ISO ClaimSearch

Update on Industry Fraud Data Improvement Initiatives

Last year, a Fraud Data Working Group proposed measures to enhance data resources to identify and reduce insurance fraud. To date, ISO has completed seven of the initiatives.

Data Initiative 3
The third data initiative required ISO ClaimSearch® to output results in an electronic format that users can manipulate for ease of analysis. The result is IQ Download, a new ISO ClaimSearch feature that:

  • uses existing ISO technology, functionality, and data fields
  • helps you analyze results more effectively
  • lets you download results into Microsoft® Excel and Access
  • offers tactical analysis, real-time capability, and expanded searches
  • broadens the scope and functionality of the system’s current fraud-detection capabilities
  • allows you to sort data quickly and focus on relevant facts

Data Initiatives 4 and 5
ISO completed the fourth and fifth data initiatives in November 2007. Initiative 4 enhanced ISO ClaimSearch Match Report summaries, and Initiative 5 added 15 common fraud indicators to the ISO ClaimSearch Match Reports.

To help users understand how to read the new Match Reports, we created a sample report with new information for participants who receive Internet and PDF reports. You can view the sample at www.iso.com/newmatchreports.

We also held five online training sessions in November and December that were open to all participating company personnel. More than 400 ISO ClaimSearch users participated.

Data Initiative 7
Data Initiative 7 designates more than 25 optional fields as “very important” in fighting fraud. We’ve added the optional fields to the benchmarking section of the system’s Executive Analysis Reports.

The quarterly Executive Analysis Report, which is available to home office contacts, provides an accounting of claims reported to the ISO ClaimSearch system on a group and company level and then compares the data against industry totals. The report includes:

  • quarterly claims volume for five quarters by group and company
  • quarterly claim-report trending with graphs
  • hit-rate and match-rate analyses as compared against industry experience
  • ISO ClaimSearch optional field reporting by percentage as compared against industry percentages

With the completion of Data Initiative 7, the Executive Analysis Reports include a new benchmark that compares how often users populated the “very important” fields in the current quarter against how often they populated them during the same quarter last year. The enhancement will help managers see changes in percentages over time.

With your cooperation, we can achieve significant progress in the battle against insurance claims fraud.

If you have questions, please call ISO ClaimSearch Customer Support at 1-800-888-4476 (option 2, option 2). Or send e-mail to njsupport@iso.com.

 

Summary of Fraud Data Improvement Initiatives

Initiative 1:
Add optional fields to ISO ClaimSearch database at party-to-loss level
Completed July 2007

Initiatives 2 and 6:
Change process and criteria for submitting questionable claims data
Completed October 2007

Initiative 3:
Output results in an electronic format for analysis
Completed February 2008

Initiative 4:
Revise ISO ClaimSearch match report output
Completed November 2007

Initiative 5:
Include 15 common fraud indicators across all lines of business in ISO ClaimSearch Match Reports
Completed November 2007

Initiative 7:
Designate certain optional fields as “very important” and create management reports to track how often insurers populate the fields
Completed January 2008

Initiative 8:
Create functionality for batch reporting of fraud-ring-related claims
Completion date to be announced