FOR INSURANCE CARRIERS · TIER 3 TO 5, SPECIALTY, AND FRONTING
Lead with claims. Keep the rest of your core.
VCA ClaimsCore runs your claims beside the policy system and the ledger you already have, at a fraction of the cost of a core replacement. Your adjusters get the tools a Tier 1 carrier's adjusters have, and the only system you replace is the one they work claims in.
Built for carriers whose policy system stays in place. Replacing the whole core is a different project, on a different timeline.
A TYPICAL CARRIER PACKAGE
ClaimsCore, and What a Carrier Adds to It
Handling your own claims, or overseeing your TPAs? The package follows the answer, and not every carrier needs PolicyConnect.
Every claim runs on ClaimsCore. A typical carrier package adds InsuredConnect for policyholder first notice and status, PolicyConnect for policy data, ClaimsPay for claims payments, VCA Insights for reporting, and DataBridge for your claims data in your own data warehouse. Digital FNOL →
By LineAuto Claims →Property Claims →Property and Casualty Claims →Marine and Cargo Claims →
Typical for CarriersClaimsAI: Works Inside the Core for Every SeatNot Typical for This Seat
- VCA ClaimsCoreWhere every claim is workedClaimsAI™Works inside the claim, on the core.
- InsuredConnectPolicyholder self-service
- PolicyConnectPolicy detail on the claim
- DataBridgeData to your warehouse
- ClaimsPayIssues payments from the claim
- VCA InsightsAnalytics across the book
- ClientPortalNot typical for this seat
- LloydsConnectNot typical for this seat
ClaimsCore is complete on its own. Each add-on joins it when the work needs it.
Not Typical for This Seat
- Policy AdministrationStays
- RatingStays
- BillingStays
- ClaimsReplaced
- Data WarehouseStays
- General LedgerStays
A core replacement moves all six layers. VCA replaces only claims, and the other five stay and connect to it.
ADD-ON: CLAIMSAI
ClaimsAI by VCA, Inside the Claim
ClaimsAI by VCA works inside one claim at a time, with four capabilities: Documents, Chat, Standing Checks and First Notice. It reads what is on the claim, summarizes what matters and drafts for review. It never sets a reserve, approves a payment or decides a claim.
ClaimsAI does not update anything in the claim. What it drafts reaches the claim only when a person copies it there. How ClaimsAI Works →
THE PROBLEM IT SOLVES
You're accountable for claims you can't always fully see, across people and partners you don't control. It is your promise; ClaimsCore is where your team keeps it. The fix belongs in the claims layer, and it does not have to wait for a new core.
VCA has served the Lloyd's market for more than a decade. Lloyd's-market reporting is graded, audited, and evidenced with data. A platform that clears it has no trouble with a carrier's audit, an MGA's capacity report, or a TPA client's monthly review.
“All the stuff that VCA does off the shelf is what we would have needed to build in another platform.”
THE CLAIM WORK
What One Carrier Claim Has to Carry
The first question is whether the claim holds what the work requires, because that is what your examiners, your actuaries, and your defense counsel end up reading. Each row names the work, then what ClaimsCore records.
- Coverage at the Date of LossA claim is decided against the policy as it stood on the day of loss, and limits, deductibles, and endorsements all move mid-term.
With PolicyConnect, an Add-OnPolicyholder details, policy number, bound and expiry dates, and coverages with limits and deductibles reach the claim, with effective dates checked at first notice, during handling, and before payment. Which fields sync, how often, and the validation rules are configured per program and line of business.
- Reserve Authority and HistoryThe reserve is half of what leadership asks about. The other half is who set it, when it moved, and how far.
In ClaimsCoreEach reserve carries a type from your own list (Indemnity, Loss Reserve, Expense or Adjusting Fees, for example) and the insurer it belongs to, and each revision records the reason, the date, and who made it. Authority limits are set for each user, and a reserve above an adjuster's limit goes to the approver they choose, with a note written to the claim.
- Subrogation and SalvageNet incurred, and every loss ratio you report, depend on paid, recovered, and reserved staying apart on the claim.
In ClaimsCoreEach recovery carries its agent, status and key dates, amounts filed, and funds received and disbursed, posted against the reserve it offsets, with the net recovery on the claim. A Subrogation Potential flag marks claims worth pursuing.
- Litigation and Defense CounselA claim in suit changes shape: counsel comes onto it, attorneys are paid from it, and it has to be found fast when someone asks.
In ClaimsCoreLitigation and defense flags mark claims that need special handling and make them searchable. Defense counsel and other attorneys sit on the claim as contacts, and payments to attorneys are recorded there.
- Catastrophe Coding at IntakeYour reinsurance recovery and the data call after a declared catastrophe both key off a cat code, so it belongs on the claim from the start.
In ClaimsCoreEach claim's loss details carry a Cat Code and Treaty Year, a CAT claim team takes surge assignments, and assignment rules route claims by loss location and adjuster workload.
- Open-Claim MigrationConversion risk lives in the open inventory, and the balances have to tie on the first morning.
In the ImplementationData migration is its own phase: open and historical claims move into ClaimsCore and are checked against the source before go-live.
Vanguard Claims, a Lloyd's DCA, moved 36,000 claim files onto VCA in four months. Read the Vanguard Claims Story →
ONE RESERVE, ON THE RECORD
Who Set It, When It Moved, and How Far
Reserve History
| Date | Movement and Reason | By | Amount |
|---|---|---|---|
| Mar 3 | Indemnity reserve setReason: First inspection | Adjuster A | $25,000 |
| Mar 17 | RevisedReason: Contractor estimate received | Adjuster A | $25,000 to $38,000 |
Pending Approvals
| Type | Requested Value | Review |
|---|---|---|
| Indemnity | $60,000 | Waiting for Approval |
Submitted to Claims Manager B, chosen from the approver list. A note naming who it went to is written to the claim.
THE ARCHITECTURE
How the Claims Layer Connects to What Stays
Three connections. The systems on the other side of them stay as they are.
PolicyConnect, an add-on, brings policy and coverage detail in from your policy administration system.
Claim transactions are stored on the claim and reachable through VCA's API framework, so a custom connection can link them to your ERP or general ledger and the finance stack you have already invested in stays where it is. DataBridge, an add-on, sends claims data out on a schedule you set, as often as hourly, into your own data warehouse.
WHAT STAYS, AND WHAT CONNECTS IT
SOME CLAIMS IN HOUSE, SOME PLACED
One Book, However It Is Handled
Your book runs through a desk that works the lines it knows, programs placed with TPAs, and an IA panel for the field work and the CAT surge.
ClaimsCore runs your own desk. Where a TPA or adjusting firm works your claims inside your VCA environment, the claims you answer for sit in a system you govern. A fronted program works the same way: placed with a TPA, answered for by you.
Your In-House Desk
Intake, adjusting, reserves, payments, and reporting, configured to the lines your desk works and the authority levels you set.
Programs Placed with TPAs
A TPA can work your claims inside your environment, under the authority limits you set for its users, or keep its own system, with what reaches your account agreed in discovery.
IA Panels and the CAT Surge
Assignments go out to your panel. An adjusting firm on VCA works each one in its own account, from its own seat, and what passes between its account and yours is agreed in discovery.
SPECIALTY AND FRONTING
Programs on Your Paper, Overseen Claim by Claim
Fronted programs put your paper behind MGAs and program administrators, and the claims on them are still yours to answer for, program by program.
- Authority for Each UserAuthority limits set for each user, with the authority protocols and reporting requirements attached to them tracked alongside. Limits that change by program contract are custom rules VCA builds.
- Partner MonitoringEvery reserve change, contact, and payment a TPA working in your VCA environment makes on your paper, recorded on the claim.
- Reporting Across ProgramsVCA Insights, an add-on, compares programs and shares branded dashboards and scheduled reports with your leadership and the partners you report to.
Accelerant, Hadron, and Thomas Miller use VCA for program business.
VCA for MGAs →WHAT GETS FILED ABOUT THE WORK
Reporting is a calendar. The claim is the answer.
Statutory loss reporting, market conduct examinations, Medicare Secondary Payer reporting, and the obligations that ride on every payment all draw on the same place: codes, dates, and dollars captured on the claim while the work happens. None of it ships as a compliance module.
ClaimsPay, an add-on, issues claims payments from the claim. VCA Software and Vitesse announced a strategic partnership on September 16, 2026, connecting claims management and insurance payments so a payment approved in VCA is issued without re-keying payment details between systems.
VCA Insights, an add-on, turns the same claim data into dashboards and scheduled reports, filtered by line of business, program, and timeframe. The filings stay yours, and so does the judgment about what goes in them.
THE CALENDAR, IN CLAIMS TERMS
Annual Statement and Schedule P
Paid loss, case reserves, and loss adjustment expense by line of business and accident year, developing over successive periods and reconciling to the ledger. Your contribution is coding: the right line, the right accident date, and claim financials that finance recognizes.
Market Conduct
Claim counts by state and line, suits among them, timeliness measured from dates recorded on the claim, and the data call after a declared catastrophe. The standards are set by each state and by your own service policy.
Medicare Secondary Payer, Section 111
The filing needs beneficiary status, ongoing responsibility for medicals, and the total payment obligation to the claimant, with claimant identifiers and injury coding.
The Payment Side
Information returns on reportable payments, sanctions screening of payees, and unclaimed property on uncashed checks all key off the payment, so the payee, amount, and date recorded on the claim have to be right for whoever screens, reports, and remits.
BEFORE THE FIRST CALL
What Your CIO Will Want to Know
Configuration, integrations, and security come up in every carrier evaluation. Here are the short answers, and where each one goes deeper.
- Configuration and ControlYour claims directors and IT leaders set lines of business, loss types, statuses, diaries and automated alerts in the admin console, without a developer. Permissions go down to individual statuses and actions, with a record of who did what and when.What ClaimsCore Does →
- IntegrationsPublished integrations include XactAnalysis, Symbility, CoreLogic, Hover, and Encircle on the loss side, with Microsoft 365, SendGrid, and Amazon S3 under the claim.Every Integration →
- Security and ProcurementThe security page covers the SOC 1 and SOC 2 certified credential, the independent audit behind it, and what procurement asks first.Start the Security Review →
GOING LIVE, AND STAYING LIVE
Discovery First, Then Configuration
Only the claims layer changes, so the project is discovery, configuration, migration, and the integrations in scope, each sized to that one layer.
From your side, the people who work the claims join discovery alongside IT, and one named owner who can say yes makes the configuration decisions. The implementation page walks through every phase.
Discovery
VCA maps how your claims actually move: intake sources, assignment rules, authority levels, reporting obligations, and the handoffs between your desk, your TPAs, and your panel. Nothing gets configured until the work is understood.
Configuration
Workflows, letters, statuses, reserve categories, and reporting formats, set up per client or per program, with authority limits set for each user, and only as much as the work needs.
Go-Live, and After
Training comes after configuration and migration, so handlers learn ClaimsCore already set up for their claims, then work real ones on it. After go-live, client services is at clientservices@vcasoftware.com, and configuration grows as programs and lines are added.
WHY VCA
Why Carriers Choose VCA
Deep in claims, and sized to the one layer you are changing.
- Depth of Claims ExpertiseAn adjuster built VCA around the claim, and VCA knows claims from every seat it works with.20+ Years Building Claims Software →
- Speed of ImplementationDiscovery maps how your claims move before anything is configured, and the project is sized to the claims layer alone, not to a multi-year core replacement. Your file handlers typically need 30 to 60 minutes of training.
- Capital EfficiencyYour policy system, rating, billing, and ledger stay where they are. What you buy is the claims layer, complete on its own.
Questions Carriers Ask
Does VCA replace our policy administration system?
No. VCA ClaimsCore runs the claims layer beside it. PolicyConnect, an add-on, brings policyholder, policy, and coverage detail in from your policy administration system, so handlers open each claim with the policy facts in place, and your policy system and general ledger keep doing their jobs.
How long does a carrier implementation take?
Plan on 12 weeks to 6 months, the Carrier License band. Every VCA implementation starts with discovery: VCA maps how your claims actually move before anything is configured, then ClaimsCore is configured to that process. Where a carrier lands in the band depends on the integrations in scope, the open inventory that migrates, and the programs live on day one.
If we leave VCA, what happens to our claims data?
With DataBridge, an add-on to VCA ClaimsCore, a copy of your claims data already sits in infrastructure you own: it is delivered into your own data warehouse on a schedule you set, as often as hourly. How the full claims record comes back at the end of an agreement, in what format, how fast, and at what cost, belongs in the agreement, so have it in writing before a first term.
What should we have in writing before we sign?
How renewal pricing works, how a program added mid-term is priced, the service levels, and how your claims data comes back at the end of an agreement. Each belongs in the agreement rather than on a call, and VCA's pricing page sets out what to ask for on each one.
We handle some claims in house and place the rest with TPAs. Does VCA cover both?
Yes, side by side. Your in-house desk works its claims in VCA ClaimsCore. A TPA handling one of your programs can work inside your VCA environment, under the authority limits you set for its users, or keep its own system, with what reaches your account agreed with it in discovery.
Can VCA ClaimsCore carry subrogation, litigation, and catastrophe claims?
Yes, on the claim itself. Each recovery carries its agent, status, key dates, amounts filed, and funds received and disbursed, posted against the reserve it offsets, with the net recovery on the claim. Litigation and Defence flags (the product's label) mark claims that need special handling, defense counsel sit on the claim as contacts, and payments to attorneys are recorded there. Each claim's loss details carry a Cat Code and Treaty Year, and a CAT claim team takes surge assignments.
Does VCA handle our statutory and market conduct reporting?
VCA carries the claim data those filings are built from, and your teams file them. Line-of-business coding and service standards are your operation's to set, and ClaimsCore is configured to them.
Which lines of business does VCA support for carriers?
Every property and casualty line: personal and commercial lines, casualty, property, specialty, in-house programs, and subscription and individual-risk market business. Not workers' compensation or health benefits claims. Surety is a specialty line, and Western Surety runs its bond claims on the platform.
What is VCA doing about AI?
ClaimsAI is an add-on to VCA ClaimsCore that works inside the claim. It finds, summarizes, and drafts, and the claims professional decides, sets reserves, approves, and pays. ClaimsAI does not update anything in the claim: what it drafts reaches the claim only when a person copies it there.
Does VCA take on claims work itself?
No. VCA makes claims management software and only claims management software, with no adjusting arm, no TPA division and no claims services business. Being a pure claims company, with no services arm competing with the people it serves, lets VCA stay on their side of the table.
Bring us a claim where the promise was hard to keep
Tell us about the claim you got asked about last quarter, the one whose reserve history nobody could reconstruct, and we'll show you where every piece of it lives in ClaimsCore.
Request a Demo