Australian insurers choose between putting a claims platform beside their core and replacing the core itself. ClaimsGateway (claimsgateway.com), Five Sigma and Wilbur are claims platforms that can sit beside an existing core. Guidewire ClaimCenter, Duck Creek Claims and InsuredHQ are claims inside core suites, which suit insurers replacing policy, billing and claims together.
Key takeaways
- An insurer's claims decision is really a programme decision: add a claims platform beside the core, or replace the core.
- According to AFCA, general insurance complaints reached 36,022 in 2025-26, and delay in claim handling was the most common issue.
- According to the Code Governance Committee, insurers recorded 70,325 Code breaches in 2024-25, 59% of them in claims.
- Under APRA's CPS 234, insurers must notify APRA of a material information security incident within 72 hours, including on systems run by third parties.
What are insurers really choosing between?
An insurer improving claims is usually choosing between two routes. One is to put a dedicated claims platform beside the existing core, connected by API. The other is to replace the core with a suite that runs policy, billing and claims together. The first is faster to change; the second consolidates more.
Neither route is right in general. A large insurer already standardising on one core vendor may sensibly take that vendor's claims module. However, an insurer whose core works for policy and billing, but whose claims process is slow to change, often gains more from a claims platform beside it. The core module or claims platform sets out that trade in detail.
The route also decides the size of the project. Replacing a core is a multi-year programme for most insurers. Adding a claims platform, by contrast, can be scoped to one line or one channel first. The replacing a legacy claims system covers how insurers stage that work.
How were these options assessed?
Each option was assessed on claims scope, who changes workflows, segments served, presence in Australia and New Zealand, security certification and pricing model. For insurers, two questions carry extra weight: how the system connects to an existing core, and who changes workflows once it is live, the business or IT.
Every vendor fact was checked on the vendor's own site, or a dated news source where noted, in October 2026. Implementation times were not compared, because no vendor here publishes them and claims about speed vary with scope. The ClaimsGateway insurers page shows how one claims platform approaches insurer claims.
Which claims platforms can sit beside an insurer's core?
Dedicated claims platforms treat the claim as the whole product and connect to an insurer's existing policy and billing systems. ClaimsGateway, Five Sigma and Wilbur are in this group. They suit insurers whose core is staying, but whose claims process needs to change faster than the core allows.
1. ClaimsGateway
Best for: Insurers that want a configurable claims platform beside their core, with workflows the business can change.
Typical customer size / segment: From small brokers to large enterprises, as its own site positions it, with a dedicated page for insurers.
Key strengths:
- Workflows are configured without developers, so claims changes are owned by the business.
- API-first, with integrations including Zendesk, MYOB Acumatica and Salesforce, plus custom API integrations.
- Payments are built in, with 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: Insurers replacing policy, billing and claims in one programme will be better served by a core suite.
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: Insurers that want AI built into claims handling, either on Five Sigma's platform or on top of their existing claims system.
Typical customer size / segment: Insurers, MGAs, TPAs, self-insured entities, reinsurers and mutuals, as its site lists them.
Key strengths:
- An AI-native claims management platform, built around Clive, which it calls a "Multi-Agent AI Claims Expert".
- Clive can work on top of existing claims systems, so an insurer can add it without replacing one.
- Chosen in May 2026 by Quartz Claims, an Australian TPA serving insurers (Coverager).
Claims scope: The whole product.
Who changes workflows: Not stated on the pages reviewed.
Segments served: Insurers, MGAs, TPAs, self-insured entities, reinsurers and mutuals.
Australian and New Zealand presence: One named Australian customer, Quartz Claims. No Australian insurer customer or local office is stated.
Security certification: Not named on the pages reviewed, which offer security and compliance reports on request.
Watch-outs: Its site does not state where support is based, so insurers should confirm data residency and support before CPS 234 due diligence.
Pricing: Not published.
3. Wilbur
Best for: Insurers that want a cloud claims platform with AI and analytics modules and a connected supplier network.
Typical customer size / segment: Insurers, managing general agents, brokers and TPAs, according to Insurance Business (September 2024).
Key strengths:
- A real-time claims management platform developed by Claim Central Consolidated.
- AI and analytics modules launched in September 2024, aimed at claims efficiency, fraud and underwriting.
- Insurers are the first segment it names.
Claims scope: The whole product.
Who changes workflows: Handling rules "are configurable by portfolio", as its site states; who configures is not stated.
Segments served: Insurers, MGAs, brokers and TPAs.
Australian and New Zealand presence: Its 2024 launch included an Australian roadshow, according to Insurance Business.
Security certification: Not stated on its homepage.
Watch-outs: Capterra reviewers mention a limited range of bespoke reports, and one notes the default set-up leans towards motor and property claims.
Pricing: Not published.
Which core suites include claims?
Core insurance suites run policy, billing and claims as one system, so claims is one application of a wider platform. Guidewire, Duck Creek and InsuredHQ are in this group. They suit insurers replacing or standardising their core, who value one vendor and one data model more than claims flexibility.
4. Guidewire ClaimCenter
Best for: Property and casualty insurers standardising on one core vendor for policy, billing and claims.
Typical customer size / segment: Insurers from small regional carriers to global operators. Guidewire states "270+ customers in more than 30 countries" (guidewire.com, October 2026).
Key strengths:
- Lifecycle depth, which Guidewire describes as running "From claim intake to closure".
- Part of Guidewire InsuranceSuite, alongside PolicyCenter and BillingCenter, on Guidewire Cloud Platform.
- Claim payments are tied to reserve lines inside the system, as its developer documentation describes.
Claims scope: One application in a core insurance suite.
Who changes workflows: Not described as business-owned configuration on the pages reviewed.
Segments served: Property and casualty insurers.
Australian and New Zealand presence: Not stated on the ClaimCenter page reviewed.
Security certification: Not stated on the ClaimCenter page reviewed.
Watch-outs: It is strongest as part of the full suite, so an insurer keeping a different core should weigh the integration effort.
Pricing: Contact for pricing.
5. Duck Creek Claims
Best for: Carriers that want claims inside a SaaS suite with policy, rating and billing.
Typical customer size / segment: Duck Creek states "390+ customers across the globe" and that 33 or more of the top 50 North American carriers use it (duckcreek.com, October 2026).
Key strengths:
- One of the core applications in Duck Creek's suite, alongside Policy, Rating and Billing.
- Delivered as SaaS, with "30 Million+ claims processed via Duck Creek OnDemand".
- Suite breadth, which suits an insurer wanting one vendor across the policy lifecycle.
Claims scope: One application in a core insurance suite.
Who changes workflows: Not stated on the page reviewed.
Segments served: Property and casualty carriers.
Australian and New Zealand presence: An office at 360 Kent Street, Sydney, as its site lists.
Security certification: Not stated on the page reviewed.
Watch-outs: By its own figures, its customer base leans towards North American carriers, so ask for Australian references.
Pricing: Contact for pricing.
6. InsuredHQ
Best for: Smaller insurers and MGAs that want policy, billing and claims together in one light cloud core.
Typical customer size / segment: Insurers, MGAs, brokers and insurtech start-ups. Named customers include Quest Insurance and New India (insuredhq.com, October 2026).
Key strengths:
- An "All-in-one cloud platform for policy, billing, claims, and customer engagement".
- Integrations with AWS, Stripe, Xero and Worldpay, as its site lists them.
- A lighter core than the carrier-scale suites, aimed at mid-market insurers.
Claims scope: One of five capability areas.
Who changes workflows: Not stated on the homepage.
Segments served: Insurers, MGAs and brokers.
Australian and New Zealand presence: New Zealand based. Australian customers are not identified on its homepage.
Security certification: Not named on its homepage.
Watch-outs: Claims sits inside a policy-led core, so an insurer whose pain is claims depth should test that module closely.
Pricing: Not published.
What is the regulatory case for better claims handling?
The regulatory case is about time and communication. According to AFCA, delay in claim handling was the most common general insurance complaint in 2025-26. The Code Governance Committee's 2024-25 figures show claims caused 59% of Code breaches, many of them missed updates rather than wrong decisions.
The detail matters more than the totals. According to the Code Governance Committee, insurers missed the requirement to update claimants at least every 20 business days 18,350 times in 2024-25, up 67%. In addition, 77% of all breaches were attributed to staff negligence or error. Those are process failures more than knowledge failures.
Of course, software does not fix a parts shortage, a stretched builder or a catastrophe surge. What it can do is make a deadline visible before it is missed, and record that the claimant was told. APRA's standards add weight to the choice of system: CPS 234 requires insurers to notify APRA of a material information security incident within 72 hours, and CPS 230 has required them to manage material service providers since 1 July 2025. The CPS 234 explainer covers what that means for a claims system.
Which route fits which insurer?
Three rules cover most insurers. An insurer already replacing its core should usually take the suite's claims module. An insurer keeping its core but struggling to change claims fast enough should look at a claims platform beside it. And a smaller insurer building from scratch may suit a light core that includes claims.
The middle case is the most common, and the hardest to see from inside. If every claims change waits for the next core release, the claims process is being run on the core's timetable. In that situation, a platform the business can configure lets claims move at its own pace. The ClaimsGateway and Guidewire comparison shows how that plays out against one widely used core.
Frequently asked questions
What claims system do Australian insurers use?
Australian insurers use a mix of core suites and dedicated claims platforms, and few publish which one runs their claims. Core suites with claims include Guidewire ClaimCenter, Duck Creek Claims and InsuredHQ. Dedicated claims platforms selling to insurers include ClaimsGateway, Five Sigma and Wilbur, which can sit beside an existing core.
Should an insurer replace its core to improve claims?
Not necessarily. Replacing a core is a large programme, worth it when policy, billing and claims all need to change. However, when only claims is the problem, adding a dedicated claims platform beside the existing core is usually faster and lower risk. The deciding question is whether the core itself is the constraint.
Can a claims platform integrate with Guidewire or Duck Creek?
Dedicated claims platforms are usually built to connect to a core by API, though each integration has to be scoped. For example, ClaimsGateway is API-first and offers custom API integrations. An insurer should ask any vendor which core systems it has connected to before, and what data passes in each direction.
How long does a claims system implementation take?
It depends on scope more than vendor. Replacing a core suite is commonly a multi-year programme, while adding a claims platform for one line can be scoped much smaller. None of the vendors in this list publishes implementation times, so insurers should ask for references from projects of a similar size and scope.
What does APRA expect of a claims system?
APRA does not approve claims systems, but its standards apply to them. Under CPS 234, an insurer must protect its information assets, including those run by third parties, and notify APRA of material incidents within 72 hours. Under CPS 230, it must manage material service providers, which can include its claims platform vendor.
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
- Guidewire ClaimCenter alternatives: options for insurers moving off or around ClaimCenter.
- Claims software in Australia: the full market, grouped by type of system.
- The Code of Practice explained: the claims timeframes insurers work to.
Sources
- Insurance Business Australia. "Record AFCA complaints mask a worse story in insurer compliance data." 4 August 2026. https://www.insurancebusinessmag.com/au/news/breaking-news/record-afca-complaints-mask-a-worse-story-in-insurer-compliance-data-584812.aspx (reports AFCA's 2025-26 figures and the Code Governance Committee's 2024-25 data)
- APRA. "Operational risk management (CPS 230)." Checked 16 October 2026. https://www.apra.gov.au/operational-risk-management
- MinterEllison. "Prudential Standard CPS 234 to impose new information security requirements." https://www.minterellison.com/articles/prudential-standard-cps-234-new-information-security-requirements
- 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/
- Insurance Business Australia. "Wilbur unveils AI and analytics tools for insurance industry." 3 September 2024. https://insurancebusinessmag.com/au/news/technology/wilbur-unveils-ai-and-analytics-tools-for-insurance-industry-503854.aspx
- Guidewire. "ClaimCenter claims management software" and "Overview of checks in ClaimCenter." Checked 16 October 2026. https://www.guidewire.com/products/core-products/insurancesuite/claimcenter-claims-management-software and https://docs.guidewire.com/cloud/cc/202302/cloudapibf/cloudAPI/topics/112-CCFin/02-check-creating/c_overview-of-checks-in-ClaimCenter.html
- Vendor websites, each checked 16 October 2026: fivesigmalabs.com, duckcreek.com, insuredhq.com, claimsgateway.com.
- Wilbur, wilbur.io, and its Capterra reviews (search results only), checked 21 October 2026. https://wilbur.io
