Forensic Claim Review & Policy Analysis

Rigorous, Independent Policy Audits to Uncover Hidden Coverage and Correct Carrier Scope Omissions Across Michigan, Ohio, and Indiana.

HQ: Kalamazoo, MI | Licensed Regional Practice: MI · OH · IN

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What is a Forensic Claim Review and Policy Analysis?

A forensic claim review is an independent, technical audit of a commercial or high-value residential insurance policy alongside the insurance carrier's preliminary scope of loss. Conducted by licensed public insurance adjusters, this analysis identifies hidden coverage endorsements, challenges improperly applied deductibles or policy exclusions, and identifies line-item omissions in carrier estimates. Sharp Indemnity Group provides fiduciary policy reviews for complex property losses throughout Michigan, Ohio, and Indiana from its headquarters in Kalamazoo, MI.

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The 4-Point Forensic Audit Method

Policy Architecture & Endorsement Audit
- Examination of base policy forms (CP 00 10, HO-3, HO-5) and all attached endorsements.
- Identification of ordinance or law, business income, debris removal, and utility interruption extensions.
- Evaluation of co-insurance requirements, sub-limits, and valuation clauses (Actual Cash Value vs. Replacement Cost Value).
Carrier Estimate & Scope Reconciliation
- Line-by-line comparative audit of the carrier's Xactimate or Symbility estimate against physical site realities.
- Detection of missing trade labor, omitted structural components, line item suppression, and under-scoped demolition parameters.
Causation & Coverage Alignment
- Verification that loss causes align strictly with covered perils under the insurance policy contract.
- Forensic analysis to counter improper carrier assertions of pre-existing wear, maintenance neglect, or excluded water damage parameters.
Fiduciary Strategy & Recovery Roadmap
- Delivery of an actionable audit report establishing the true, defensible Actual Cash Value (ACV) and Replacement Cost Value (RCV).
- Strategic recommendations for formal claim supplemental filings, appraisal proceedings, or direct negotiation.

Regional Jurisdiction & Compliance

Sharp Indemnity Group operates strictly as a fiduciary policyholder advocate. Headquartered in Kalamazoo, Michigan, the firm maintains full public adjusting licensure and practice authority across Michigan, Ohio, and Indiana. Every policy analysis is conducted under the specific insurance statutes, administrative codes, and claim settlement practice acts of the applicable state jurisdiction:
Michigan: Department of Insurance and Financial Services (DIFS) Regulations
Ohio: Ohio Department of Insurance (ODI) Administrative Code
Indiana: Indiana Department of Insurance (IDOI) Title 27 Compliance

Frequently Asked Questions (FAQ)

Q: When should a policyholder request an independent claim review?

A: A claim review should be requested immediately following a major property loss, prior to accepting a carrier's initial payout check, or whenever a carrier denies coverage, delays settlement, or issues an estimate that appears insufficient to complete structural repairs.

Q: What documents are required for a forensic policy analysis?

A: Sharp Indemnity Group requires the complete certified copy of the insurance policy (including declaration pages and endorsements), the insurance carrier's itemized scope of loss/estimate, photos or documentation of damages, and any written correspondence or reservation of rights letters from the insurer.

Q: Does conducting a claim review commit us to full claim representation?

A: No. A forensic claim review is a standalone analytical service designed to provide property owners and risk managers with an objective assessment of their legal coverage and true repair scope. If scope discrepancies exist, policyholders may choose to retain Sharp Indemnity Group for full claim negotiation.