How TPAs Use Document Automation to Win Carrier Contracts

The third-party administrator market is more competitive than it has ever been. Carriers have options — more TPAs offering equivalent headcount, equivalent geographic coverage, and equivalent claims handling expertise than at any previous point. The differentiators that drove TPA selection decisions a decade ago — size, network, sector specialisation — are table stakes now. Every credible TPA can check those boxes.

What separates TPAs that win delegated authority mandates from those that lose them is increasingly operational infrastructure: the ability to demonstrate, with data, that claims are processed consistently, accurately, and cost-effectively at scale. Carriers are not evaluating your team's experience anymore. They are evaluating your systems. Document automation is the single most visible indicator of whether your systems are built for serious delegated authority work or whether you are still running operations on manual processes that will degrade as volume grows.

What Carriers Actually Evaluate When Choosing a TPA

When a carrier conducts due diligence on a TPA for a delegated authority mandate, the evaluation criteria are more specific than most TPA proposals acknowledge. Carriers have learned, from hard experience, that delegated authority is a risk to manage actively rather than transfer passively.

When a carrier delegates claims authority to a TPA, it creates a principal-agent relationship in which the TPA is exercising the carrier's authority — and the carrier retains ultimate responsibility for the outcomes. Settlements paid incorrectly, compliance failures in customer communications, inadequate fraud detection, inaccurate bordereaux reporting — these are the carrier's exposures, even when the TPA made the decisions that caused them.

This understanding has raised the bar. Carriers are not asking "can this TPA handle our claims?" — they are asking "can this TPA handle our claims in a way that we can verify, report on, and defend to our regulators?" Those are very different questions, and the distinction determines the evidence carriers seek during due diligence.

Consistency and Auditability

Carriers delegate authority because they want claims handled consistently according to their guidelines — not according to the judgment of whichever adjuster happens to pick up the claim. A process documented in a manual is a guideline. A process enforced by a workflow system is a constraint. Carriers want constraints. They want to be able to ask their TPA: "Show me the last 100 claims of this type. Show me that each one followed the same process steps, applied the same valuation methodology, and produced a documented rationale." TPAs that can produce this evidence win. TPAs that cannot lose.

Compliance Posture

Regulatory compliance in delegated claims handling is increasingly a carrier-level concern. FCA Consumer Duty requirements, fair customer outcome obligations, vulnerability tracking — these obligations attach to the carrier even when claims are handled by a TPA. Carriers conducting due diligence now include compliance infrastructure in their evaluation. They want to see that vulnerability flags are captured systematically, that communications are logged, and that the TPA's operations can survive the same FCA supervisory review that the carrier itself would need to pass.

Cost Per Claim and Turnaround Time

Cost per claim is the economic basis on which mandates are priced. Carriers benchmark against market rates and select TPAs that can demonstrate efficiency with data, not assertions. Turnaround time SLAs matter because slow claims handling generates customer complaints, regulatory attention, and — for some claim types — late payment penalties. Your ability to demonstrate historical SLA performance, with claim-level data, is a material differentiator during mandate competition.

How Document Automation Signals Operational Maturity

Documents are the raw material of claims processing. Every claim begins with a notification document. Every claim involves supporting evidence — medical records, engineer reports, photographs, invoices. Every claim generates correspondence. Every claim produces a settlement document or decision letter.

The way a TPA handles those documents determines the quality of everything that follows. Manual document handling — receiving documents by email, printing and scanning them, manually entering data into a claims system — produces delays, data entry errors, lost documents, and processing inconsistency. It also produces cost. Each manual step is a labour cost that accumulates in your cost-per-claim figure.

When a carrier's due diligence team reviews TPA operations and sees structured document intake, automated classification, and automated data extraction flowing directly into the claims workflow, they are seeing evidence of an operation that has been deliberately engineered for consistency and scale. That is not a minor operational detail — it is the foundation of the operational maturity case that wins carrier mandates.

Structured Intake: No Lost Documents

The document processing capability starts at intake. In a manual operation, documents arrive through multiple channels — email, post, portal — and require human intervention to route them to the right claim. Errors at this stage cascade: a document routed to the wrong claim, or lost in an email inbox, creates a processing delay that shows up in SLA performance and can affect settlement accuracy if the document contains information that should influence the valuation.

Automated intake processes every incoming document through the same structured pipeline regardless of channel. The document is received, its type is identified, and it is associated with the correct claim and stored in a retrievable format — automatically, without handler intervention. The TPA that can tell a carrier "we have never lost a claim document because our intake system does not rely on human routing decisions" is making a statement that carries real weight in a due diligence conversation.

Automated Classification: Consistency at Volume

One of the most common failure modes for TPAs taking on new carrier mandates is volume-induced quality degradation. When claim volumes spike — at renewal season, after a weather event, after a carrier migrates a portfolio — TPAs operating on manual processes see SLA performance deteriorate and error rates increase. Staff capacity that handled the baseline volume cannot absorb the surge.

Automated document classification does not degrade under volume. The system that correctly classifies 500 documents per day classifies 5,000 documents per day with the same accuracy. When you can demonstrate this capability with data showing consistent classification accuracy across volume ranges, you are demonstrating something that manually-operated TPAs cannot: that your operational quality is independent of volume fluctuations. For carriers considering delegation of a large portfolio, this is a material risk reduction.

Faster Cycle Times Through Automated Workflow Routing

Once documents are classified and data extracted, automated workflow routing uses that structured data to move claims through the handling process without waiting for human intervention at each step. A complete set of supporting documents triggers automatic progression. A settlement calculation within the TPA's automatic authority limit triggers automatic approval. An exception — a claim that requires senior review — is automatically flagged and routed without a handler needing to identify it manually.

The result is measurable cycle time reduction. Claims that would have spent days in a queue waiting for a handler to process paperwork are progressed automatically within hours of document receipt. This is not a marginal improvement — it is a fundamental change in how long claims take to resolve, with direct implications for customer satisfaction, SLA performance, and cost per claim.

The Audit Trail as a Competitive Weapon

Here is the framing that separates TPAs who win mandates from those who do not: carriers are not asking you to handle their claims. They are asking whether they can trust you with their authority. And trust, in a business context, is built on evidence.

A TPA that can give a carrier real-time visibility into claims operations — every decision logged, every document processed, every communication sent, every settlement calculated and recorded — wins the business. A TPA that says "trust us, our team is experienced" loses to one that says "here is the data."

The audit trail capability is not a compliance feature — it is a sales tool. TPAs that can demonstrate during due diligence that their platform automatically logs every claim event — document received, classification applied, data extracted, workflow state changed, handler action taken, communication sent, settlement approved — are demonstrating something that carriers cannot get from a manually-operated TPA regardless of team experience.

The practical carrier benefit is ongoing, not just at the point of due diligence. A carrier with access to real-time audit trail data from their TPA's platform can run their own spot-check reviews without requesting file pulls. They can identify process adherence issues before they accumulate into material problems. They can verify that their guidelines are being followed at the individual claim level, not just at the aggregate reporting level.

This capability is increasingly becoming a threshold requirement for carriers considering delegation — not a differentiator, but a minimum. TPAs without it are not competing against TPAs that have it. They are competing against the carrier's option to not delegate at all, which is a rational choice if the alternative is delegating to a TPA that cannot provide operational visibility.

Carriers who delegate authority to TPAs operating on the Regure platform can review their delegated portfolio directly — seeing every claim action, every document processing event, and every settlement decision in a tamper-evident log that reflects what actually happened, not what was reported after the fact. This is the visibility that converts initial mandate awards into long-term carrier relationships.

Reducing Cost Per Claim to Win Pricing Battles

The competitive pressure on TPA pricing is direct and quantifiable. Industry benchmarks for property claims handling show manually-operated TPAs typically processing at $28 to $40 per claim when all handling costs are included. TPAs operating with automated document processing, automated data extraction, and workflow automation process the same claim types at $15 to $22 per claim.

That gap — $12 to $18 per claim — is the pricing advantage available to TPAs that have invested in automation. At a portfolio of 20,000 claims per year, that gap represents $240,000 to $360,000 per year in cost difference. A carrier evaluating competing TPA bids can see this difference clearly, and they will price their mandates accordingly.

The mathematics are not subtle. Manual processing has irreducible labour costs at each step: opening and logging the document, reading and entering the data, routing to the appropriate handler, filing and retrieving when needed. None of these steps adds decision-making value. All of them add cost. Automation eliminates them, and the cost reduction flows directly to the bid price.

The TPA that cannot automate its document processing cannot compete on price against one that can. In a market where operational capability is otherwise comparable, price is the deciding factor. And in a market where a $2 reduction in cost per claim can be the margin of victory in a competitive bid, automation is not an operational nicety — it is a commercial necessity.

Real Operational Improvements: What Implementation Looks Like

For TPA operations leaders who understand the competitive case but need to think through the implementation path, the practical approach is incremental rather than transformational. You do not need to replace your entire claims infrastructure to gain the benefits of document automation. You need to build the automation layer on top of your existing operations, starting with the highest-impact components.

Intake Automation First

The highest-impact starting point is document intake automation: automated receipt, classification, and routing of incoming claim documents. This eliminates the queue that builds when handlers are manually processing incoming documents, removes the most manual handling from the process, and produces the immediate SLA and cost improvements that are visible to carriers during the first few months of a new mandate.

Intake automation also produces the structured data that downstream automation depends on. Once you have a reliable, structured data extraction process for incoming documents, the rest of the automation stack becomes significantly easier to build and validate.

Workflow Routing and Exception Handling

The second layer is using the structured data from documents to drive workflow state changes automatically. Simple triggers — a complete set of supporting documents received, a settlement calculation within the automatic authority limit, a time-elapsed flag on a pending claim — can drive workflow progression without handler intervention. Exception handling — identifying claims that fall outside normal parameters and routing them to senior review — can be automated based on configurable rules rather than relying on individual handler judgment.

The result is a claims operation where handlers focus on decisions that require judgment, rather than on administrative steps that precede and follow those decisions. Handler productivity increases, processing time decreases, and cost per claim falls.

Timeline and Return on Investment

TPAs implementing document automation typically have the initial capability operational within weeks. The full automation stack — intake, data extraction, workflow automation, audit trail capture, and reporting — is typically operational within two to three months for standard mandate types.

ROI materialises quickly because the cost reductions are immediate and quantifiable. Reduced handling time per claim, reduced data entry errors, reduced rework from misrouted documents — these show up in the cost-per-claim figure within the first claims cycle after implementation. TPAs that have made this investment consistently report break-even within the first year of operation, with ongoing cost advantages in subsequent years.

For enterprise TPA operations handling multiple carrier mandates simultaneously, the ROI case is stronger still. The automation infrastructure is shared across all mandates, so the fixed cost is amortised across a larger claim volume, driving unit costs down further. The audit trail and reporting infrastructure that satisfies one carrier's due diligence requirements satisfies all of them, because the capability is built into the platform rather than configured separately for each mandate.

The Mandate Competition Has Changed

The TPA mandate competition in 2026 is won on operational infrastructure. The carriers who delegate the most valuable portfolios are conducting due diligence that goes far beyond reviewing team CVs and reference lists. They are examining technology infrastructure, process documentation, reporting capabilities, and audit trail quality. They are asking for evidence — not assurances.

Document automation is the foundation of that evidence. It enables consistent process adherence, accurate reporting, defensible decision trails, and competitive cost-per-claim performance. It is the capability that most differentiates TPAs ready to compete for serious carrier mandates from those still building toward that standard.

If you are a TPA operations leader evaluating how to build the infrastructure that wins carrier mandates in the current market, book a Regure demo to see how the platform delivers the document automation, audit trail capability, and operational reporting that carriers expect — on a timeline that lets you bid for mandates rather than waiting for a platform to be ready.