Third-Party Claims Administrator

A third-party administrator handles claims that fall inside your retention, where the carrier is not yet paying. It investigates, sets reserves, selects and manages defense counsel, and reports to the carrier when a claim threatens the carrier layer.

Once the retention is large enough that most claims never reach the carrier, claims handling stops being a service you receive and becomes a function you are buying, and the entity performing it controls investigation quality, defense counsel selection and reserve accuracy. All three are your money. Reserve accuracy matters twice, because reserves drive your collateral requirement and they drive how an underwriter reads your loss run. Choose on caseload per adjuster and on long-term care experience rather than on fee, confirm the carrier approves the appointment, and build the escalation trigger into the service agreement explicitly, because an administrator handling a claim inside your retention does not relieve you of the obligation to report a claim that could reach the carrier layer.