A national TPA serving more than 140 self-insured employers, public entities and program carriers needed proof of recovery performance, client by client. Ishqkala swept 24 months of closed files across 38 client programs, each in its own segregated workspace, and found 1,027 actionable files worth $9.6M. Per-client yield reporting now anchors the TPA's stewardship reviews and RFP responses.
The challenge
Every client program came with its own service instructions, authority limits and recovery rules, and adjusters carrying 100 to 150 active claims applied them as best they could. Subrogation referral depended on the adjuster. Risk managers asked in stewardship meetings why recoveries were flat, and new RFPs asked for recovery yield by line, a number the TPA could not produce with confidence.
The hardest files were workers' comp claims with a third party involved: a delivery driver rear-ended on a route, a technician hurt by a defective lift. The facts sat in nurse case manager notes and recorded statement summaries, and each state's comp statute sets its own lien and subrogation rules. Clients also required that their claim data never mix with another client's.
The approach
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Client consent and segregated workspaces
The TPA obtained written approval from each client to include its files. Ishqkala set up a separate workspace per client program, so data, manifests and reporting never cross client lines.
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First sweep on three programs
A first sweep across three client programs swept 6,400 closed files and found 148 actionable opportunities, enough for TPA leadership to approve a wider rollout.
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Full sweep from Origami Risk
Scheduled SFTP extracts delivered 48,900 closed files from 38 programs, the first three included, with claim notes, recorded statement summaries and police reports. Each client received its own Recovery Opportunity Manifest.
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Routing by client instructions
Inter-company auto went to the TPA's recovery desk for Arbitration Forums, workers' comp third-party actions went to client-designated counsel to protect lien rights, and high-dollar property went to panel counsel.
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Client recovery reporting
Per-client dashboards track identified, pursued and recovered dollars and cycle time, and feed the TPA's quarterly stewardship reports.
“Every RFP asks about subrogation, and every TPA says it is good at it. We now answer with each client's recovery yield, file by file, and we can show a risk manager the dollars we found in their own closed claims. That changed the conversation, and it has won us new programs.”