In cooperation with Verisk Analytics, a software program provider to the insurance industry, CSI developed a program to permit insurance company staff to electronically submit potentially fraudulent claims into the InfoShare™ application used by the NJ Attorney General’s Office of Insurance Fraud Prosecutor (OIFP) and the NJ Department of Insurance Bureau of Fraud Deterrence.
Insurance companies report fraudulent claims to the National Insurance Crime Bureau, which builds a database of claimants and service providers involved in such claims. Using the Insurance Services Office (ISO) Claims Search portal provided by Verisk Analytics, registered users can route claim information to the states’ regulatory and criminal investigation agencies.
Joe Britt of CSI and Sherry Horowitz of the Office of the Attorney General coordinated the project among staff from Verisk Analytics, the Office of the Insurance Fraud Prosecutor and the Bureau of Fraud Deterrence. The project included analysis of New Jersey’s regulatory reporting rules to collect the required data, and revisions required to the ISO Claims Search portal and the InfoShare™ case management system. Verisk Analytics also agreed to modify their application to accept electronic documents and to make them available for transmission into InfoShare™. CSI also modified InfoShare™ to provide OIFP investigators the ability to do a “quick check” if reported subjects already have other cases in the InfoShare™ database, as well as a convenient display of the incoming data and supporting documentation. Cases can quickly be routed to the appropriate offices for criminal or civil investigation.
New Jersey Manufactures and Selective Insurance companies have participated in a two month trial program utilizing this new feature of the ISO Claims Search and InfoShare™ applications. The feature became available to all participating insurance companies in October.