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Claims administrators and TPAs

Many insurers. One desk. Each client's rules kept apart.

A claims administrator handles claims for many insurers at once, each with its own wordings, authorities, service levels and reports. HONESTAS keeps each client in its own walled space with its own rules, checks every decision against that client's authority and seals it into a record the client can check. Client reports are built from those records, not retyped.

Book a demo Follow one claim
Each client's rules and authoritiesDecisions checked against the client's authorityClient reports built from sealed records
honestas · mail · the team's addressSample data
A shared claims address in HONESTAS with six people, a same-day first-reply standard, who has each message and a reply checked before it is sent
A shared claims address. Six people, one first-reply standard, and every reply checked and signed before it goes.Sample data
Where it helps

Six jobs on a claims administrator's desk.

Each one is done under a client's rules and leaves a sealed record that client can check. Open one to see what goes in, what comes out and who signs.

Taking on a new client

Each client's wordings, authorities, service levels and report formats are loaded as rules in its own walled space, and tested on past claims before they go live.

Goes in
The claims handling agreement, wordings and authority schedule
Comes out
A client space with its rules tested and in force
Signs
Client manager, then the client's own sign-off
Handling within the client's authority

Before a handler signs, HONESTAS checks the amount against that client's authority for that handler. Above it, the claim is referred to the client with the file.

Goes in
The claim and the client's authority schedule
Comes out
A decision inside authority, or a referral with reasons
Signs
Claims handler. The client, above the limit
Service levels and mail

Shared claims addresses with a clock per client. Replies are checked and signed before they leave, in the client's name where the agreement says so.

Goes in
Mail, calls and each client's service levels
Comes out
Replies on time, each with its checks kept
Signs
The handler who wrote it
Papers held and owed

Every file shows what is held and what is still owed, who owes it and since when. A search runs across every claim a handler may see.

Goes in
Documents and the wording's conditions
Comes out
Chasers, and a list of what is late
Signs
Claims handler
Client reporting

Client reports, claims bordereaux and audit samples are built from sealed records. A client can open any line and check it against the record behind it.

Goes in
Sealed decisions, payments and clocks
Comes out
Reports and bordereaux, each line linked to its record
Signs
Client manager
Audits by the client

A client's auditor gets a seat on that client's claims only, with every page opened recorded for both firms.

Goes in
The audit scope
Comes out
A scoped seat and a record of what was read
Signs
Compliance lead
One claim, step by step

One desk, three insurers and a missing certificate.

Fulmar Claims, a fictional claims administrator, handles for three fictional insurers. Six steps from the first email to a client report. Scroll, and the screen follows the step.

  1. 01 · Mail in

    A cold store loses four days of power.

    Bácús Chill writes to Fulmar's claims address about a refrigeration failure. The policy is Northgate's, so the claim opens in Northgate's space, under Northgate's wording and Northgate's first-reply clock.

    Cian Moran, claims handler at Fulmar, takes it.

  2. 02 · Client rules

    The same desk, a different rulebook.

    Cian handles for three insurers. For this claim HONESTAS applies Northgate's authority, wording, conditions and reporting, not Wrenmoor's, and shows him which rules are in force.

    Fulmar's client manager keeps each client's rules up to date.

  3. 03 · Papers owed

    The certificate that decides cover.

    The file shows what is held and what is still owed. The wording makes the sprinkler certificate a condition precedent, so it is at the top, with who owes it and for how long.

    Cian chases the customer for the certificate.

    honestas · the file · what we hold, and what is lateSample data
    A commercial claim file for a refrigeration failure, showing six papers held and three still owed, including a missing sprinkler certificate
    What we have and what we are owed. Six papers held and three owed. The sprinkler certificate is a condition precedent under §7.2, so it sits at the top.Sample data
  4. 04 · Across claims

    Chase all three at once.

    Two other claims are waiting on the same certificate. One search finds every one Cian may see, and one button chases all three that are owed, each in the right client's name.

    Cian sends three chasers in one go.

    honestas · the file · finding one across everythingSample data
    A search across every claim a handler may see for the sprinkler certificate, three held and three owed, with how long each has been outstanding
    Every sprinkler certificate, everywhere. Three held and three owed across six claims, with one button to chase all three. The search crosses only what you may see.Sample data
  5. 05 · Referral

    Above his authority, so it goes to the client.

    The stock and business interruption loss comes to £186,400, above Cian's £50,000 limit for Northgate. The claim is referred with its file, and Northgate's claims lead decides it in Northgate's space.

    Sara Lindqvist, Northgate's claims lead, decides and signs.

  6. 06 · Client report

    A report Northgate can check line by line.

    At month end the client report and the claims bordereau are built from sealed records. Northgate opens any line and lands on the record behind it.

    Fulmar's client manager sends it. Northgate checks it.

honestas · the file · what we hold, and what is lateSample data
A commercial claim file for a refrigeration failure, showing six papers held and three still owed, including a missing sprinkler certificate
What we have and what we are owed. Six papers held and three owed. The sprinkler certificate is a condition precedent under §7.2, so it sits at the top.Sample data
honestas · the file · finding one across everythingSample data
A search across every claim a handler may see for the sprinkler certificate, three held and three owed, with how long each has been outstanding
Every sprinkler certificate, everywhere. Three held and three owed across six claims, with one button to chase all three. The search crosses only what you may see.Sample data
The rules you answer to

Mapped to the rules your clients answer to.

Your clients stay responsible for the claims you handle. Each sealed record is linked to the rules they must show they met.

  • Solvency IIDirective 2009/138/EC, Art 49An insurer that outsources claims handling stays fully responsible for it, and must be able to oversee it.
  • DORARegulation (EU) 2022/2554, Art 28Insurers manage the risk of the ICT services they rely on, including the systems their claims administrators use.
  • GDPRRegulation (EU) 2016/679, Art 28A claims administrator acting for an insurer processes claimants' data only on that insurer's instructions.
  • Consumer Protection CodeCentral Bank of Ireland, S.I. 80/2025 and 81/2025Clear information and fair treatment for claimants in Ireland, whoever handles the claim, from 24 March 2026.
  • Claims handling, UKFCA ICOBS 8.1.1R and PRIN 2AClaims handled promptly and fairly, and good outcomes for retail customers across the chain.
  • Lloyd's delegated claimsIntermediaries Byelaw (No. 3 of 2007)Claims handled for Lloyd's syndicates by approved delegated claims administrators, under registered contracts.

Not legal advice. Certification and legal opinions stay between you and your advisers.

Go deeper

Go deeper

SolutionsGeneral insurance

The same claim, from the insurer's side.

PlatformRooms and team chat

Walls between clients that hold on every message.

OutcomeFaster claims

Claims wait least where it is clear who may decide.

Book a demo

Bring one client's claims.

Bring one claims handling agreement and a few anonymised files. We will load the client's rules and run a claim from the first email to the client report.

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