Disability and healthcare claims administration by brokers: a French specialty ? 

How the French market is gradually converging towards the TPA model we observe abroad

Foreign clients are always surprised to learn that insurance brokers in France are also very often the administrators of disability and healthcare claims (in 88% of cases when a broker is already mandated to provide advice according to a 2018 Deloitte study). Conversely, French clients  implementing covers for their subsidiaries find out that the management of benefits is performed by insurers and dedicated third party TPA administrators with brokers having limited information on claims experience.

In France, the outsourcing of claims management by insurers has been in place for many years and has always been a major asset for brokers. They had made the necessary investments to ensure that their systems were more efficient than those of insurers. Thanks to direct access to data, this outsourcing gave access to detailed key claims information, in order for the broker to better fulfill his role as advisor, to negotiate the best conditions for renewals, the design of covers and the communication with employees. This is therefore a differentiating factor compared to other brokers who do not have this capacity. However, it can also be a double-edged sword when the quality of service is lacking…

With the digitalization of offers, the need to provide a better user experience, new regulations, data protection issues and finally the COVID-19 pandemic,  tools need to be totally redesigned and the investment for brokers is becoming too high . New insurtech players dedicated to management (software, digitalization, artificial intelligence and fraud detection) are emerging to support brokers and insurers on a white label basis. The French market is gradually converging towards the TPA model we observe abroad. Brokers still have access to the strategic data on which they have built their commercial messages, but they will have to play at a highest level to provide the right support to clients in a rapidly changing market regardless of their size. And even if Rome wasn’t built in a day, new Insurtech  players are already ready to take up the challenge…

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Stephanie Denoual

Global Employee Benefits Advocate | Founder of SoBenefit®

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