Ensylon | Product Engineering

Get in Touch

Third-Party Administrator (TPA)

Automating Operations for a Group Insurance TPA

A leading Third-Party Administrator (TPA) managing voluntary group insurance products was facing critical operational challenges. As their newly launched insurance product started gaining traction, they needed to scale their backend processing systems quickly. The client had a small operations team and a history of high error rates in processing premiums and claims. These inefficiencies had already led to lost business opportunities in the past.

$350M+

premium processed in 6 months.

$1M+

annual cost savings.

90%

reduction in processing errors.

$350M+

premium processed in 6 months.

$1M+

annual cost savings.

90%

reduction in processing errors.

Client Details:

About Third-Party Administrator (TPA):

A leading TPA managing group insurance faced operational challenges as their new product gained traction. With a small team and high error rates in premium and claim processing, they had already lost business. Their goal: scale backend systems, cut manual effort, and improve quality—without adding staff.

Client

Third-Party Administrator (TPA)

Industry

Insurance

Country

India

Explore Services

Objectives:

  • Streamline and scale operations to support growing transaction volumes
  • Eliminate manual processing and reduce human errors in premium and claims workflows
  • Build a unified automation framework that connects disparate systems
  • Improve operational visibility and reduce overhead cost

Our Approach:

Our engagement began with a deep-dive assessment of the client’s current state. We evaluated existing workflows, pain points, system architecture, team roles, and governance structure. Based on this, we co-developed a transformation roadmap covering process improvements, technology integrations, and resource allocations.

We designed and deployed a custom automation solution that eliminated manual Excel-based processing and enabled system-level data integration. By removing dependency on siloed workflows, we ensured real-time connectivity across multiple carriers, products, and transaction types.

Engineering & Integration

  • Integration of disparate client systems for seamless data flow
  • Replacement of spreadsheets with structured, real-time interfaces
  • Deployment of governance frameworks for exception handling
  • Use of proprietary accelerators, including:
    • Capability Maps
    • Automation Screening Framework
    • Testing Framework
    • PDD Templates

Client Details:

About Third-Party Administrator (TPA):

A leading TPA managing group insurance faced operational challenges as their new product gained traction. With a small team and high error rates in premium and claim processing, they had already lost business. Their goal: scale backend systems, cut manual effort, and improve quality—without adding staff.

Client

Third-Party Administrator (TPA)

Industry

Insurance

Country

India

Explore Services

Key Results

Metric
Outcome
Premium Processed
$350M+ in less than 6 months
Headcount Reduction
Only 1 FTE needed on each side of the operations
Annual Savings
$1M+ in cost reductions
Error Reduction
90%+ improvement in transaction accuracy

Key Analytics

  • Throughput: 10x increase in policy and claim handling capacity
  • Uptime: Maintained 99.9% uptime during peak volume cycles
  • Accuracy: Data accuracy rates exceeding 98.5% post-deployment
  • Implementation Time: Full solution deployed within 8 weeks

Client Satisfaction

"The automation framework completely transformed our back-office capabilities while allowing us to grow fast—without growing headcount."
Third-Party Administrator (TPA)
Client
Scroll to Top