Detailed Data: A Must for Effective Claims ManagementBy John Giknis | August 8, 2012
The clock is ticking down on ISO ClaimSearch® legacy reporting. With its demise at year-end, participants will use Universal Format only. The whole industry will benefit from the advantages that change brings. (See our recent blog on the end of legacy reporting.)
Universal Format reporting allows for more data fields at the accident level, and more detailed data captured means more information for investigations. Individual companies and their claims processors are responsible for collecting that additional information. However, companies that increase their data collection definitely help improve the quality of the data available to the entire industry for claims evaluation and insurance fraud detection.
With all the buzz about predictive analytics going around the industry, detailed data capture has never been more important — nor has the ability to collect more information and do more with it, such as claim scoring, appending missing data, and including fraud indicators and flags.
You need robust data to direct you, inform you, and validate your decisions. In the claims management arena, having as much data as possible can help you process claims and search for insurance fraud.
The industry has established several key requirements:
- accident-level data to identify the role of all parties in a claim
- integration of data across all lines of business — property, casualty, and auto
- more data content for more information within claim reports
- enhanced depth of data for more thorough reporting within lines of business
- improved breadth of data for more types of claims and lines of business
- proactive fraud detection capabilities
Universal Format reporting helps the industry achieve all those requirements. The better the quality of the data going in, the higher the hit rate (the percentage of incoming claims that match claims in the database and generate an outgoing result report). We have more than 800 million claims in the database today, and Universal Format claims have increased to more than 23 percent of the total database. Currently, 97 percent of claim reports submitted are in Universal Format.
What does all this mean? The ability to produce higher hit rates — with more and better data and reports — makes Universal Format a universal hit.
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