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Case Not Closed: Your New Next Step in Claim Investigations

When I was a special investigations unit director, we would close a case, celebrate our success, and move on to the next one. That isn’t so different from what happens in the rest of the SIU community. After all, a closed investigation means the work is done, right?

For my team, all of that changed when we started to use the NetMap for ClaimSearch suite of products.

NetMap for ClaimSearch, a visual link analysis tool, can pull data from ISO ClaimSearch® as well as other data sources to identify the connections among claims, claimants, addresses, and other information. In the end, you gain a visual representation of what could be organized claims fraud. With NetMap®, you can start from a single point of suspicious activity and grow out the networks, gaining a full view of a suspected ring’s scope and influence on your business.

With that sort of information, you can take informed action to protect your company.

When we had NetMap in place, an SIU investigation didn’t necessarily end when we learned what we needed. Instead, our NetMap analyst would run suspicious claims through NetMap and discover any broader implications. In this new environment, the investigation ended only when we found everybody involved.

With the way we used NetMap for ClaimSearch, an SIU investigation didn’t necessarily end when we came to a singular case resolution. Instead, our NetMap analyst would dig deeper into the data and determine what other losses linked to the identified bad claim. In this new environment, the investigation ended only when the analyst fully identified and resolved all of the associated parties.

NetMap is a powerful tool for investigating suspicious claims and detecting organized fraud. Use it to follow leads to their fullest conclusions.

Thomas Mulvey

Thomas Mulvey has been in the business of insurance investigations for more than 27 years. In his current position, he serves ISO as assistant vice president of SIU and claim services. He is also the coordinator of ISO’s Insurance Fraud Management Conference.

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