The pace of consolidation in the claims services and TPA (third-party administrator) market is accelerating – reshaping competitive dynamics and redefining what it takes to succeed. Regional and specialty firms are being acquired by larger platforms seeking to expand geographic reach, broaden service offerings, and achieve scale. That scale is no longer just a strategic advantage – it’s essential to long-term relevance.
As larger players grow in size and sophistication, smaller firms are finding it increasingly difficult to keep up. Mounting pressures are prompting many owners to consider a sale or strategic partnership as a path forward. These pressures include:
- Rising client expectations and pricing pressure. Clients – including carriers, self-insured entities, and managing general agents (MGAs) – are demanding faster claim resolution, better outcomes, and greater transparency. Meanwhile, pricing models are shifting toward flat-fee and outcome-based arrangements, transferring more financial risk to service providers. For smaller firms, maintaining performance and profitability under these conditions is becoming more challenging.
- Demand for integrated services. Clients increasingly seek bundled offerings – claims handling, field services, analytics, and managed care – all under one roof. Firms that can’t deliver a full-service model are losing ground.
- Technology investment requirements. Digital access, real-time reporting, and operational visibility are now baseline expectations. Meeting these demands requires significant investment in platforms, integrations, and automation – resources that are difficult to deploy without scale.
- Regulatory complexity. Compliance with evolving standards for data security, reporting, and audit readiness requires dedicated infrastructure and specialized expertise. For smaller firms, keeping pace with these requirements is increasingly resource intensive.
For some firms, these challenges are compounded by ownership dynamics – particularly among founder-led businesses without clear succession plans. In those cases, the urgency to find a strategic partner and exit is even greater.
Buyer demand is also increasing
These same market forces are also fueling demand from buyers. Both private equity-backed and other strategic acquirers are pursuing acquisitions to build national and international platforms designed to deliver broader solutions, support more complex programs, and meet the evolving needs of large-scale clients.
Private equity-backed buyers are driving much of the merger and acquisition (M&A) activity:
- Sedgwick continues to be a prolific acquirer. In 2024, it raised a $1 billion minority investment from Altas Partners, with continued backing from majority shareholder The Carlyle Group, as well as Stone Point Capital, CDPQ, and Onex.
- Davies Group, backed by BC Partners and HGGC, is headquartered in the U.K. It has expanded its U.S. presence through acquisitions including IAS Claim Services, Johns Eastern, and Brown & Brown’s TPA and claims businesses.
- Cor Partners, whose portfolio includes Eberl Claims Service, Engle Martin, Envista Forensics and DBI Consultants, has pursued a buy-and-build strategy to expand its capabilities across loss adjusting, forensic engineering, and consulting. The company is backed by BW Forsyth Partners.
- Ryze Claim Solutions was recapitalized by Bain Capital Insurance in 2024. Since then, Ryze has acquired Leading Edge Claims Service and Acorn Claims as part of its strategy to build a national P&C platform.
- Intercare, acquired by Aquiline Capital Partners in 2025, includes Intercare, InterMed, and George Hills – California-based businesses focused on workers’ comp and liability claims administration and managed care. The platform is pursuing acquisitions where leadership remains in place while leveraging shared infrastructure and capital.
Other strategic acquirers are also active in the market:
- Gallagher Bassett, a division of Arthur J. Gallagher, continues to grow through acquisitions, most recently adding capabilities in marine, legal, and incident management services.
- Crawford & Company has taken a more selective approach, with recent M&A activity focused on expanding its international presence.
- Tristar, a privately held TPA, has pursued targeted acquisitions including Risico Claim Management and Risico Total Managed Care’s self-insured book of business and FiRMS Claims Services – to broaden its geographic reach and service offerings.
Consolidation in the claims services and TPA space shows no signs of slowing.
Several trends are likely to shape the next phase of market evolution:
- More platform-level transactions. As private equity hold periods extend, some sponsors are preparing for recapitalizations, secondary sales, or full exits via M&A or IPO. This will likely drive renewed acquisition activity at both the platform and bolt-on levels.
- Increased focus on complex claim capabilities. Buyers are seeking firms with the expertise to manage high-acuity, technically demanding claims. As client programs grow more sophisticated, the ability to deliver strong outcomes on complex files will be a key differentiator.
- Expansion into adjacent services. Buyers are targeting firms that offer more than core claims handling. Capabilities like forensic accounting, managed repair, temporary housing, restoration, clinical oversight, compliance support, subrogation, and analytics are becoming part of the broader value proposition, deepening client relationships and creating new cross-sell opportunities.
- Technology scrutiny is intensifying. Buyers are placing greater emphasis on how firms use technology to drive efficiency and scale. Systems that support automation, integration, and data-driven decision-making are increasingly critical.
- Differentiation will determine success. As competition intensifies, firms that bring something distinctive – whether through specialization, client mix, or operating model – will be better positioned to grow and attract interest.
As the market continues to evolve, firms that adapt, invest, and differentiate will be best positioned to lead in a more integrated and competitive claims ecosystem.
