ClaimSorted is a digital claims TPA. They seek to provide a 5-star claims experience to policyholders while also reducing operational and indemnity costs for insurance companies through their claims team and advanced automation. Andrew Daniels sat with Founder and CEO, Pavel Gertsberg, to learn more about how ClaimSorted is impacting the industry.

Who are ClaimSorted’s clients?
Our clients include MGAs and insurers operating in personal lines. Specifically, we sell what we call a “modern TPA solution,” which combines the latest software with a best-in-class team.
What does your product do?
Our product creates a structured, custom claims-handling process tailored to each client. We begin by taking the client’s policy wording, claims guidelines and philosophy, then map out the entire customer journey. Each workflow is unique to the client, ensuring a seamless experience for policyholders. Additionally, we emphasize automation for smaller administrative tasks, allowing our claim handlers to focus on customer experience and technical claims. This approach also helps reduce claim leakage and improve indemnity management.
How much capital have you raised?
While we haven’t officially announced the amount, I can share that we’ve raised millions in funding. Our backers include Y Combinator, Firstminute Capital and prominent insurtech founders.
Was the company born from within or outside the industry?
The company was born from within the industry. Initially, I built an MGA specializing in pet insurance, which we scaled to 20,000 customers. During that time, we faced significant challenges with outsourced claims handling. This experience led us to identify and address the gaps in the third-party claims administrator (TPA) market.
What growth metrics have you accomplished over the last 12 months?
Although we are a new company, we’ve expanded rapidly and now operate in 50 U.S. states, as well as in the UK and Europe. We support claims in a variety of areas, including travel, motor, property, pet and warranty. We are actively piloting a healthcare initiative with an emerging market government and working with some of the largest insurers globally. While I can’t disclose all names due to NDAs, we’re proud of our collaborations.
Within your domain, what is the current challenge that the industry is facing?
The biggest challenge is the lack of competition and optionality in the outsourced claims market. In niche areas like pet insurance or political risk, there are only a handful of TPAs, often providing mediocre services without much incentive to improve. Insurers and MGAs need better options, and we aim to offer that superior alternative.
How does ClaimSorted take a unique approach to providing value?
Our approach is built on structured, tailored workflows that align with each client’s unique needs and claims philosophy. This customization ensures better customer experiences and reduced claim leakage. Moreover, automation allows us to redirect resources toward more complex claims and customer care. Finally, our emphasis on transparency and collaboration helps us share valuable insights and data with clients, ensuring mutual growth.
What inspired the team to start this company?
The inspiration came from direct experience. While running our MGA, we saw how poorly some TPAs performed. One incident stands out: A policyholder was distressed over a delayed claim and called me directly. When I escalated the issue to the TPA, their response was, “It’s only been 30 days.” This lack of urgency and empathy was unacceptable. That experience, coupled with the realization that many in the industry rely on TPAs they wouldn’t even recommend, drove us to create a better solution.
Can you share any goal(s) for the next 12 months?
Over the next year, we aim to strengthen partnerships with some of the largest insurers globally and expand our R&D efforts. For example, we’re refining cost control mechanisms for travel medical claims, enhancing third-party capture in motor claims and finding innovative ways to fight and prevent fraud. Our ultimate goal is to continue improving customer experience across all lines of business while maintaining our focus on innovation and operational excellence.