Fast-track meritorious claims while improving fraud detection
ISO ClaimSearch® is more than the world’s largest database of property/casualty claims—it’s also a robust claims intelligence platform. Its claims-matching technology is an essential first step in fraud detection, and the results can help facilitate fast-tracking. The platform also provides seamless access to integrated claims fraud-detection and investigative analysis tools.
Matching: Important first check against insurance claims fraud
When an adjuster enters a claim into ISO ClaimSearch, it's compared to more than 1 billion claims. If there's a match, the adjuster gets an alert with details. This match report is a vital first check against claims fraud because it can turn up:
- multiple policies on the same vehicle
- prior SIU involvement
- several addresses for the same individual
- Social Security number used for more than one person
- a number of other insurance claims fraud indicators
Claim alerts dashboard speeds decision making
Determine if claims can be fast-tracked or if they require a closer look with at-a-glance insight.
Each claim is color-coded (next to the claim number in the upper left-hand corner) to reflect whether it has the following:
The dashboard includes a list of specific alerts (if applicable) as well as a timeline of any matching claims with loss type. You can drill down to learn more about both alerts and matches.
If claim status is green, consider fast-tracking. Yellow claims with matches may need a quick review—or more, depending on the matching claims found. Red claims with alerts may need to be slowed down for evaluation and possibly referred to SIU.
Life insurers can use the advanced claims-matching technology of ISO ClaimSearch to help:
- Detect point-of-sale misrepresentation at the point of claim
- Identify claims filed by insureds after a death claim
- Find missing beneficiaries
- Automatically check and report claims for potential fraud, child support liens, and OFAC
Powerful claim insights for insurers, self-insureds, TPAs, and more
ISO ClaimSearch serves thousands of insurers, all 27 workers’ compensation insurance funds, more than 1,000 self-insureds, numerous third-party administrators (TPAs), and many state fraud bureaus and law enforcement agencies involved in insurance fraud investigation and prosecution.
Full suite of claims solutions provides compliance, claims development, and deeper fraud analysis and tools
Claims matching and alerts are just the beginning. The ISO ClaimSearch full suite of claims solutions assists with: