Core and Optional Services
Through ISO ClaimSearch® you can access a variety of core services. Core services are services included with your organization's ISO ClaimSearch participation.
The cost of participation varies by the type of organization as well as your organization's needs. Your company may need to request certain services to obtain them, and some services have prerequisites.
ISO ClaimSearch also offers several optional services. Optional services are services that your organization can purchase separately.
Follow the links for information on these core services from ISO ClaimSearch:
- Claims reporting and processing service
- Claims inquiry service
- Statutory and regulatory reporting
- OFAC LookUp
- NICB reporting
- Health Care Provider Report / Healthcare Provider Plus Report
- Child Support Enforcement Agency Reporting (CSEA) Service
- ClaimSearch IllustratorTM
- Account Management
- ISO ClaimSearch NMVTIS Reporting Service
Follow the links for information on these optional services from ISO ClaimSearch:
- Art Loss Register (ALR)/National Equipment Register (NER)
- Decision Net®
- ISO Claims Partners’ Liability Navigator™
- The NetMap® Suite of Products
- OFAC Compliance Service
- SIU Case Manager
- ISO ClaimAlert: Foreclosure
- ISO ClaimSearch Medicare Secondary Payer Reporting Service
Insurers and other participants electronically submit hundreds of thousands of claims per day, in all lines of business. ISO ClaimSearch automatically loads claims into the database. Then, the system searches to find other claims filed by the same individuals or businesses, either as claimant or as insured.
The system automatically returns reports of other claims with matching information in such fields as:
- telephone number
- name and date of birth
- vehicle identification number (VIN)
- driver's license number
- Social Security number
- tax identification number (TIN)
- other parties to loss
And ISO ClaimSearch features an advanced "address hygiene" function that standardizes address information. The system automatically assigns the correct postal address as claims come in — but does not replace the original address. The system files a copy of the standardized address in the database and uses it for searching.
ISO ClaimSearch reports improve the accuracy of your decisions about the validity of claims and speed the payment of meritorious claims. The reports also help you detect invalid or suspicious claims.
Special Investigations Units (SIUs) and claims personnel also use ISO ClaimSearch for follow-up fraud investigations. You can customize your queries to search on any field of information to support a specific investigation.
You can submit queries online, in real time, to receive instantaneous results. If you're qualified by membership for each database segment, you can choose to search across all property, casualty, and vehicle claims.
System reports give you thorough information that can help you identify the claimant's or insured's full profile, suspicious claims, individuals with suspicious patterns of claims, and even possible fraud-ring activity.
For states with statutory or regulatory reporting requirements, ISO ClaimSearch may provide the required claims data or access to the data to state fraud bureaus, fire marshals, or other entities on behalf of insurers as allowable by statute and insurers. These services allow for a significant reduction in workload for our participating organizations and ensure certain requirements are met.
For a comprehensive understanding of the various mandatory reporting services and matching programs ISO ClaimSearch provides, please review the Mandatory Statutory Reporting Document
VINassist™ is a web-based, encrypted application that lets you edit and decode 17-digit vehicle identification numbers (VINs). VINassist can detect:
- incorrectly recorded VINs
- altered VINs
- VINs switched from other vehicles
- VINs that describe vehicles never manufactured
The Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury administers and enforces economic and trade sanctions against certain foreign governments, organizations, and individuals. OFAC has compiled a master list of more than 5,000 "specially designated nationals and blocked persons." U.S. insurance companies and their employees are responsible for screening claims against that master list.
ISO ClaimSearch customers can use the OFAC LookUp service to help find out if an individual is on the government's watch list of potential terrorists and drug traffickers.
The service is not a replacement for our comprehensive optional ISO ClaimSearch OFAC Compliance Service, which — for a modest fee — automatically checks all of your incoming claim reports against the OFAC list.
Members of the National Insurance Crime Bureau (NICB) can use ISO ClaimSearch to report questionable claims to the NICB questionable claims database.
These reports provide professional profiles of individual healthcare practitioners across a wide range of medical disciplines. Coverage includes, but is not limited to, physicians, physician assistants, specialists, chiropractors, nurses, and physical therapists.
Healthcare Provider Report may consist of the following:
- professional experience and credentials, business practice addresses, group affiliations, hospital affiliations, specialties, and educational background
Healthcare Provider Plus Report also includes:
- sanctions records and related details, such as sanction date, sanction agency, description of violation, severity of action (ranges from reprimands to license revocation), fines, and outcomes related to the sanction
The Child Support Enforcement Agency (CSEA) Reporting Service helps you comply with state requirements to support the collection of delinquent child-support payments.
The service features two programs:
- The Child Support Lien Network (CSLN) program interfaces with the CSLN database containing information on delinquent child support obligors in a number of states.
- The Office of Child Support Enforcement (OCSE) program interfaces with the federal OCSE database containing information on delinquent child support obligors in 50 states and the District of Columbia, as well as three U.S. territories (U.S. Virgin Islands, Guam, and Puerto Rico).
Because the OCSE and CSLN programs have different participating states — and may maintain different information on delinquent child support obligors — you could benefit by participating in both services.
When you submit a claim report from a participating state, ISO ClaimSearch will search the CSLN and OCSE databases. If the claim matches a record in one or both databases, the system will send the claim to the CSLN and/or the OCSE. The CSLN and/or the OCSE will then refer the claim to the appropriate state child-support agency.
ClaimSearch Illustrator® is an easy-to-use desktop application that helps you visualize relationships among data elements within ISO ClaimSearch claim records. Match reports from the ISO ClaimSearch system often contain pages of comprehensive information on matching claims histories. ClaimSearch Illustrator uses pictures and icons to create presentation-quality graphics that display connections among data elements from the reports — so you can decide if a claim needs further investigation.
ClaimSearch Illustrator is a perfect complement to ViewLink ManagerTM and NetMap for ClaimsTM — two powerful link-analysis and data-visualization products that help you spot fraud quickly. You can use ClaimSearch Illustrator to review claim records in a graphic illustration and then use the analytical tools within ViewLink Manager or NetMap for Claims to provide in-depth analysis for your investigations.
Account management allows authorized management and individual users to access a variety of management reports, including billing detail and usage reports for Decision Net® and ClaimDirectorSM and usage reports for claims reporting and claims inquiry.
To learn more…
…about ISO ClaimSearch, return to the menu. Participation in ISO ClaimSearch is open to insurers, self-insured organizations, and claims administrators. To find out how your company or organization can participate, call us at 1-800-888-4476. Or send e-mail to firstname.lastname@example.org. And for other information or services, refer to the ISO ClaimSearch Service Directory.