For the ISO ClaimSearch® user community, 2013 was another year of significant growth. In addition to increases in the number of claim records in the property/casualty insurance industry’s all-claims database, our membership has ticked higher and is participating in a wider range of claims compliance services. While ISO ClaimSearch remains the premier tool for identifying suspicious claims activity, it has also evolved into a broader platform for improving claims handling and reporting.
Three out of four hits, growing numbers of records
ISO ClaimSearch ended 2013 with 920.7 million records. The 70.3 million new claim records in 2013 included 6.3 million glass claims, which is a new data set we began collecting last year. Overall, ISO ClaimSearch processed 152.5 million new or updated records last year. Powered by this unique, large body of historical claims information, 76 percent of all claims submitted to ISO ClaimSearch — more than three out of four — generate a match, with an average of 4.8 claims per match.
Member growth, Claims Inquiry upgrade
As a result of increased adoption within existing member companies and the addition of new participants, the ISO ClaimSearch user community grew as well. From 2012 to 2013, active users grew from nearly 86,000 to more than 88,000. ISO conducted more than 300 webinar trainings, and more than 3,000 users were trained on the ISO ClaimSearch system in 2013.
ISO ClaimSearch users conducted 23.7 million searches through the Claims Inquiry tool, which benefited from an upgrade last year. As a contributory database, ISO ClaimSearch relies on the participation of the industry, and we appreciate the support we receive. Because of the claims community that has evolved around ISO ClaimSearch, the system remains the premier solution for identifying suspicious claims activity and supporting investigators.
More than match reports
ISO ClaimSearch has grown beyond its core antifraud function. The system offers a significant number of state and federal compliance and reporting solutions, many of them free for our member companies.
ISO ClaimSearch helps more than 1,200 companies comply with NMVTIS federal loss reporting requirements, and the system processed more than 3.5 million total-loss records on behalf of our members for no additional fee. Companies using ISO ClaimSearch to match claims against the Office of Foreign Assets Control (OFAC) watch list of Specially Designated Nationals identified more than 318,000 possible matches for further investigation based on 65.6 million claims submitted.
Medicare and Medicaid claims-reporting solutions have also helped insurance companies and other ISO ClaimSearch members attain compliance in a cost-effective manner. Like the NMVTIS Compliance Reporting Service, the ISO ClaimSearch Medicaid Reporting Service is free for our members. Currently, it serves more than 150 insurer groups (representing more than 300 insurance companies) for Rhode Island Medicaid reporting requirements. The ISO ClaimSearch Medicare Secondary Payer Reporting Service helps 541 companies comply by processing approximately 16 million queries and transmitting more than 453,000 records to CMS’s (Centers for Medicare and Medicaid Services) data contractor every month.
Getting more from your data
The ISO ClaimSearch team continually looks for new ways to make the platform and its underlying data set more useful to claims departments across the United States. We are working on a “reimagination” of ISO ClaimSearch. Our team is currently in the early stages, and as this effort progresses, ISO will directly engage the claims community for insights on how ISO ClaimSearch can become an even more effective tool for handling all claims — from meritorious to suspicious.