Digital TPA: Driving Innovation in Healthcare Qorus-NTT DATA Innovation in Insurance Awards 2026

InSalute Servizi, a digital-driven TPA, launched a transformation program to redesign healthcare claim management within the Intesa Sanpaolo Assicurazioni App. The objective was to differentiate in a competitive market, enable scalable industrial growth, increase operational efficiency, and deliver tangible added value through integrated new customer journeys and Digital Health services.

The initiative responded to rising customer expectations for seamless, mobile-first services and to the need to reduce operational complexity, claim rework, and customer support requests. Call center and claims handlers’ insights highlighted recurring friction points, driving the redesign toward error prevention, clarity, and simplicity.

The TPA market remains highly cost-driven and operationally focused. Few players offer fully integrated digital ecosystems combining claim management, online booking from in-network healthcare facilities/specialists’ agendas, and in-app medical documentation. This gap represented a clear opportunity for differentiation through innovation and customer-centricity.

The transformation was inspired by best-in-class fintech and e-commerce platforms, emphasizing frictionless journeys, real-time validation, and proactive error prevention. Internal data analytics and customer support feedback were key inputs in shaping the new digital flows.

The initiative required strong cross-functional collaboration across Digital Experience, IT, Operations, Claims, Network Management, Customer Care, Legal and Compliance.

The program has delivered measurable impact, including a 50% reduction in rejections of in-network health service requests submitted via the App, a 30% reduction in rejections of reimbursement requests entered via App, zero rejections due to insufficient documentation, a 50% reduction in rejections due to incomplete documentation, an increase of 5 p.p in digital channel usage rate and an increase of 50% in-network health service requests.