The insurance third-party administrator market size is expected to reach US$ 544.67 billion by 2031 from US$ 256.02 billion in 2023. The market is estimated to record a CAGR of 9.9% from 2023 to 2031. Digital third-party administrators are likely to remain a key market trend in the coming years.
The insurance claim process can be complex and time consuming. A third-party administrator can help policyholders claim their policy benefits. They guide policyholders throughout the claim procedure and file claims on their behalf. Once the claims are filed, third-party administrators investigate and verify them. 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 insurance third-party 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. The increasing need for administrators in health insurance with the surging complexity of claim processes fuels the growth of the insurance third-party administrator market. Further, the proliferation of the insurance industry creates opportunities for market growth in the future. 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.
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.
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. Insurers such as Oriental Insurance, New India Assurance, National Insurance, and United India opt for administrator services offered by 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.
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.
Key segments that contributed to the derivation of the insurance third-party administrator market analysis are type and end user.
The regional trends and factors influencing the Insurance Third-Party Administrator Market throughout the forecast period have been thoroughly explained by the analysts at Insight Partners. This section also discusses Insurance Third-Party Administrator Market segments and geography across North America, Europe, Asia Pacific, Middle East and Africa, and South and Central America.
| Report Attribute | Details |
|---|---|
| Market size in 2023 | US$ 256.02 Billion |
| Market Size by 2031 | US$ 544.67 Billion |
| Global CAGR (2023 - 2031) | 9.9% |
| Historical Data | 2021-2022 |
| Forecast period | 2024-2031 |
| Segments Covered |
By Insurance Type
|
| Regions and Countries Covered | North America
|
| Market leaders and key company profiles |
The Insurance Third-Party Administrator Market market is growing rapidly, driven by increasing end-user demand due to factors such as evolving consumer preferences, technological advancements, and greater awareness of the product's benefits. As demand rises, businesses are expanding their offerings, innovating to meet consumer needs, and capitalizing on emerging trends, which further fuels market growth.
Market players density refers to the distribution of firms or companies operating within a particular market or industry. It indicates how many competitors (market players) are present in a given market space relative to its size or total market value.
Major Companies operating in the Insurance Third-Party Administrator Market are:
Disclaimer: The companies listed above are not ranked in any particular order.
The insurance third-party administrator market is evaluated by gathering qualitative and quantitative data post primary and secondary research, which includes important corporate publications, association data, and databases. A few of the developments in the insurance third-party administrator market are listed below: Sedgwick has announced several new updates to its artificial intelligence-powered (AI) technology 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.
(Source: Sedgwick, Press Release, May 2024)
(Source: Crawford & Company, Press Release, May 2022)
The "Insurance Third-Party Administrator Market Size and Forecast (2021–2031)" provides a detailed analysis of the market covering the areas mentioned below:
The global third-party administrator market was estimated to be US$ 356.42 billion in 2023 and is expected to grow at a CAGR of 9.7 % during the forecast period 2023 - 2030.
Technological innovations in the market, which is anticipated to play a significant role in the global third-party administrator market in the coming years.
The key players holding majority shares in the global third-party administrator market are Sedgwick, Crawford & Company, CorVel, United Healthcare Services, Inc., and Helmsman Management.
The global third-party administrator market is expected to reach US$ 747.50 billion by 2031.
Increasing demand from the healthcare industry and growing digitalization are the major factors that propel the global third-party administrator market.