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Industry Groups Join to Streamline Fraud Claims Reporting

Source: NAIC


Posted on 21 Apr 2010

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ISO (Insurance Services Office), the National Association of Insurance Commissioners (NAIC) and the National Insurance Crime Bureau (NICB) today announce an initiative that streamlines the process of reporting possible fraud in a filed claim. Companies can now file a single report directly to multiple state insurance departments and the NICB/ISO. Reports filed with the NICB/ISO Fraud Bureau Reporting Program will now also be filed with the NAIC Online Fraud Reporting System (OFRS), eliminating duplicate filing in most states.

Most state insurance regulators mandate that insurance companies directly report suspected fraudulent or suspicious activities in a filed insurance claim. Beginning today, 47 states will accept reports either through the NAIC OFRS or via a direct system connection from NICB/ISO. ISO ClaimSearch provides the reporting system used by NICB and its member companies.

"Addressing insurance fraud is an important step in reducing costs and protecting both consumers and insurers," said Jane L. Cline, NAIC President and West Virginia Insurance Commissioner. "The NAIC is pleased to be part of this agreement with the NICB and ISO. The more data state insurance departments receive, the further we can go in eliminating insurance fraud."

"This agreement has been a high priority for the NAIC Antifraud Task Force over the last year," said Sandy Praeger, Chair of the NAIC Antifraud Task Force and Kansas Insurance Commissioner. "This agreement saves insurance companies and fraud investigators time and improves investigative resources for state fraud bureaus. We are already receiving twice as many fraud referrals from property and casualty insurers now that NICB/ISO members are providing reports to the NAIC OFRS system."

The NICB and ISO expect to provide the NAIC OFRS with approximately 80,000 reports of suspected fraud per year.

"This expansion of NICB's Fraud Bureau Reporting Program, in cooperation with the NAIC and state fraud bureaus, brings us closer to offering a single system where the insurance industry can report suspected fraud and get the data in the hands of people that can make a difference," said Joe Wehrle, NICB President and CEO.

"We're very pleased to implement this fraud reporting enhancement for the industry and the NICB. It's part of our continuing effort to streamline the claims and fraud investigations process and assist the industry's ability to combat fraud," said Richard Della Rocca, vice president of ISO Claims Solutions.

There is no cost to the state insurance departments when suspected fraud is reported through the NAIC OFRS system.


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