Clarity for Claims That Demand a Closer Look

Our role is not to determine coverage or replace existing claims professionals.
Our role is to provide an independent analytical perspective that supports confident, defensible decision‑making.

We believe the strongest claim decisions are built on evidence, not assumptions

Insurance Carriers:

SIU and claim teams needing structured review when documentation, indicators, or circumstances require deeper clarity

TPA

High-volume or complex claim environments that benefit from external investigative support.

MGA & Brokers

Specialized reviews to protect program integrity.

Attorney & Coverage Counsel

Defensible, evidence-led records before taking legal positions.

employers and entities requiring independent review of incidents, documentation, and claim circumstances.

Self Insured Organizations

Fraud indicators, Questionable documentation, or altered records.

Reported circumstances conflict with available evidence or timeline date

Material questions remain unresolved near key claim decision deadline

Fraud Indicator Analysis

Travel Claim Analysis

Claim Defensibility Analysis

OUR CORE SERVICES

Review

Verify

Document

Clarify

Analyze

Understand the file

Test against evidence

Determine Context

Preserve reasoning clearly

Turn into usable insight

"Plausibility is not verification. Suspicion is not evidence".

OUR METHODOLOGY

CAG operates outside client systems and internal workflows.

No software implementation required

Each assignment is evaluated objectively based on information provided and external verification, free from Internal bias

CAG does not adjust claims or make coverage decisions.

You retains 100% authority over all final decisions.

Independent Perspective

Carrier Control

Designed to complement your existing operation.

No system integration

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Tone fades. Facts remains: What Claims Work Taught Me About Documentation

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

Article

REAL-WORLD OUTCOMES

Insurance Fraud Doesn’t Have a Financial Profile

Article

Observations and analysis drawn from real-world claims handling, SIU operations, and fraud review work.

Have a Claim That Warrants a Closer Look?

When a claim presents unresolved questions, documentation concerns, fraud indicators, or required additional analytical rigor, CAG can provide an independent assessment.