Terms of Service

Effective Date: November 29, 2025

Last Updated: January 05, 2026

Welcome to Claim Analysis Group. Please read these Terms of Service (“Terms”) carefully before using our website (https://www.claimanalysisgroup.com/) or engaging us for our independent claim analysis services (the “Services”).

By accessing our website, submitting a case file, or checking a box to accept these Terms, you (“Client,” “you,” or “your”) agree to be bound by these Terms. If you are entering into this agreement on behalf of a company or other legal entity (such as an insurance carrier, TPA, or SIU team), you represent that you have the authority to bind that entity.

1. Scope of Services

Claim Analysis Group provides independent, human-led investigative file analysis, verification reviews, fraud indicator review, and claim defensibility review.

Strict Limitations of Service:

• No Claims Adjusting: Claim Analysis Group is an independent research and analysis firm. We do not adjust claims, negotiate settlements, communicate with claimants, or make final coverage or denial determinations. All final claims decisions rest solely with the Client.

• No IT Integration: Our services are provided via secure external communication (email or web form portal). We do not require, nor will we request, direct access to your internal claims management systems or databases.

2. Client Obligations & Case Submission

To allow us to perform the Services efficiently, you agree to:

Provide complete, accurate, and legible documentation for any file submitted for review. Ensure that you have all necessary legal rights, permissions, and consents to share Insured/claimant data and files with us in accordance with applicable privacy laws.

Submit files securely, utilizing your organization's secure email network or our designated encrypted web form.

3. Fees, Invoicing, and Payment

• Pricing: Services are billed based on our standard flat-rate menu per file type or as otherwise agreed upon in a separate Master Services Agreement (MSA) or statement of work.

• Invoicing: Invoices are issued upon completion and delivery of the final analysis report or on a monthly recurring basis, depending on your account structure.

• Payment Terms: All invoices are due within 30 days from the invoice date (Net 30) unless alternative terms are agreed upon in writing. Overdue balances may be subject to a late fee or suspension of subsequent file reviews.

4. Intellectual Property

• Our Property: Claim Analysis Group retains all rights, title, and interest in our proprietary methodology, analysis frameworks, website content, logos, and reporting templates.

• Your Property & Deliverables: Upon full payment of our fees, the final custom analysis report delivered to you becomes the property of the Client. You are granted a perpetual, non-exclusive right to use the report internally for claims handling, litigation support, or compliance purposes.

5. Confidentiality & Security

Both parties agree to protect and treat all non-public information received from the other party as strictly confidential.

• We handle all submitted claims data in accordance with our Privacy Policy.

• We implement rigorous administrative and technical safeguards to secure your data while it is in our possession.

• Because our operational model relies on a limited-retention workflow, case documents are securely purged from our active systems within a standard operational window following report delivery.

6. Disclaimer of Warranties & Limitation of Liability

• As-Is Reports: Our analysis reports are objective, independent evaluations based solely on the data provided to us by the Client at the time of submission. We do not guarantee that our findings will result in a specific claims outcome, legal victory, or fraud conviction.

• No Legal Advice: Our reports and defensibility reviews constitute investigative consulting, not formal legal advice. Clients should consult qualified legal counsel regarding formal claim denials or litigation.

• Limitation of Liability: To the maximum extent permitted by law, Claim Analysis Group shall not be liable for any indirect, incidental, special, or consequential damages (including, without limitation, loss of profits, bad faith claims, or regulatory penalties incurred by the Client). In no event shall our total aggregate liability exceed the total fees paid by the Client to us for the specific file review giving rise to the claim.

7. Termination

Either party may terminate a service arrangement at any time. Upon termination:

• Client remains responsible for paying Claim Analysis Group for any work-in-progress or completed reports delivered prior to termination.

• Claim Analysis Group will securely destroy any pending case files in our possession belonging to the Client.

8. Governing Law & Dispute Resolution

These Terms and any dispute arising out of them shall be governed by and construed in accordance with the laws of the state of Texas in which Claim Analysis Group is legally registered, without regard to its conflict of law principles. Any legal action or proceeding relating to these Terms shall be brought exclusively in the courts located in the jurisdiction of the state of Texas.

9. Changes to These Terms

We reserve the right to modify these Terms at any time. We will post the revised version on our website and update the "Last Updated" date at the top. Your continued submission of case files following an update constitutes acceptance of the modified Terms.

10. Contact Information

If you have any questions or need clarification regarding these Terms of Service, please contact us at:

Claim Analysis Group, LLC

Phone: 713-487-7297

Email: info@claimanalysisgroup.com

Mail: 11811 North Freeway, Suite 222

Houston, TX 77060

Website: www.claimanalysisgroup.com