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ClaimSorted: Health, Life & Accident TPA

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Overview

ClaimSorted Health is a next-generation health, life and accident Third-party Administrator (TPA) that enables insurers to outsource their entire claims operations, where we manage the end-to-end claim handling process.

Unlike traditional TPAs, ClaimSorted uses a mix of AI and human expertise to process claims faster and cheaper, while providing a 5-star customer experience and generating actionable data insights.

Key Features

1. Customisable e-FNOL. The e-FNOL is fully customisable with your logos and colours and you pick questions that you want to ask during the claim submission process. Alternatively, we can use your existing e-FNOL solution and we can integrate with it via API or SFTP

2. Claim assessment and automation. We speed up the claim processing, reduce fraud and improve customer experience with a mix of automation and a team of in-house experts. Each claim follows a sequence of steps which maintains consistent customer experience and minimises claim leakage

3. Analytics. You can see the data on open and closed claims, complaints, paid amounts and much more

4. Data & MI. You'll get the data shared with you every day so you can analyse it and use it for underwriting. All the data we capture is yours and you can access it at any time

5. Payouts. We will process payments using your preferred method

6. Claims portal. Customers can see the claim status and ask questions. The portal is also fully customisable to your brand

Key Benefits

  • We see our TPA service as an extension of your company rather than an outsourced partner
  • Unlike traditional TPAs we prioritise customer experience and indemnity management
  • We use a mix of AI and human expertise to make sure we're paying the right amount, at the right time and charging a fair fee for the service
  • If at any point you want to move claims in-house you can license the software by paying a small subscription fee