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Origami Claims from Origami Risk
Origami Claims is a flexible claims administration system that supports multiple lines of business. It offers features for FNOL, assignment, documentation, settlement, payment processing, and reporting. The system is configurable to support different workflows and integrates with other Origami modules and third-party systems.
Product analysis by function
Claims Processing Systems for Claims Management
End-to-end platforms that manage the entire claims lifecycle from first notice of loss through settlement and payment. These systems streamline workflows, track claims progress, and maintain documentation.
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Core Claims Processing
(13 Yes /13 Known /13 Possible features)
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First Notice of Loss (FNOL) Capture Ability to record and process the initial notification of an insurance claim. |
Origami Claims provides FNOL capture functionality as part of its core claims workflow features, as indicated on its product overview. | |
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Automated Workflow Management System automates routing, escalation, and approvals for claims processing stages. |
Automated workflow management is referenced explicitly in marketing materials and documentation as a core system strength. | |
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Coverage Verification Functionality to verify the claimant's policy coverage and eligibility for the specific loss. |
Coverage verification is included as part of claims intake and validation described in product literature. | |
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Claim Assignment System can assign claims to adjusters or service units automatically or manually. |
Claim assignment, both automated and manual, is supported and highlighted in Origami Claims’ configurable workflows. | |
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Claims Segmentation Ability to route claims to different workflows based on value, complexity, or risk. |
Origami supports claims segmentation, routing claims based on value, complexity, or rules per solution documentation. | |
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Duplicate Claim Detection System detects and flags potential duplicate claims. |
Duplicate claim detection is a standard capability in Origami Claims, per datasheet and FAQ. | |
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Subrogation Handling Capability to support subrogation processes, including recovery pursuit. |
Subrogation handling is detailed as an available claims process module in Origami Claims. | |
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Litigation Management Integration or module to manage litigated claims and legal correspondence. |
Litigation management is supported as part of advanced claim handling modules (see feature grid on website). | |
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Automated Claim Settlement Calculation System computes recommended settlement amounts based on policy terms, guidelines, and prior payments. |
Automated claim settlement calculations are supported via rules engine and integration with payment workflows. | |
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Fast-Track Processing Ability to fast-track simple claims for rapid settlement. |
Origami advertises fast-track claims workflows for simple claims enabling rapid settlement. | |
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Claim Re-Open and Reconsideration Support for claim re-opening and reconsideration workflow. |
Claim reopen/reconsideration processes are configurable in Origami’s workflow tools. | |
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Partial Payment Processing Supports partial settlements and scheduled payments. |
Partial payment is supported as part of flexible settlement options. | |
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Claim Closure Management Tracks and manages closure of claims, with reasons and audit logging. |
Claim closure management (with reasons and audit trail) is a core tracked status in Origami Claims. |
Digital Document & Communication Management
(10 Yes /10 Known /10 Possible features)
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Document Upload & Management Allows users to upload, store, retrieve, and tag claim documents and images. |
Document upload/management is a core feature offered for claims documentation. | |
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E-signature Support Integrated electronic signature capture for approvals and claimant statements. |
E-signature support is available; Origami integrates with e-signature tools for approvals and claimant statements. | |
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Email and SMS Integration System integration with email/SMS to send updates and receive correspondence. |
Email and SMS integrations are referenced in communications and notification tools. | |
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Template Generation Automated generation of letters, statements, and claim forms using templates. |
Template generation for standard correspondence is cited as a feature in solution briefs. | |
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DMS Integration Integrates with enterprise document management systems (DMS). |
Origami supports integration with enterprise DMS systems according to product integration documentation. | |
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Optical Character Recognition (OCR) System extracts text from scanned claim forms and documents for automation. |
OCR capabilities are listed as available to extract data from uploaded documents. | |
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Bulk Uploads Allows users to upload multiple claim documents at once. |
Bulk document upload functionality is present in the claims document center. | |
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Voice Notes and Call Recording Ability to attach audio notes or record calls within a claim file. |
Voice notes/call attachments are referenced as claim file enrichments per product demos. | |
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Automated Document Indexing Tags and indexes claim documents automatically for fast retrieval. |
Automated indexing and tagging for document retrieval is part of DMS integration. | |
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Notifications & Reminders Automated reminders and alerts related to claim documents and deadlines. |
Automated notifications and reminders (alerts, follow-ups) are described in workflow tools. |
Fraud Detection and Risk Control
(9 Yes /9 Known /10 Possible features)
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Automated Fraud Scoring Assigns a risk/fraud score to each claim based on configurable rules and data sources. |
Fraud scoring is supported via rules engines, as described in product claims fraud prevention features. | |
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Link Analysis Identifies relationships between claims, claimants, and third parties (network mapping). |
Link analysis/network mapping capabilities are offered as part of fraud investigation tools. | |
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Red Flag Rules Engine Configurable business rules to flag suspicious claim characteristics automatically. |
Red flag rules engines are configurable in Origami for automatic fraud risk detection. | |
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Watch List Screening Checks claim participants against internal and external watch lists. |
Watch list screening/flagging against internal or external lists is described in anti-fraud capabilities. | |
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SIU Referral Workflow Enables automatic or manual referral of claims to the Special Investigations Unit (SIU). |
Origami supports SIU referral and workflow escalation to special investigation teams. | |
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Historical Claim Analysis Analyzes claimants’ and third-party history for prior suspicious activities. |
Analysis of historical claims and third-party histories is a reporting and risk module feature. | |
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Geolocation & IP Tracking Logs and analyzes where claims are filed from to detect anomalies. |
Geolocation and IP logging are mentioned as part of event monitoring and anomaly detection tools. | |
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External Data Integration Integration with fraud databases, public records, and third-party data for enhanced analysis. |
Origami offers API and integration options for external fraud and data sources. | |
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Automated Alerts & Escalation Automatic notification/escalation to fraud teams based on risk thresholds. |
Automated fraud alerts/escalations to internal teams are cited in marketing sheets. | |
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Monitoring Volume of Flagged Claims Tracks percentage of claims flagged for review. |
No information available |
Data Integration & Third-Party Connectivity
(9 Yes /9 Known /9 Possible features)
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Core Policy Administration Integration Bi-directional data sync with core policy administration and billing systems. |
Bi-directional integration with core admin and billing modules is a core architecture feature. | |
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API Capabilities System exposes and consumes APIs for claim data exchange and service integration. |
Origami Claims offers API capabilities for third-party integrations and data exchange. | |
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External Adjuster Portal Secure portal for external adjusters and providers to interact with claim files. |
External adjuster/vendor portals are part of the Origami suite as described for claim resolution. | |
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Supplier & Vendor Management Integration with repair shops, healthcare, legal service providers, etc. |
Supplier and vendor management (integration with repair, legal, medical) is documented. | |
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Banking/Payment Gateway Connectivity Links to payment platforms for automated claim disbursement. |
Bank/payment gateway connectivity for claim disbursement is a system highlight. | |
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Regulatory Data Exchange (e.g. EDI) Supports required data exchanges with regulators or industry databases (e.g. ISO, EDI). |
Regulatory data export, such as EDI, is supported for compliance with regulatory bodies. | |
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Real-time Data Feeds Ability to consume real-time third-party data feeds (weather, medical, etc.). |
Real-time data feeds can be ingested, as suggested in documentation for weather and third-party data sources. | |
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Bulk Data Import/Export Facilitates large scale data import/export for reporting and analysis. |
Bulk data import/export features are standard in Origami’s platform. | |
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Custom Integration Adapters Support for building/adapting custom connectors to non-standard partner systems. |
Custom integration adapters and connectors are configurable for third-party systems. |
Customer Experience & Self Service
(9 Yes /9 Known /9 Possible features)
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Customer Portal Allow customers to file, track, and update claims online. |
Customer portal for claim filing and tracking is a central offering in Origami Claims. | |
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Mobile App Support Dedicated smartphone/tablet app for claim notification and updates. |
Mobile app support is referenced as part of the multi-channel approach. | |
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Omnichannel Communication Claimants can interact over web, app, phone, email, or chatbot seamlessly. |
Omnichannel communications, including portal, email, phone, are described in solution details. | |
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Status Tracking Customers can see real-time status and timeline for their claims. |
Status tracking and timelines are available to customers on the web portal. | |
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Self-Service Document Upload Customers can securely upload claim-related documents and images. |
Self-service document upload by claimants is part of the portal and claim intake. | |
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Claim Payment Update Customers can view remittance/payment status directly. |
Claimants can see payment status and remittance details within the system. | |
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Live Chat Support Embedded live chat with support staff or adjusters. |
Live chat for support is included among customer service features. | |
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Customer Satisfaction Survey Automated feedback surveys for post-claim service assessment. |
Customer satisfaction surveys post-claim are mentioned as available functionality. | |
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Online Appointment Booking Schedule assessments, inspections, or adjuster visits online. |
Online appointment/assessment scheduling is available through the portal. |
Analytics & Reporting
(10 Yes /10 Known /10 Possible features)
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Standard Claims Reporting Wide range of pre-built, regulatory, and operational claims reports. |
Standard claims reporting is a strength of Origami’s analytics suite. | |
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Ad-hoc Report Builder Users can define and produce custom reports on claims data. |
Ad-hoc/custom reporting is part of Origami’s configurable analytics module. | |
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Dashboard Visualization Graphical dashboards for claims KPIs, SLAs, trends, and volumes. |
Dashboard visualizations for claims SLAs and KPIs are included and demonstrated. | |
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Loss Ratio Calculation Tracks claim payments versus earned premium for profitability monitoring. |
Loss ratio calculation tools and profitability reports are described. | |
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Drill-down Analytics Interactive analysis from summary to underlying case detail. |
Drill-down analytics from summary to detail is referenced in analytics demos. | |
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Automated SLA Monitoring System tracks and reports service level agreements/turnaround time adherence. |
Automated SLA tracking/reporting is available for workflow and performance monitoring. | |
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Export to Multiple Formats Download/export analytical results in Excel, PDF, CSV, or other file formats. |
Data export to Excel/CSV/PDF formats is supported as standard output options. | |
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Predictive Analytics Advanced modeling to predict claim costs, reserve requirements, or risk factors. |
Predictive analytics modules for reserving and risk modeling are marketed in advanced analytics. | |
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Real-time Report Refresh Analytics are refreshed in real-time as claims progress. |
Real-time refresh/updates of analytics dashboards are referenced in product screenshots. | |
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User Access Controls for Reports Reports/analytics can be restricted to specific roles or users. |
User-based access controls for analytics and reports are available via role-based permissions. |
Payments & Disbursements
(8 Yes /8 Known /9 Possible features)
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Automated Payment Calculation Settlement amounts and deductions are computed automatically. |
Automatic payment calculation modules compute settlements as described in workflow automation descriptions. | |
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Multiple Payment Modes Support for ACH, checks, debit cards, and digital wallets. |
Multiple payment modes (ACH, check, card, etc.) are supported in payment module. | |
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Split/Multi-party Payments Ability to disburse claim proceeds to multiple parties in a single transaction. |
Split/multi-party payment capability is described in settlement handling options. | |
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Payment Authorization Controls Integrated controls for multi-level approval before payment release. |
Multi-level payment authorization/approval controls are configurable. | |
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Automated Entry to General Ledger Disbursement transactions automatically post to financial ledgers. |
Automated general ledger entry is a highlighted integration for finance teams. | |
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Reissue/Stop Payment Workflow Facilitate payment reversals, reissues, and stops efficiently. |
Reissue/stop payment workflow is included for payment troubleshooting. | |
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Payment Status Tracking Visibility into payment transmission and clearing status. |
Payment status tracking and visibility are standard portal and admin tools. | |
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Custom Payee Management Add, edit, or validate claim payees (claimants, providers, vendors). |
Custom payee management (add/edit/validate) is referenced in financial module documentation. | |
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Bulk Payment Processing Capacity Number of claims settled in one batch. |
No information available |
Security & Compliance
(10 Yes /10 Known /10 Possible features)
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Role-based Access Control (RBAC) Granular control over which users or groups access specific claim data. |
RBAC is a standard security feature—permissions managed by role and group. | |
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Audit Logs Comprehensive, time-stamped log of all user activities within the system. |
Audit logs of system/user activity are emphasized as an audit/compliance strength. | |
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PHI/PII Encryption in Transit & At Rest Sensitive data (personal, health, financial) is encrypted throughout its lifecycle. |
PHI/PII encryption is discussed in the context of HIPAA/GDPR compliance. | |
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Configurable Retention Policies Definition and automation of document/data retention according to regulation. |
System allows configurable document/data retention policies, as described in admin tools. | |
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Regulatory Compliance Certifications Supports requirements such as PCI-DSS, GDPR, HIPAA, SOX, etc. |
Origami advertises compliance with security standards like HIPAA and GDPR. | |
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Single Sign-On (SSO) Support Enables SSO for enterprise authentication and security. |
Enterprise SSO is supported via integration with identity providers, per technical documentation. | |
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Multi-factor Authentication Enhances log-in security with additional authentication methods. |
Multi-factor authentication is available for system access per security overviews. | |
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Data Masking Sensitive data is masked for unauthorized or limited-access users. |
Data masking is available in the admin/security settings. | |
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Active Directory/LDAP Integration Integrates with enterprise identity and directory services. |
Active Directory and LDAP integration claimed as standard for enterprise deployments. | |
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Automated Compliance Reporting Generates audit and regulatory reports required by authorities. |
Automated compliance reporting is present for audit/regulatory requirements. |
Configurability & Customization
(9 Yes /9 Known /9 Possible features)
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Business Rule Engine Non-technical users can modify/define business rules for claims workflows. |
Business rule engines (easy for business users) are an emphasized admin convenience. | |
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Custom Fields & Forms Create and manage new data fields, screens, and input forms. |
Custom fields/forms are mentioned as part of the system configurability. | |
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Workflow Designer Design and update claim process steps without programming. |
Workflow/process designer (no code) is available for admins to configure claims processes. | |
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Branding/White Labeling Customize interface branding, colors, and logo per business unit. |
White labeling and interface branding are supported for clients’ visual identity. | |
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Configurable Notifications Set up and change system notifications, escalation matrix, and triggers. |
Configurable system notifications and escalation rules are present. | |
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Multi-language Support System UI and communications can operate in multiple languages. |
Multi-language user interface and communications are advertised. | |
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Localization (Currency/Time Zone) Supports regional currencies, time zones, and date formats. |
Localization (currency, date, timezone) is described for global clients in documentation. | |
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Dynamic Form Logic Input forms can adjust dynamically based on user selection or claim type. |
Dynamic form logic (inputs change based on data/claim type) is supported. | |
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Role-based UI Personalization User interface displays relevant information and tools based on user type. |
Role-based UI personalization part of RBAC and UI flexibility. |
Performance & Scalability
(1 Yes /1 Known /7 Possible features)
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Average Claim Processing Speed Typical backend processing time per claim. |
No information available | |
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Peak Concurrent Users Supported Maximum simultaneous system users without degradation. |
No information available | |
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Maximum Claims per Day Highest number of claims system can process in a day. |
No information available | |
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System Uptime/Availability Percent of operational availability. |
undefined System uptime/availability is documented as 99.9% or above in marketing and SLA references. |
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Disaster Recovery RTO Recovery time objective after a system failure/disaster. |
No information available | |
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API Response Time Average latency of claim-related API calls. |
No information available | |
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Batch Processing Speed Capacity to handle claims/data batch jobs efficiently. |
No information available |
User Experience & Accessibility
(8 Yes /8 Known /8 Possible features)
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Responsive Design System UI adapts for desktops, tablets, and smartphones. |
Origami Claims uses responsive design for device adaptability. | |
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Accessibility Compliance (e.g. WCAG) Supports users with disabilities in accordance with WCAG or similar standards. |
Accessibility and WCAG support is referenced for inclusivity in user interface design. | |
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Customizable User Dashboards Users can personalize data widgets, views, and claim summaries. |
Customizable dashboards are available; users can personalize for their role/function. | |
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In-app Help & Guidance Context help, guided workflows, and tooltips available inside the platform. |
In-app help, guided workflows, and tooltips are standard user assistance tools. | |
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Inline Search Powerful search engine for rapidly locating claims, documents, or customers. |
Powerful inline search is a staple of the platform for documents, users, and claims. | |
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Integrated Task Management Users can track, assign, and resolve claim-related tasks. |
Task management is included for tracking and assignment within the claims workflow. | |
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User Productivity Analytics Tracks and reports productivity metrics per adjuster/user. |
User productivity analytics are available for managers to monitor adjuster workloads. | |
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Low-Code/No-Code Admin Tools Non-developers can modify workflows and reports without coding. |
Low-code/no-code admin tools for configuration are a major marketing point. |
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