The Rise of Insurance Third Party Administrator Market: A $544.67 Billion Industry Dominated by Tech Giants - Sedgwick, Crawford and Company and CorVel Corp | The Insight Partners

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Oct 30, 2024, 10:31 ET

The global insurance third party administrator market is set for explosive growth, with projections indicating a surge to $544.67 billion by 2031. This remarkable expansion, driven by the increase in preference for administrators in health insurance and growing complexity of insurance claims.

NEW YORK, Oct. 30, 2024 /PRNewswire/ -- According to a new comprehensive report from The Insight Partners, "Insurance Third Party Administrator Market Size and Forecast (2021 - 2031), Global and Regional Share, Trend, and Growth Opportunity Analysis Report Coverage: By Insurance Type (Healthcare, Retirement Plans, Commercial General Liability Insurers, and Other Insurance Types), End User (Large Enterprises and SMEs), and Geography". For Detailed Market Insights, Visit: https://www.theinsightpartners.com/reports/insurance-third-party-administrator-market

The report runs an in-depth analysis of market trends, key players, and future opportunities. In general, the insurance third party administrator market comprises a vast array of type and end user which are expected to register strength during the coming years.

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Market Overview and Growth Trajectory:

Insurance Third Party Administrator Market Growth: According to an exhaustive report by The Insight Partners, the Insurance Third Party Administrator Market is experiencing significant growth, driven by digital third-party administrators. The market, valued at $256.02 billion in 2023, is expected to grow at a Compound Annual Growth Rate (CAGR) of 9.9% during 2023–2031.

The global insurance third party administrator market is observing substantial growth and is expected to maintain its upward trajectory in the foreseeable future. The increasing need for administrators in health insurance and the surging complexity of insurance claims fuel the growth of the insurance Third Party administrator market. Further, the proliferation of the insurance industry creates opportunities for market growth. Digital Third-Party administrators are emerging as a significant trend in the market. On the other hand, data privacy concerns and security concerns limit the growth of the insurance Third Party administrator market.

Digital Third-Party Administrators: Digital Third Party administrators are transforming the insurance Third Party administrator business by harnessing the capabilities of AI and machine learning, which can allow the scanning of massive volumes of data to detect fraudulent claims and predict future hazards. The advanced data management capabilities lower costs for insurers and allow them to make more educated underwriting and risk management decisions. Digital Third-Party administrators provide self-service portals for policyholders to file claims, track their progress, and access policy papers. This promotes transparency and convenience, resulting in a more positive consumer experience.

Increase in Preference for Administrators in Health Insurance: Third Party administrators serve as mediators between insurance companies and policyholders. They oversee specific services, such as processing claims, providing customer support, and managing payment transactions on behalf of health insurance companies. These service providers play a pivotal role in handling different facets of health insurance. They maintain policyholders' important records in a dedicated database and provide smooth back-end assistance. Third Party administrators also ensure the correct processing of policyholders' claims. They guarantee that the hospitals they manage meet the standards of network membership, allowing for hassle-free claim settlement. Various value-added services provided by several Third-Party administrators include specialized consultations, ambulance services, medical supplies, wellness programs, lifestyle management, 24-hour toll-free helplines, and health facilities. Due to these benefits, various renowned insurers opt for Third Party administrators. For example, insurers such as Oriental Insurance, New India Assurance, National Insurance, and United India are using Vidal Health Insurance TPA, Health Insurance TPA of India Ltd, Focus Health Services TPA Pvt. Ltd, Family Health Plan Insurance TPA Limited, and others. Thus, a broad application of Third Party administrators in healthcare insurance drives the growth of the market.

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Growing Complexity of Insurance Claims: The insurance industry is highly regulated, and need to comply with multiple state and federal rules can be difficult. Third Party administrators play a vital role in settling insurance claims. They play a crucial role in administering insurance policies and claims on behalf of policyholders. The primary responsibility of any Third-Party administrator is to help policyholders during the claim settlement process between the policyholder and the insurer. This process begins when policyholders report their claims to the insurance company. It entails obtaining critical data such as the insurance number, incident details, and contact information. Various Third Party administrators are offering claim management with integrated solutions to simplify claim management. In December 2021, CorVel Corporation launched CogencyIQ. Leveraging artificial intelligence and predictive analytics, its products offer actionable insights and solutions for risk managers and claims professionals. CogencyIQ works seamlessly with CorVel's integrated claims management technology, CareMC Edge, to provide a comprehensive solution for customers with the tools needed to analyze large data volumes and navigate complex claims. Thus, the burgeoning complexity of insurance claims creates a need for Third Party administrators, which is driving the growth of the market.

Geographical Insights: In 2023, North America led the market with a substantial revenue share. Asia Pacific is the second-largest contributor to the global insurance third party administrator market, followed by Europe.

Insurance Third Party Administrator Market Segmentation, Applications, Geographical Insights:

Based on insurance type, the insurance third party administrator market is segmented into healthcare, retirement plans, commercial general liability insurers, and other insurance types. The healthcare segment held the largest share of the insurance Third Party administrator market in 2023.
Based on end user, the insurance third party administrator market is segmented into large enterprises and small and mid-sized enterprises. The large enterprises segment held the largest share of the insurance Third Party administrator market in 2023.
The insurance third party administrator market is segmented into five major regions: North America, Europe, APAC, Middle East and Africa, and South and Central America.

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Key Players and Competitive Landscape:

The Insurance Third Party Administrator Market is characterized by the presence of several major players, including:

Sedgwick
Crawford and Company
CorVel Corp.
United Healthcare Services LLC
Helmsman Management Services, LLC
Charles Tayler
ExlService Holdings, Inc.
Gallagher Bassett Services LLC
Meritain Health, Inc.

These companies are adopting strategies such as new product launches, joint ventures, and geographical expansion to maintain their competitive edge in the market.

Insurance Third Party Administrator Market Recent Developments and Innovations:

"Sedgwick has announced several new updates to its artificial intelligence-powered (AI) technology program. Building on a half-century of claims handling excellence and a robust data science program. The technology goal is to expedite the claims process by predicting, addressing, and automating steps in the claim lifecycle, thereby enhancing consumer experiences and streamlining claim resolutions."
"Crawford & Company's Third-Party administration business in the United Kingdom, Crawford TPA, has teamed with British insurtech Automated Insurance Solutions (AIS) to support speedier motor claims processing in the country. Crawford TPA will use AIS's automated motor claims liability assessment tool, BAIL, as part of its growing digital claims management ecosystem."
"CorVel Corporation, a national provider of risk management solutions, has launched CogencyIQ. Leveraging artificial intelligence and predictive analytics, CorVel can provide actionable insights and solutions for risk managers and claims professionals. CogencyIQ works seamlessly with CorVel's integrated claims management technology, CareMC Edge, to provide a comprehensive solution for customers with the tools needed to analyze large amounts of data and navigate complex claims."

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Insurance Third Party Administrator Market Drivers, Challenges, Future Outlook and Opportunities:

In terms of revenue, North America dominated the insurance third-party administrator market share, followed by APAC and Europe. The insurance third-party administrator market in North America is subsegmented into the US, Canada, and Mexico. The US is anticipated to hold the largest market share in the region in 2031. In the US, there are three main insurance sectors: property/casualty (P/C), i.e., mainly auto, home, and commercial insurance; life/annuity, mainly life insurance and annuity products; and private health insurance. Such a vast industry generates the demand for third-party administrator services in the country. The third-party administrators in the country are engaged in various strategies to reach more customers. For example, in January 2024, Rokstone, a specialty insurance and reinsurance managing general agency and a part of the Aventum Group, launched a new third-party administrator service based in Kentucky. Rokstone's new Verus TPA manages Rokstone's agricultural claims in the US.

As countries grow and people gain more discretionary income, they are more likely to be able to afford and recognize the value of insurance products such as life, health, and property insurance plans. This is especially true for a burgeoning middle class striving for financial stability. People are becoming increasingly conscious of the possibility of financial loss due to unforeseen circumstances such as illness, accidents, or natural catastrophes. As a result, individuals, businesses, and other entities seek insurance policies to safeguard themselves from the repercussions, which fuels the demand for insurance solutions that can assist in managing these risks. According to the Federal Insurance Office (FIO), the US had 667 licensed L&H insurers, 2,656 P&C insurers, and 1,355 health in 2022. According to the India Brand Equity Foundation (IBEF), the insurance industry is one of the premium segments seeing significant expansion in India. This upward trend in the insurance sector can be ascribed to rising revenues and increased awareness of the profession. India has the sixth-largest life insurance market among emerging economies, growing at a pace of 32–34% per year. In recent years, the industry has experienced vigorous competition among rival businesses. Moreover, the insurance sector faces numerous constraints, including highly dynamic regulatory complications, which present organizations with considerable threats to financial and operational stability. Thus, the ongoing proliferation of the insurance industry is creating opportunities for the growth of the insurance third-party administrator market.

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Conclusion:

A Third Party administrator is an entity that handles administrative and operational tasks associated with an insurance plan. Administrative duties frequently include processing claims, enrolling consumers, and collecting premiums, adhering to federal rules. Third Party administrators do not create the policies of health insurance plans, but they help guarantee their implementation. A single Third-Party administrator may work with multiple insurers. While Third Party administrators are typically linked with health insurance, they are employed in a wide range of other segments of the insurance industry. Commercial liability insurers and retirement plan administrators frequently hire Third Party administrators to serve as claims adjusters or customer service representatives. Third Party administrator companies can be major multinational corporations, while individuals having Third Party administrator certification can also work as independent contractors.

The insurance claim process can be complex and time consuming. In such cases, a Third Party administrator can help policyholders claim benefits. The administrators guide policyholders throughout the claim procedure and file claims on their behalf. Once a claim is filed, the Third-Party administrator will investigate and verify it. Further, their services can be tailored to a wide range of needs. Moreover, insurers can customize their agreements made with Third Party administrators based on their specific needs. Other noteworthy offerings of administrator services include health benefits reporting and analytics, adjudicating claims, customer service for plan members, healthcare provider network access, detailed healthcare expense reporting, and collaborations with brokers and health insurance consultants.

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With projected growth to $544.67 billion by 2031, the Insurance Third Party Administrator Market represents a significant opportunity for insurance carriers, Third Party administrators (TPA), regulatory bodies, and end users. By staying abreast of market trends, embracing innovation, and focusing on quality and performance, companies can position themselves for success in this dynamic and evolving market landscape.

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