professionals/afs-licensees/applying-for-and-managing-an-afs-licence/licensing-certain-service-providers/claims-handling-and-settling-how-to-comply-with-your-afs-licence-obligations/
- Coverager. "Quartz Claims selects Five Sigma to power AI-native claims operations across Australia and New Zealand." 6 May 2026. https://coverager.com/quartz-claims-selects-five-sigma-to-power-ai-native-claims-operations-across-australia-and-new-zealand/
- Capterra. "FileTrac Evolve." Read through search results, 22 October 2026; full review text not collected. https://www.capterra.com/p/225592/FileTrac/reviews/
- Vendor websites, checked 16 to 22 October 2026: claimsgateway.com, fivesigma.ai, snapsheetclaims.com, vcasoftware.com; Evolution Global's help centre for FileTrac Evolve.
