Independent SIU Analysis for Claims That Need a Closer Look

Structured, human-led fraud indicator analysis that strengthen defensible claims decisions without accessing client systems or disrupting existing workflows.

Remote service available Nationwide

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Busy desk

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airplanes window view of sky during golden hour

Focused investigative analysis for travel-related claims, including trip cancellation, interruption, and medical reimbursement scenarios.

Travel Claim Fraud Indicator Review

Fraud Indicator Claim Analysis

Independent, structured analysis of claims presenting potential fraud indicators, investigative ambiguity, or escalation considerations.

Our Core Investigative Services

Claim Background Insight Review

Targeted background analysis to support claims involving identity, activity history, or contextual verification needs.

Case Studies

Trip Cancellation Claim Fraud: A Case Study Using Metadata, Language, and Pattern Analysis

View Case Studies

Workplace Injury & Bodily Injury Claim with Coordination Indicators

Why Claim Analysis Group

Independent & Human-Led

Every review is conducted byan independent analyst, no automation, no assumptions, no internal bias

No integration Support

We work entirely outside client systems. No IT onboarding, data access, or workflow disruption is required.

SIU-Focused Perspective

Defensible Documentation

Our work is grounded in real-world SIU operations across multi-jurisdictional and regulatory environments

Our findings strengthen claim files with clear, organized reasoning that supports confident, defensible decisions.

How Our Independent Reviews Add Value

Claim Analysis Group provides structured, independent fraud analysis designed to:

Reduce Leakage

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A padlock and dollar bills rest on a computer keyboard.

Identify inconsistencies early and prevent unnecessary payouts.

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Man holding head in frustration at desk with laptop.

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person in orange long sleeve shirt writing on white paper

Improve Decision Confidence

Clear, structured findings that support SIU and adjuster decisions.

Our reviews highlight gaps and reinforce claim file defensibility.

Strengthen Documentation

Our Review Process

Intake & Documentation Review
Pattern & Behavior Analysis
Findings & Indicators Report
Optional clarification Call

Our Operational Commitments.

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two people shaking hands in front of a laptop

Same-Day Intake

Start the investigative review process immediately to prevent case stagnation and delays.

Clear, Concise Report

Reports are structured, defensible, and focused on providing immediate, actionable clarity for your team.

You Retain Full Control

No system access, we provide insight; you always maintain authority over claims decision-making and escalation

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black smartphone near person

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a man and a woman shaking hands in front of a laptop

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unknown persons using computer indoors

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low angle photo of city high rise buildings during daytime

Insurance Carriers

MGAs & Brokers

Third party Administrators

Self-Insured Organizations

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

Providing structured investigative insight to support delegated authority environments

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

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

Who We Serve

CAG Employees

CAG Employees

When to Engage Claim Analysis Group

Discrepancies in documents or statements
Timeline inconsistencies
Suspected low-dollar fraud (travel claims)
High caseload or limited SIU availability
Need for unbiased external analysis

Claim Analysis Group (CAG) work to clarify uncertainty, identify inconstancies, and outlines the next steps needed to confidently move a claim forward. All claim decisions remain the responsibility of the carrier or TPA

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Ready for an independent Review?