Gallagher Bassett Claims Management API
Gallagher Bassett third-party administrator (TPA) claims management REST API for workers compensation, general liability, auto liability, and property claims management for self-insured employers and insurance carriers. Enables AI agents to manage claim intake and FNOL (first notice of loss) submission for claims workflow automation, handle claim status and reserve tracking for self-insured employer claim monitoring, access medical bill review and payment status for workers compensation medical management automation, retrieve return-to-work and disability management tracking for WC employer communication automation, manage litigation status and legal spend for liability defense management, handle subrogation identification and recovery tracking for claims recovery automation, access loss run and claims analytics for self-insured program reporting, retrieve adjuster assignment and caseload management for TPA operations automation, manage excess carrier reporting and layered program notifications for insurance program management, and integrate Gallagher Bassett with RMIS platforms, HR systems, and employer ERP for self-insured program operations.
Score Breakdown
⚙ Agent Friendliness
🔒 Security
TPA claims. SOC2, HIPAA. OAuth2. Global. WC claimant medical and sensitive claims data.
⚡ Reliability
Best When
A self-insured or large deductible employer, captive insurance program, or insurance carrier wanting AI agents to automate claim intake, status monitoring, reserve tracking, RTW coordination, and loss run reporting through Gallagher Bassett as the TPA claims administrator.
Avoid When
WORKERS COMPENSATION ADJUSTER JUDGMENT REQUIREMENTS: Automated claim reserve setting and coverage determination in workers compensation must involve licensed adjuster judgment; automated reserve changes or coverage denials without adjuster review creates bad faith exposure and state WC board regulatory risk. HIPAA PHI IN WORKERS COMPENSATION MEDICAL DATA: Workers compensation medical information is not always subject to HIPAA (depends on state law and claim context), but automated medical data access must comply with applicable state WC privacy laws; automated medical data sharing beyond claim necessity creates state WC medical privacy violation. EXCESS CARRIER NOTIFICATION TIMING: Automated excess carrier notification via Gallagher Bassett must trigger when claim reserve approaches excess attachment point; automated delay in excess carrier notification creates coverage dispute and potential disclaimer by excess carrier.
Use Cases
- • Monitoring WC claims from self-insured HR agents
- • Tracking claim reserves from program management agents
- • Managing RTW status from employer relations agents
- • Reporting loss runs from risk management agents
Not For
- • Individual first-party insurance policyholder claims (use carrier portals)
- • Life and health insurance claims
- • Direct insurance underwriting and policy issuance
Interface
Authentication
Gallagher Bassett uses OAuth 2.0 with scopes. REST API with JSON. Rolling Meadows, Illinois HQ (Gallagher Bassett Services, Inc.). Subsidiary of Arthur J. Gallagher & Co. (NYSE: AJG). AJG is $10B+ revenue global insurance brokerage and risk management company. Gallagher Bassett is the TPA subsidiary, one of the largest US TPAs. Workers compensation, GL, auto, property claims. 5,000+ clients. Self-insured and large deductible program focus. RMIS integration. Competes with Sedgwick, Broadspire, and Crawford for TPA claims management.
Pricing
Rolling Meadows IL. AJG NYSE:AJG subsidiary. $10B+ parent revenue. Largest US TPA. Per-claim or program fee structure for self-insured clients.
Agent Metadata
Known Gotchas
- ⚠ RESERVE ADEQUACY ADJUSTER OVERSIGHT REQUIREMENT: Automated claim reserve monitoring in Gallagher Bassett must flag reserve changes for adjuster review; automated reserve calculations without adjuster confirmation creates reserve inadequacy exposure and potential bad faith for under-reserving; implement adjuster review workflow for automated reserve recommendations
- ⚠ EXCESS CARRIER ATTACHMENT POINT MONITORING AND NOTIFICATION: Automated claim monitoring must trigger excess carrier notification when aggregate reserve or paid amounts approach excess layer attachment point; automated delay in excess carrier notification creates potential coverage gap and excess carrier disclaimer; implement attachment point threshold alert with notification workflow
- ⚠ WORKERS COMPENSATION STATE JURISDICTION COMPLIANCE VARIATION: Automated WC claim management must apply jurisdiction-specific WC statute (California, Florida, New York, Texas opt-out all differ significantly); automated claim decisions (compensability, medical authorization, benefit rates) using wrong jurisdiction rules creates WC board regulatory violation
- ⚠ RTW coordination physician functional capacity requirements — automated return-to-work coordination must obtain work restrictions from treating physician before RTW placement; automated RTW without physician-documented functional capacity creates OSHA recordable injury risk if modified duty exceeds restrictions
- ⚠ Subrogation identification timing and statute of limitations — automated subrogation flag for third-party liable claims must identify recovery potential early in claim lifecycle; subrogation statute of limitations (typically 3 years from payment, but varies by state and claim type) requires timely identification; automated subrogation identification delay creates recovery right forfeiture
- ⚠ Multi-state employer WC claim routing — automated FNOL for multi-state employers must route to correct state jurisdiction based on state of injury (not state of hire); automated WC claim creation in wrong jurisdiction creates statutory benefit rate errors and regulatory compliance issues for multi-state employer programs
Alternatives
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Scores are editorial opinions as of 2026-03-07.