Combined Investigators

What Combined Investigators does

Ethos Risk Services (the operating brand associated with the queried entity) is a private, U.S.-headquartered claims investigation and medical management firm serving insurance carriers and self-insured employers. Its core service lines span field investigations (surveillance, claims investigations, medical canvassing, and a Digital Investigations module) and medical management (case management, medical bill review, Medicare solutions, IME coordination, and utilization management), with an enhanced Ethos PLUS premium tier. Customers are primarily enterprise insurance buyers across property & casualty, auto, workers compensation, and disability lines.

The company operates the Sightline proprietary case management platform (sightline.ethosrisk.com), which provides real-time case intake, progress tracking, and report delivery to claims handlers. Supporting technology includes digital forensics for online investigations and a Pathfinder workflow tool for case assignment. Operations span all 50 U.S. states and 80+ countries, and the firm holds URAC Workers' Compensation Utilization Management accreditation (valid through 2027-11-01) along with SOC 2 Type 2 and HIPAA compliance certifications, which collectively position it for regulated WC medical-management vendor rosters.

Revenue is generated through fee-for-service investigation work and managed medical management services, billed per case or engagement on a quote-based pricing model. Go-to-market is sales-led, combining direct enterprise outreach to carriers, an inbound website case-assignment flow, inside sales, and a relationship-building channel of free continuing education webinars for insurance professionals. The company is privately held, led by CEO David Collins, with 51-100 employees and a St. Petersburg, FL headquarters. Note: firmographics provided a 1986 founding date and combinedinvestigators.com URL, while detailed corporate records indicate 2006 founding and ethosrisk.com as the primary operating domain; this discrepancy was unresolved in the source material and is reflected as such.

Name

Combined Investigators

Legal name

Ethos Risk Services

Website

https://combinedinvestigators.com

Company type

Private

Founded year

2006

Operating status

Operating

Headcount range

51–100 employees

Short description

Ethos Risk Services provides claims investigation and medical management services to U.S. and international insurance carriers. Its Sightline platform enables real-time case management, and the firm serves most of the largest U.S. property & casualty, auto, workers compensation, and disability insurers.

Ownership category

akta.pro rank

Product category

Insurance Claims Investigation and Medical Management Services

NAICS

Investigation and Personal Background Check Services (561611), Claims Adjusting (524291)

SIC

Services-Engineering, Accounting, Research, Management (8700)

akta.pro primary industry

Investigations & Background Screening Services (IMAIAEAK)

akta.pro secondary industries

Eligibility, Coverage Verification & Policy Administration Support (BPAAAFAC), Digital/Online Investigations & OSINT (Non-cyber) (BPAKAEAF)

Keywords

• Insurance claims investigation
• Claims verification services
• Surveillance investigations
• Medical management services
• Insurance fraud detection

Headquarters

HQ city

St. Petersburg

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Investigation Services: Fee-for-service investigation services including surveillance, claims investigations, and digital investigations billed per case or engagement.
2. Medical Management Services: Ongoing medical management services including case management, medical bill review, utilization management, and IME services, likely billed per case or on a managed services basis.
3. Ethos PLUS: Premium service tier offering enhanced capabilities for clients requiring more comprehensive claims verification.

Go-to-market motion1 record

Distribution channels4 records

Marketing channels8 records

Core offering

Combined Investigators provides insurance claims investigation and verification services for property & casualty, auto, workers compensation, and disability insurance carriers, including surveillance, claims investigations, digital investigations, and medical canvassing across all 50 US states and 80+ countries. The firm also delivers a medical management suite covering case management, medical bill review, Medicare solutions, independent medical evaluations, and utilization management, all accessed and tracked in real time through its proprietary Sightline case management platform.

Product overview

Ethos Risk Services operates as a claims verification and management platform with integrated service modules. The core technology is the Sightline platform, which provides real-time case management, reporting, and workflow tracking. This platform is complemented by two main service divisions: Investigations (covering surveillance, claims investigations, digital investigations, and medical canvassing) and Medical Management (covering case management, medical bill review, Medicare solutions, IME, and utilization management). Ethos PLUS serves as a premium service tier offering priority access and enhanced capabilities. The company also provides Pathfinder for case assignment and Continuing Education webinars for client development. Together, these components form an integrated claims verification ecosystem trusted by major insurance carriers.

Differentiator

Problem solved

Functional benefit

Products and services

• Sightline Platform Cloud-based proprietary case management and reporting platform that enables real-time case progress tracking, report access, and actionable insights for insurance claims verification across the firm's investigation and medical management engagements.
• Investigations Comprehensive suite of investigation services covering surveillance, claims investigations, digital investigations, and medical canvassing to verify insurance claim validity and identify fraud across all 50 US states and 80+ countries, for property & casualty, auto, workers compensation, and disability insurance carriers.
• Medical Management Suite of medical management solutions including case management, medical bill review, Medicare set-aside arrangements, independent medical evaluations (IME), and utilization management to support claims resolution and medical cost containment for insurance clients.
• Ethos PLUS Premium enhanced service tier providing additional capabilities and priority processing for clients requiring more comprehensive claims verification and handling of complex or high-value claims.
• Pathfinder Specialized platform component supporting case assignment and workflow management, enabling streamlined submission and routing of investigation requests through the firm's service delivery operations.

Quantifiable outcome

• 99% claim verification accuracy positioning

Named customers4 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Emerging players

• FRISS: Insurance fraud, risk and compliance SaaS vendor offering AI-driven detection and investigations support to P&C, workers comp and health insurers; directly competes with Ethos on the fraud-detection portion of the carrier workflow.
• Shift Technology: AI-native insurance fraud detection and claims automation vendor serving global carriers; competes for the same carrier budget allocated to claims verification and fraud reduction, displacing manual investigation work.

Broad incumbents

• Verisk: Large, publicly traded data analytics and risk-assessment provider to the insurance industry, including claims and fraud solutions; overlaps with Ethos in serving insurance carrier workflows but at much broader scale and with a data/analytics-led model.
• Mitchell International: Established property & casualty and workers compensation technology and medical management provider; overlaps with Ethos' medical management, bill review, and IME offerings in serving the same carrier customers.
• LexisNexis Risk Solutions: Major insurance and identity-data vendor serving carriers on fraud, claims, and investigative workflows; comparable in serving insurance customers for risk/claims verification, but via data products and analytics rather than field investigations.
• TransUnion (Insurance Solutions): Major credit bureau providing investigative, identity-verification and risk data products to insurance carriers; overlaps with Ethos on insurance-customer verification use cases, though primarily via data rather than field investigations.

Direct peers

• MCM Investigations: US private investigation firm providing surveillance, claims investigations and fraud support primarily to insurance carriers and attorneys; directly comparable service mix and customer base to Ethos Risk Services.
• Global Investigative Solutions: Insurance-focused investigation firm providing surveillance and SIU support to property & casualty carriers; comparable in target customer (insurance carriers), geography (US), and core service of field surveillance and claims investigations.
• Clarence M. Kelley & Associates: Long-established US private investigation and insurance claims investigation firm offering surveillance, claims investigations, and fraud support to insurance carriers — directly comparable service line, customer base, and delivery model to Ethos Risk Services.

Others

• NICB (National Insurance Crime Bureau): Industry-supported non-profit that combats insurance fraud through data sharing and investigation coordination; adjacent to Ethos because Ethos' carrier clients are NICB members and the two collaborate on fraudulent-claim workflows.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/CombinedInv
• Facebookfacebook.com/profile.php?id=100063627369714
• LinkedInlinkedin.com/company/ethos-risk-services

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Combined Investigators