This Founder Started an Insurance Company. Then He Discovered a Hidden Truth About the Industry

Most people don’t realize it, but when you submit an insurance claim, it often doesn’t go to your insurer. It’s handed off to an outsourced agency, a third-party administrator, or TPA, that manages claims for dozens, sometimes hundreds, of insurance brands.

That hidden layer is something Pavel Gertsberg had never even heard of, until he started his own insurance company.

When Pavel launched his first insurer, he set out to build something better. A product that gave people real peace of mind. Not just at sign-up, but in the moment they needed it most. Things ran smoothly at first. Then the claims started coming in.

Pavel assumed his team would handle them. After all, claims are the heart of what insurance is supposed to deliver—timely help when things go wrong. But almost immediately, he hit a wall.

Everyone in the industry told him: “Claims? You’ll need a third-party administrator for that.”

Outsourcing claims, he learned, wasn’t just common, it was the norm. He was told there was no real alternative.

Pavel was surprised. He didn’t even know what a TPA was. Yet suddenly, he was signing contracts with one, because that’s just how the industry worked.

So he handed over the claims. And that’s when things started to go wrong.

Claims Were No Longer in Pavel’s Control

Very quickly, customers began reaching out, frustrated and confused. Claims were delayed. Updates were inconsistent. People facing emergencies, car accidents, travel disruptions, and home damage, were left waiting.

Pavel and his team tried everything to make the process better. They pushed their TPA for faster responses and clearer communication. But no matter how hard they worked, little changed.

It became clear that this wasn’t just a slow partner, the entire model was broken.

Insurance Isn’t Boring, It’s the Last Line of Defence

Too often, people think of insurance and claims as dull or unimportant. But Pavel saw the truth up close—claims are the last line of defence for millions of people.

They’re the difference between someone being without a home for months after a storm, or just a day. Between losing a job because they can’t get to work, or having a rental car delivered that same afternoon. Between a small business going bankrupt, or getting the money it needs to rebuild.

Time to Build Something New

Pavel and his co-founder, German, realized that fixing claims couldn’t just be about patching broken systems with automation and AI layers. That would only mask the symptoms.

To truly make things better, the entire model had to be rebuilt, from the ground up. So the team started ClaimSorted.

ClaimSorted: Rebuilding Claims From the Ground Up

ClaimSorted is a next-generation claims TPA designed to deliver fast, empathetic, and scalable claims support. It combines powerful automation with skilled human teams to give policyholders the speed they need and the care they deserve.

Having received initial backing from Y Combinator, ClaimSorted has now raised a $3M pre-seed round led by Firstminute Capital, with additional support from Y Combinator, Precursor Ventures, and Transpose.

Just 14 months after launching, ClaimSorted has signed millions of dollars in contracts and now supports tens of thousands of policyholders every month.

Pavel’s Advice for Fellow Founders

One of the biggest challenges for any founder is finding the initial traction that allows you to land your first few customers and secure early investment. For many, these outcomes arise through seemingly ‘lucky’ opportunities. But that doesn’t mean luck is completely outside of our control, Pavel believes. “Luck is statistics. If you statistically work for long enough on something, with enough passion and enough intelligence, luck will statistically happen. It might happen on day one, or after two years of work, but it will happen.” 

The best way to find the drive to keep going, Pavel explains, is to “work on the problem that you’re passionate about. If you live and breathe the problem, and work hard enough for a long enough time, it will work out.”

And as you do find that traction and begin to scale, Pavel explains that the next challenge for a founder becomes hiring the right people. “You can never know exactly how to hire the right people,” he says, “so you just have to keep learning about it and try to get better.” 

From his experience, Pavel says that he’s learned to “look for visionaries, not mercenaries,” and for candidates that have the combination of ambition, intelligence, and drive to work hard. But ultimately, Pavel has made it a priority to hire team members that aspire to one day start companies themselves, and has vowed to personally assist any team members that do decide to make the leap to founding a company. 

To learn more about Pavel’s journey, you can follow him on LinkedIn and visit claimsorted.com