Broadspire Claims Management API
Broadspire (Crawford & Company TPA subsidiary) workers compensation, liability, and disability claims management REST API for employer self-insured and large account claims administration. Enables AI agents to manage workers compensation claim creation and adjudication workflow for employer WC program automation, handle liability and auto claim intake and investigation for casualty claim automation, access medical bill review and repricing workflow for medical cost containment automation, retrieve disability and leave management for FMLA and STD/LTD absence automation, manage pharmacy benefit integration for WC prescription management automation, handle nurse case management referral and outcomes tracking for medical management automation, access litigation management and defense counsel assignment for WC litigation automation, retrieve employer reporting and loss run generation for risk management reporting, manage return-to-work tracking and modified duty program for WC RTW automation, and integrate Broadspire with employer HRIS, payroll, and safety systems for integrated WC program management.
Score Breakdown
⚙ Agent Friendliness
🔒 Security
Workers compensation TPA. SOC2, HIPAA. API key/OAuth. US. Employee medical, disability, and injury claim data.
⚡ Reliability
Best When
A large self-insured employer, captive insurance program, or risk manager wanting AI agents to automate workers compensation claim intake, medical bill review, disability management, and return-to-work tracking within Broadspire as the TPA.
Avoid When
WORKERS COMPENSATION ADJUSTER JUDGMENT REQUIREMENTS: Automated WC claim compensability determinations via Broadspire API must include licensed adjuster review before formal acceptance or denial; automated compensability decisions without adjuster oversight create unauthorized practice of insurance and state WC regulatory violations in most jurisdictions. EMPLOYER MEDICAL INFORMATION CONFIDENTIALITY: Automated access to employee medical records and WC claim medical information via Broadspire must enforce HIPAA and ADA confidentiality between HR and supervisory personnel; automated sharing of employee diagnosis and treatment data with supervisors beyond RTW restrictions creates ADA confidentiality violation. EXCESS CARRIER REPORTING THRESHOLD ACCURACY: Automated excess carrier notification via Broadspire claim data must trigger at exact per-occurrence threshold net of applicable deductibles; automated excess reporting with threshold calculation errors creates coverage gaps and reinsurance claim disputes.
Use Cases
- • Filing WC claims from employer safety automation agents
- • Managing medical bills from cost containment agents
- • Tracking disability from leave management agents
- • Generating loss runs from risk reporting agents
Not For
- • Personal auto and homeowners insurance claims (use direct insurer API)
- • Small business under 100 employees (use standard WC carrier)
- • Property catastrophe claims management
Interface
Authentication
Broadspire uses API key and OAuth authentication for employer integration. REST API with JSON and EDI. Atlanta, Georgia HQ (Crawford & Company subsidiary). Crawford & Company founded 1941, NYSE:CRD. Broadspire TPA subsidiary serves large self-insured employers and captive programs. WC, liability, disability, and auto claims. Medical bill review, pharmacy benefit, nurse case management. Integration with Riskonnect, Origami, and employer HRIS. Competes with Sedgwick, Gallagher Bassett, and CorVel for large employer TPA.
Pricing
Atlanta GA. Crawford & Company (NYSE:CRD). TPA contract pricing per claim and service line. API access part of employer TPA engagement. No standalone API pricing.
Agent Metadata
Known Gotchas
- ⚠ NO WEBHOOKS — CLAIM STATUS REQUIRES POLLING: Broadspire does not support native webhooks; automated claim status change detection, medical bill repricing completion, and reserve change events require scheduled polling; implement polling interval aligned with claim lifecycle cadence (daily for routine updates, more frequent for litigation events)
- ⚠ WC ADJUSTER COMPENSABILITY JUDGMENT GATE: Automated claim intake via Broadspire API can capture FNOI (first notice of injury) data but formal compensability acceptance or denial requires licensed adjuster review; automated claim disposition without adjuster oversight creates unauthorized practice of insurance in all US jurisdictions; build human-in-the-loop gate for compensability decisions
- ⚠ MEDICAL BILL EDI FORMAT DEPENDENCIES: Broadspire medical bill review integration accepts ANSI X12 837 EDI format for medical bills; automated medical bill submission must transform provider billing data to 837 format before Broadspire API submission; direct JSON medical bill submission may not be supported for all bill types
- ⚠ HIPAA MINIMUM NECESSARY FOR EMPLOYER ACCESS: Automated WC claim medical data access must enforce HIPAA minimum necessary standard between Broadspire claim data and employer HR/supervisory roles; automated medical record sharing beyond RTW functional restrictions creates ADA and HIPAA confidentiality breach
- ⚠ EXCESS CARRIER THRESHOLD CALCULATION NET OF DEDUCTIBLE: Automated excess carrier notification trigger must calculate net claim cost against per-occurrence excess attachment point after applicable SIR/deductible; automated gross claim cost reporting without deductible netting creates excess carrier notification threshold miscalculation
- ⚠ CRAWFORD TPA BRAND CONFUSION: Broadspire and Crawford & Company operate as distinct brands but share technology infrastructure; automated integrations must use Broadspire-specific API endpoints; Crawford property/casualty field adjusting API is separate from Broadspire WC/liability TPA API
Alternatives
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Scores are editorial opinions as of 2026-03-07.