Clarity for Claims That Demand a Closer Look

Our Core Services

Independent, structured analysis of claims presenting potential red flags, inconsistencies, or investigative ambiguity requiring deeper review.

Comprehensive evaluation of travel, baggage, and trip cancellation claims. We cross-reference documentation, timelines, and supporting evidence to identify inconsistencies, verify claim details, and strengthen claim defensibility.

An objective, deep-dive review of submitted receipts, invoices, medical notes, and employer documentation. We evaluate authenticity indicators, identify inconsistencies, and flag potential alterations or manufactured records.

When a Second Look Matters

Some claims move forward without difficulty. Others reach a point where the decision carries greater weight. In those moments, a structured second review helps ensure the file clearly supports the decision being made

Claim Defensibility Review

A rigorous, structured evaluation of file's overall strength to help ensure decisions are clearly documented, logically supported, and defensible if challenged.

Turnaround: Standard defensibility briefs delivered within 3–4 business days (expedited rush reviews available for upcoming legal or statutory deadlines)

Why We Exist

Insurance organizations already employ skilled adjusters and SIU investigators. The challenge is rarely a lack of expertise. More often, it is a lack of investigative capacity.

High-volume claim operations require timely decisions. While major fraud schemes naturally receive significant investigative attention, many lower- and mid-complexity claims still present inconsistencies that deserve structured review.

CAG exists to expand investigative capacity, not replace it. We provide disciplined investigative analysis that helps claims and SIU teams make informed, defensible decisions while allowing internal resources to remain focused on the most resource-intensive investigations

In claims, SIU and compliance environments, decisions carry consequences. The CAG difference is rooted in:

Each file undergoes an initial review to identify fraud indicators, documentation inconsistencies, verification gaps, or other areas requiring closer analysis.

Clients receive a concise report outlining key observations, identified concerns, and supporting findings to assist with internal claim evaluation and decision-making.

CAG functions as an independent analytical resource. All claim handling authority and final claim decisions remain with the client.

Our Operational Commitment

• When fraud indicators are present but unclear

• When claims require deeper documentation review

• When defensibility must be strengthened

• Discrepancies in documents or statements

• Timeline inconsistencies

• Suspected low-dollar fraud (travel claims)

• High caseload or limited SIU availability

• Need for unbiased external analysis

We provide essential investigative capacity and clarity to the professionals and organizations who need it most

Supporting claims and SIU teams with independent analysis on complex or ambiguous files.

Providing structured investigative insight to support delegated authority environments

Supporting internal risk and claims teams with neutral, documented investigative review.

Assisting high-volume claims operations with additional analytical depth where internal resources are constrained.

Our mission is to strengthen the fight against insurance fraud by providing claims and SIU teams with independent investigative and analytical support that restores bandwidth, clarifies inconsistencies, and delivers defensible insight guided by human judgment, integrity, and confidentiality.