New Fraud Fight Initiatives To Rev Up ISO Data

An insurance industry group working to foil fraud said it has developed eight technical initiatives to help in the fight.

The efforts of the industry fraud data working group were unveiled recently by Susan Q. Hood, State Farm claims vice president and working group chairperson, at the Insurance Fraud Management Conference in Phoenix, according to the Insurance Services Office.

Jersey City, N.J.-based ISO said Ms. Hood's announcement–concerning enhancements that will help mitigate the impact of fraud on the insurance industry and consumers–was made to claims and special investigation unit executives at the meeting.

In her keynote remarks, Ms. Hood said the initiatives were 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 over $30 billion a year, and these initiatives will help the industry to better combat it,” Ms. Hood said.

The fraud data working group is made up of representatives from the insurance industry, the National Insurance Crime Bureau (NICB), and ISO.

According to ISO, the initiatives will enable ISO's all-claims database to be leveraged as the principal, central 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,” according to Ms. 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 will also promote best practices and protocols for insurers' timely and accurate submission of fraud-related data,” said Richard Boehning, senior vice president of ISO.

“A number of the changes will affect the data that companies can submit and the data we can return for claims investigation,” Mr. Boehning added. “It will be important for companies to develop internal plans to adapt to the changes in order to capture the value intended.”

ISO said its staff will work closely 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 added that it will also release regular communications to ISO ClaimSearch users and the industry overall as initiatives are completed during the coming months.