Claims workflow and billing system for pet insurers

The problem

Pet insurance carriers operate on fragmented legacy systems; claims require manual routing and re-entry across teams; member support escalates to live chat for simple tasks like address updates; billing systems fail to auto-cancel lapsed policies; integration between claims adjudication and reimbursement is manual and error-prone. Customers wait days for status updates and see multiple login sessions or dead-end referrals.

Who has it: US and UK pet insurance carriers with 50k-500k active policyholders and annual claims volume of 50k-500k, operating legacy mainframe or disjointed on-premise claims systems.

Why now: Pet insurance is a large and growing US market with millions of insured pets experiencing rapid year-over-year expansion. Most carriers still run on aging back-office systems designed before mobile or API-first operations. NAIC and state insurance regulators now expect faster claims resolution and digital claims evidence. Carriers face rising labor costs for claims adjudication and customer support; recent IPOs (Lemonade, Kindred Ventures-backed Empower) have raised capital for digital-first insurance, creating urgency to modernize incumbent carriers.

Where this came from

• App StoreEmbrace Pet Insurance - 38 of 49 recent reviews are 1-3 star
• App StorePets Best Pet Health Insurance - 178 of 199 recent reviews are 1-3 star
• App StoreMetLife Pet - 127 of 199 recent reviews are 1-3 star
• App StorePet Assure - 20 of 49 recent reviews are 1-3 star

24 public sources behind this idea.