A guide to choosing the right TPA partner

Selecting the right Third-Party Administrator (TPA) is critical for any organisation.

A strong TPA partnership not only streamlines operations and reduces costs but also enhances the claims experience for both businesses and their customers.

Below are five key qualities to look for when choosing a TPA partner, as outlined by Milia Xystros, Head of Crawford TPA.

Industry expertise

It’s essential that a TPA understands the unique challenges of your industry. A TPA with a proven track record in managing claims relevant to your business will provide tailored solutions, not a generic approach. 

For example, in one instance, a complex property claim tied to the overseas assets of a global insurer was rapidly escalated into litigation.

With integrated capabilities in loss adjusting and legal services, Crawford swiftly took action to protect the insurer's interests.

Leveraging deep local expertise, we coordinated an extensive investigation plus a legal defence to address both technical and legal challenges.

Choose a TPA team that can provide seamless collaboration across departments to mitigate potential risks and provide significant value in claims resolution, so that your objectives can be met efficiently and effectively.

Data-driven approach

Robust data analytics capabilities are essential for efficient claims processing.

A data-driven TPA can identify trends, predict costs, and optimise workflows, leading to significant improvements.

This will help you gain valuable insights and make informed decisions. By leveraging data analytics, TPAs can identify potential fraud, reduce processing time, and improve overall claim outcomes.

In today’s dynamic environment, a forward-thinking TPA can give you a competitive edge.

Seek a partner who embraces innovation, using technologies like AI and machine learning to automate tasks, improve accuracy, and enhance the claims experience.

A TPA that invests in technology will keep your claims process efficient and accurate, ensuring your business stays ahead of the curve.

A strong network of experts

A TPA with a well-established network of experts — adjusters, legal professionals, and healthcare providers — can expedite claim resolution and provide comprehensive support.

A strong network also enables seamless access to specialised services, reducing delays and overall claim costs.

In a real life example, a complex international claim centred on a family dispute, where legal proceedings were threatened across multiple jurisdictions.

Crawford teams collaborated seamlessly throughout the claim, leveraging its expertise in legal, adjusting and claims management.

The technology utilised helped track progress and ensure all parties were aligned, even across borders. This collaboration extended to managing media attention and client expectations, allowing the mitigation of reputational risk.

Ultimately, the claim was resolved with minimal cost and maximum benefit to the client — demonstrating the value of a TPA with a strong network of professionals.

Transparency and communication

Clear communication and transparency are key to a successful TPA partnership. A TPA that provides regular updates, detailed reports, and proactive communication will help you manage expectations and build trust.

In one notable claim, a guest sought compensation for an item they reported lost during a hotel stay.

After investigating, Crawford found the hotel had followed all required procedures and had no liability exposure. Additionally, the claimant’s evidence didn’t match the alleged loss, and there were inconsistencies in the valuation of the lost item.

The enquiries undertaken meant the claim could be denied, however ultimately, the client chose to settle the claim for less than 3% the value of the lost item.

The right TPA partner will help you maintain the open communication with all parties involved, leading to a transparent approach that helps manage expectations, maintain trust, and deliver a fair outcome for both parties. 

Cost-effectiveness

A TPA should reduce claims processing costs while maintaining high quality.

Look for a partner who offers transparent pricing models and is committed to streamlining operations. A cost-effective TPA will eliminate redundancies, optimise workflows and negotiate better rates with vendors, ultimately saving you money.

In one scenario, a client dealing with rising reserves and defence costs had their underwriter withdraw support. Crawford stepped stepped in to review the claims, and identified that many were over-reserved

By reassessing the claims and involving legal expertise early, claims costs could be reduced significantly. The book returned to profitability and the number of claims progressing to legal representation decreased. Defence costs were cut in half compared to previous years.

Using resources strategically

While TPAs sometimes limit legal involvement to cut costs, resources can be utilised strategically to prevent escalation and drive early settlements. In one case, Crawford was able to save a client over $50,000 in just 12 months and reduce indemnity and defence costs.

Selecting the right TPA is key to optimising claims management. The right TPA partner should be more than just a service provider — they should be a strategic extension of your team.

By carefully evaluating potential partners, you can ensure your claims management strategy aligns with your business goals and delivers long-term value.