About Us & Our Commitment to Ethical SIU investigation

About us

Claim Analysis Group Claim Analysis Group exists to strengthen the fight against insurance fraud. We support insurers, TPAs, MGAs, and self-insured organizations that require structured, human-led investigative insight when claims present fraud indicators, complexities, or unresolved questions.

The Reality We Solve

We know firsthand that questionable claims often slip through not due to a lack of expertise, but because adjusters and SIU teams face operational constraints: limited time, strained bandwidth, and competing priorities

Fraud Indicator Claim Analysis

Travel Claim Fraud Indicator Review

Claim Background Insight Review

Our Approach

Insights

Case Studies

Remote Service Available Nationwide

Request a Case Review

Our Roles & Operational Boundaries

We do not replace internal teams, dictate outcomes, or access client systems. We provide objective desk-based SIU analysis that bring absolute clarity to file require closer review.

To protect your workflow and maintain complete compliance, our model operates under strict boundaries:

Zero IT Integration: We operate entirely outside internal carrier workflows, requiring no software onboarding or internal system access.
Carrier-Controlled Scope: We analyze claims solely using the file information that your team chooses to share with us in consideration of the claim.
Advanced Desktop Intelligence: Our team utilizes advanced open-source intelligence (OSINT), public-source data, and deep asset metadata analysis to evaluate fraud indicators.
Litigation-Ready Defensibility: We do not adjust claims, settle files, or make final coverage determinations. The carrier always retains complete decision-making authority. Our mission is simply to deliver structured, evidence-based documentation so that your final decision stands firmly on its own if challenged in court.

Driven by Industry Experts

Our team is composed of seasoned SIU investigators, former claims adjusters, data analysts, and compliance professionals with over a decade of hands-on industry experience. We complement your existing operations, restoring your team's bandwidth and delivering the defensible insights needed for confident claims management

Our Guiding Values

Clarity Over Assumption

Bring order to files through structured analysis and organized, reliable findings

Integrity First

Honesty, neutrality, and respect for the truth. Grounded in evidence

Every detail is handled with highest standard of discretion and security

We apply a balanced, human-led approach, critical thinking is key

Confidentiality

Human Judgement

Our work is guided by principles that emphaize integrity, disciplined analysis, and responsible judgement in every review we conduct

How We Work

No duplication of adjuster work: We complement, never replace the initial claim review
Fraud-focused methodology: Every service is built to uncover fraud exposure, inconsistencies, and indicators, not simply restate facts
Actionable intelligence: Our reports are structured for clarity, defensibility, and immediate use in carrier and SIU decision making
Human-led expertise, not automation

Our Review Process

Intake & Documentation Review
Pattern & Behavior Analysis
Independent finding Report
Optional Clarification Call

Turnaround Times

All reviews are conducted promptly while maintaining the analytical rigor required for defensible investigation insight.

Verification Insight Review

24 hours - 48 Hours

3 Days - 5 days

Travel Claim Fraud Review

24 hours - 3 days

Fraud Indicator Review

Claim Defensibility Review

Most Claim Defensibility Reviews are completed within 3-5 business days, allowing sufficient time for fisciplined review of claim documentation, investigative steps, and decision rationale