When a hospitalization file is closed on a technical reading of the policy, the first task is to reconstruct the medical and underwriting record. Triage managers index the proposal, discharge summary, and investigation report; medical advocates test necessity and exclusion wording before counsel writes.
- Cashless and reimbursement repudiations
- Pre-existing disease and non-disclosure allegations
- Waiting-period and sub-limit disputes
- Portability and continuity of cover
Life claims turn on the proposal, medicals at inception, and the investigation file the insurer later builds. We test whether a repudiation is grounded in the contract and the Insurance Act, or in an after-the-fact reconstruction of the deceased’s history.
- Death-claim repudiation and delay
- Material-suppression allegations
- Suicide clause and contestability period
- Nominee and assignment questions
Motor files move quickly and are often decided on survey reports the insured never sees in full. Digital intake extracts the policy, FIR, and survey; forensic assessors quantify the loss before the next letter or petition is written.
- Own-damage repudiation and under-settlement
- IDV and total-loss disagreements
- Breach-of-condition allegations
- Coordination with MACT counsel
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Commercial, fire & marine
Commercial files stall inside TPA and survey loops. We sit on the insured’s side of the table: technical loss assessment, causation, average, and warranties, then a disciplined claim to the carrier or the forum. Corporate retainers cover pre-loss audit and post-rejection intervention.
- Fire, special perils, and industrial loss
- Marine cargo and transit
- Engineering and product liability
- Underinsurance, average, and survey disputes
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Broker white-label desk
Brokers lose renewals on carrier decisions they did not make. This desk is built as an extension of the brokerage — branded to the partner where required, compensated on shared contingency, and staffed so the broker is never the one writing the legal notice.
- Direct pass-through of repudiated files
- White-label correspondence where instructed
- Shared contingency on recovered value
- Renewal-protective reporting back to the broker