China Claim Processing Market Research Report, 2030

The claim processing software market in China is witnessing an accelerated expansion, fueled by the rapid digital transformation in the insurance industry, the growing penetration of insurtech, and increasing regulatory mandates aimed at improving transparency and efficiency. China’s insurance market, being one of the largest in the world, has seen a surge in demand for automation-driven solutions to enhance claims processing, reduce fraud, and improve customer experience. Historically, claims processing in China involved cumbersome manual procedures that resulted in long settlement times, higher administrative costs, and a significant risk of fraudulent claims. However, as insurers shift toward AI-powered, blockchain-integrated, and cloud-based claims management systems, the industry is undergoing a substantial overhaul. Insurers are now leveraging artificial intelligence to automate claim verification, assess risks in real-time, and minimize manual intervention, ultimately reducing operational costs and expediting claim settlements. Cloud-based claim processing software is playing a crucial role in enabling remote claims management, allowing insurers to handle claims efficiently across various regions, including rural and semi-urban areas where insurance penetration is expanding. Mobile applications and self-service portals have become a standard feature, empowering policyholders to file claims digitally, track claim statuses in real-time, and receive faster resolutions. With China’s insurtech industry rapidly growing, digital innovations such as smart contracts, machine learning algorithms, and image recognition technology are further transforming claim processing, making it more seamless, secure, and fraud-resistant. Additionally, the rising adoption of telematics in auto insurance and electronic health records in medical insurance is driving insurers to integrate advanced claim processing software to optimize data usage, improve underwriting accuracy, and enhance fraud detection mechanisms. According to the research report " China Claim Processing Software Market Research Report, 2030," published by Actual Market Research, the China Claim Processing Software market is anticipated to grow at more than 8.53% CAGR from 2025 to 2030. Regulatory developments in China are playing a significant role in shaping the adoption of claim processing software, as government authorities emphasize greater transparency, faster settlements, and fraud prevention. The China Banking and Insurance Regulatory Commission (CBIRC) has implemented strict guidelines to ensure fair claims handling, compelling insurers to adopt digital solutions that provide real-time monitoring, automated compliance verification, and standardized claim resolution processes. With increasing scrutiny on insurance fraud, many companies are investing in AI-driven fraud detection tools capable of analyzing large datasets, identifying suspicious patterns, and flagging potentially fraudulent claims before they are processed. Additionally, blockchain technology is gaining traction in China’s insurance sector, as it enhances data security, reduces the risk of claim disputes, and ensures a tamper-proof digital record of transactions. As competition intensifies among insurers, companies are turning to digital claim management solutions to differentiate themselves through faster settlements, enhanced customer service, and seamless policyholder engagement. The rise of embedded insurance, where insurance is integrated into various financial products and services, is also driving the need for efficient claim processing software to manage a growing volume of claims originating from digital platforms. Moreover, China’s rapidly expanding middle-class population and increasing awareness about insurance are contributing to a higher volume of claims, pushing insurers to adopt scalable and automated solutions. AI-powered chatbots and virtual assistants have become common in customer support functions, allowing policyholders to inquire about claims, submit documents, and receive updates without human intervention. As insurers continue to embrace cutting-edge technologies, the claim processing software market in China is expected to witness sustained growth, driven by regulatory pressures, increasing digitalization, and the demand for efficient, customer-centric claim management solutions.

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The China claim processing software market is categorized based on components, with software and services forming the backbone of modern claims management operations. The software segment encompasses automated claims adjudication, fraud detection, document management, and real-time settlement tracking, which collectively streamline the entire claims processing workflow. These software solutions leverage AI and predictive analytics to accelerate claims assessment, enabling insurers to process legitimate claims efficiently while identifying fraudulent activities with high precision. The adoption of cloud-based claim processing platforms is particularly high in China, as insurers seek flexible, scalable, and cost-effective solutions that can be deployed across multiple locations without the need for extensive on-premise infrastructure. These cloud-based platforms facilitate seamless integration with existing policy management systems, improving operational efficiency and enabling insurers to offer 24/7 claims processing capabilities. On the other hand, the services segment includes consulting, implementation, software customization, training, and ongoing maintenance. With insurers rapidly transitioning from legacy systems to advanced digital platforms, service providers play a crucial role in ensuring smooth deployment, customization to meet regulatory requirements, and system optimization for maximum efficiency. Consulting services help insurers choose the most suitable claims processing software based on their operational needs, while integration services enable seamless connectivity between claims platforms and other insurance applications, including underwriting and policy administration systems. Managed services have also gained popularity, as insurance companies seek external expertise to maintain and optimize their claims management infrastructure. As Chinese insurers continue to digitalize their operations, the demand for both software and services is expected to increase, driving further growth in the market. The market is also segmented by enterprise size, with large enterprises and small to medium-sized enterprises (SMEs) exhibiting distinct requirements for claim processing software. Large enterprises, including major insurance corporations and multinational firms operating in China, require sophisticated claims management systems equipped with AI-powered fraud detection, real-time claims tracking, and automated risk assessment tools. Given the scale and complexity of claims handled by large insurers, these organizations prioritize software solutions that offer seamless integration with existing insurance platforms, centralized data management, and predictive analytics to enhance operational efficiency. Many large insurers are also adopting blockchain technology to improve transparency and security in claims settlement, reducing disputes and ensuring tamper-proof transaction records. In contrast, SMEs are increasingly embracing cost-effective cloud-based claim processing solutions that offer scalability, ease of implementation, and flexibility. Unlike large enterprises, SMEs often lack dedicated IT teams, making software-as-a-service (SaaS) models particularly attractive for claims management. These platforms provide user-friendly interfaces, automated workflows, and self-service options that help SMEs process claims efficiently without significant infrastructure investments. Additionally, AI-driven claims processing software tailored for SMEs allows smaller insurers to compete with larger players by offering faster settlements, improved customer service, and enhanced fraud prevention mechanisms. The increasing digitization of China’s insurance sector is expected to drive further adoption of claim processing software across both large enterprises and SMEs, as companies strive to enhance efficiency, reduce operational costs, and improve policyholder satisfaction. The end-user segmentation of the China claim processing software market includes insurance companies, insurance intermediaries, agents and brokers, and other entities involved in claims management. Insurance companies represent the largest segment, leveraging AI-driven claims processing platforms to enhance automation, fraud detection, and compliance with regulatory guidelines. These solutions enable insurers to minimize human errors, reduce processing times, and improve overall transparency in claims adjudication. Insurance intermediaries, including third-party administrators (TPAs) and claims outsourcing firms, rely on digital claims management software to handle claims efficiently, ensuring accuracy and compliance with industry standards. These intermediaries benefit from centralized claims data management, automated workflow solutions, and AI-driven fraud detection capabilities that streamline claim settlements. Agents and brokers, who act as intermediaries between insurers and policyholders, utilize digital claims processing platforms to facilitate communication, assist customers in filing claims, and provide real-time status updates. By integrating AI-powered chatbots and digital claims submission tools, brokers can enhance customer service, reduce paperwork, and expedite claims resolution. Other stakeholders, including healthcare providers and legal firms handling insurance claims, also rely on digital claims management systems to improve efficiency and accuracy in claims processing. The growing adoption of electronic health records (EHRs) in China’s healthcare sector has further increased the demand for AI-driven medical claims processing solutions that streamline documentation, billing, and reimbursement processes. As the insurance industry continues to evolve, claim processing software is expected to play an increasingly vital role in enhancing efficiency, reducing administrative costs, and improving overall claims management for all stakeholders in China.

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Nikita Jabrela

Business Development Manager

Considered in this report • Historic Year: 2019 • Base year: 2024 • Estimated year: 2025 • Forecast year: 2030 Aspects covered in this report • Claims Processing Software Market with its value and forecast along with its segments • Various drivers and challenges • On-going trends and developments • Top profiled companies • Strategic recommendation By Component • Software • Services

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By Enterprise Size • Large Enterprises • Small and Medium-sized Enterprises By End User • Insurance Companies • Insurance Intermediaries • Agents and Brokers • Others The approach of the report: This report consists of a combined approach of primary as well as secondary research. Initially, secondary research was used to get an understanding of the market and listing out the companies that are present in the market. The secondary research consists of third-party sources such as press releases, annual report of companies, analyzing the government generated reports and databases. After gathering the data from secondary sources primary research was conducted by making telephonic interviews with the leading players about how the market is functioning and then conducted trade calls with dealers and distributors of the market. Post this we have started doing primary calls to consumers by equally segmenting consumers in regional aspects, tier aspects, age group, and gender. Once we have primary data with us we have started verifying the details obtained from secondary sources. Intended audience This report can be useful to industry consultants, manufacturers, suppliers, associations & organizations related to agriculture industry, government bodies and other stakeholders to align their market-centric strategies. In addition to marketing & presentations, it will also increase competitive knowledge about the industry.