Fraud-fighting Data Initiatives Detailed at Conference

Addressing an industry meeting of property/casualty insurance claims and special investigations executives, Susan Q. Hood, State Farm claims vice president and chairperson of a working group on fraud data, announced a number of enhancements that will help mitigate the impact of fraud on the insurance industry and consumers.

In her speech at the 2007 Insurance Fraud Management Conference in Phoenix, Hood described eight data initiatives designed to improve data collection, data sharing, and data analytics for fighting fraud through the services of the ISO ClaimSearch all-claims database and system. "Fraud is a huge problem, costing the insurance industry more than $30 billion a year, and these initiatives will help the industry to better combat it," says Hood.

The initiatives were developed by a fraud data working group made up of representatives from the insurance industry, the National Insurance Crime Bureau (NICB), and ISO. The initiatives will enable ISO's all-claims database to be leveraged as the principal repository for claims and fraud data. "The specific initiatives will provide more actionable information for special investigations units and NICB investigators to improve their ability to identify fraudulent claims," says Hood.

Under the program, ISO will work through 2007 with insurers and the NICB to implement the eight initiatives, which include enhancements such as revising reporting formats both to and from ISO, adding more optional data fields to the ISO database, changing the process for submitting questionable claims through ISO ClaimSearch to the NICB, and creating the ability to extract and sort data.

"The initiatives also will promote best practices and protocols for insurers' timely and accurate submission of fraud-related data," says Richard Boehning, senior vice president of ISO. "A number of the changes will affect the data companies can submit and the data we can return for claims investigation. It will be important for companies to develop internal plans to adapt to the changes in order to capture the value intended."

ISO staff will work with individual ISO ClaimSearch participants to ensure they are aware of system enhancements and are informed of how to extract full value from improved system resources. ISO also will release regular communications to ISO ClaimSearch users and the industry overall as initiatives are completed during the coming months.