Reinventing TPAs: The ClaimSorted Approach to Insurance Claims

What is ClaimSorted and How Did It Begin?

ClaimSorted, a revolutionary startup founded in 2024, is redefining the landscape of insurance claims management. Located in New York, this innovative company was created by Pavel Gertsberg and German Mikulski, both of whom have a rich history in the insurance and technology sectors. The startup operates as a Third Party Administrator (TPA), a service that allows insurance companies to outsource their claim operations. However, unlike traditional TPAs, ClaimSorted integrates advanced artificial intelligence (AI) with expert human oversight to deliver unparalleled efficiency and accuracy in handling insurance claims.

How Do Pavel Gertsberg and German Mikulski Contribute to ClaimSorted?

Pavel Gertsberg and German Mikulski, the active founders of ClaimSorted, bring a wealth of experience and expertise to the table. Before founding ClaimSorted, Pavel built and scaled a pet insurance company named Fluffy, which grew to serve over 20,000 customers by collaborating with some of the largest insurers. His extensive background in marketing, sales, and product development within the SaaS and InsurTech sectors makes him a valuable asset to ClaimSorted.

German Mikulski, the Co-Founder and Chief Technology Officer (CTO) of ClaimSorted, also boasts an impressive resume. He co-founded Fluffy with Pavel, where he successfully automated approximately 70% of the back-office processes using AI. His prior experience at Deutsche Bank, where he developed Big Data systems that processed over $100 million in transactions, further enhances his technical prowess and capability to drive innovation at ClaimSorted.

What Problems Does ClaimSorted Aim to Solve?

Anyone who has ever submitted an insurance claim and experienced delays in receiving their payout can attest to the frustrations associated with the traditional claims process. The root of these delays often lies in the inefficient methods employed by many TPAs. These organizations typically rely on outdated, manual processes that resemble a "huge warehouse with thousands of people using pen and paper to process millions of claims." This antiquated approach results in slow processing times, increased errors, and heightened customer dissatisfaction.

How Does ClaimSorted Provide a Solution?

ClaimSorted is positioned as an AI-first TPA, aiming to transform the insurance claims process by automating critical functions such as fraud checks, compliance, and claim decision-making. This automation drastically reduces the time required to process claims, enabling payouts to be delivered within minutes rather than weeks. By combining the power of AI with the expertise of human professionals, ClaimSorted ensures a high level of accuracy and reliability in claim assessments.

The integration of AI allows for continuous learning and improvement, making the system more adept at identifying fraudulent claims and ensuring compliance with regulatory standards. This dual approach not only enhances the speed and efficiency of claims processing but also maintains the integrity and trustworthiness of the service.

What Makes the Team Behind ClaimSorted Unique?

The team at ClaimSorted is uniquely qualified to tackle the challenges of the insurance industry. Having previously built an insurance company, Pavel and German have firsthand experience with the difficulties and inefficiencies of working with traditional TPAs. This insight has been instrumental in shaping their vision for ClaimSorted, as they are deeply familiar with the pain points and needs of both insurers and policyholders.

Furthermore, the personal connection between Pavel and German adds a layer of trust and cohesion to their partnership. Notably, German was the best man at Pavel's wedding, highlighting the strong bond and mutual respect that underpins their professional collaboration.

How Does ClaimSorted Enhance Customer Experience?

One of ClaimSorted's primary objectives is to transform every insurance claim into a positive experience for customers. By leveraging AI to streamline and expedite the claims process, the company minimizes the stress and uncertainty typically associated with filing a claim. Customers can expect faster resolutions, reduced paperwork, and a more transparent process.

Additionally, the expert team at ClaimSorted provides personalized support to address any questions or concerns that may arise during the claims process. This combination of advanced technology and human touch ensures that customers receive the best possible service, fostering greater satisfaction and loyalty.

How Does ClaimSorted Drive Cost Efficiencies for Insurers?

For insurance companies, the efficiency gains offered by ClaimSorted translate into significant cost savings. By automating labor-intensive tasks, the company reduces the need for extensive manual labor, thereby lowering operational expenses. The AI-driven approach also decreases the likelihood of errors and fraudulent claims, which can be costly to insurers.

Moreover, the speed and accuracy of ClaimSorted's services enable insurers to process more claims in a shorter period, enhancing their overall capacity and productivity. These efficiencies not only improve the bottom line for insurance companies but also allow them to offer more competitive premiums to their customers.

What is the Future Vision for ClaimSorted?

ClaimSorted's founders envision a future where the cumbersome and outdated processes of traditional TPAs are replaced by intelligent, automated systems that deliver superior service and efficiency. As the company continues to evolve and refine its AI capabilities, it aims to set new standards for the insurance industry, driving innovation and improving outcomes for both insurers and policyholders.

The startup's immediate goal is to expand its client base by forming strategic partnerships with insurance companies. By demonstrating the tangible benefits of their AI-first approach, Pavel and German hope to attract more insurers who are eager to modernize their claim operations and enhance customer satisfaction.

What are the Key Takeaways About ClaimSorted?

In summary, ClaimSorted represents a groundbreaking advancement in the field of insurance claims management. By combining cutting-edge AI technology with the expertise of seasoned professionals, the company offers a faster, more accurate, and cost-effective solution for handling insurance claims. Founded by industry veterans Pavel Gertsberg and German Mikulski, ClaimSorted is poised to revolutionize the TPA landscape and set a new benchmark for excellence in the insurance sector.

As the startup continues to grow and innovate, it remains committed to its mission of making every insurance claim a hassle-free experience for customers while delivering substantial cost efficiencies for insurers. With its unique blend of technology and human expertise, ClaimSorted is well-positioned to lead the charge towards a more efficient and customer-centric future in the insurance industry.