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ISO ClaimSearch Detects Hard and Soft Fraud

Since its inception, the ISO ClaimSearch® database has grown continually and today contains more than 804 million records. Last year, participating companies reported more than 61 million claims. Most insurance professionals think of ISO ClaimSearch as the first line of defense against fraud.

We always emphasize how the majority of claims that do not show signs of fraud can be a rich source of information. While a particular claim may not demonstrate hard insurance fraud, adjusters often discover facts that will assist with claims mitigation and settlement negotiations. For example, a claimant may exaggerate the seriousness of an auto accident by presenting evidence of an injury from an earlier accident. Or a recent hailstorm may have struck a roof already damaged — and left unrepaired — a few years ago. As part of the claims adjustment process, ISO ClaimSearch can also uncover other responsible parties involved in claims for possible recovery activity.

Along with ever-increasing volumes of claims data, ISO is now seeing improvements in data quality. With the industrywide switch from legacy reporting formats to Universal Format, ISO can collect more valuable details, and the system can provide more actionable information for claims adjusting and fraud detection.

This article is part of the State of Insurance Claims series.

John Giknis

John Giknis, CPCU, SCLA, RPA, AIC, retired from Verisk in 2012. As ISO’s assistant vice president for ISO ClaimSearch Operations, he was responsible for the business operations of ISO ClaimSearch, the property/casualty insurance industry’s all-claim database.

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