Hesper AI
Data & Systems

ISO ClaimSearch

ISO ClaimSearch is the insurance industry's largest shared claims database, containing over 1.5 billion claims records from more than 1,100 contributing companies. Insurers use it to detect suspicious claim patterns, identify prior claim history, and flag potential fraud by cross-referencing claims across the entire industry.

In this article

How ClaimSearch worksKey capabilitiesLimitationsKey pointsHow Hesper AI helpsFAQ

How ClaimSearch works

When an insurer files a claim into ClaimSearch, the system automatically cross-references the claimant, addresses, phone numbers, SSN, vehicle VIN, and other identifiers against the entire database. It returns matches showing prior claims, duplicate claims filed with other carriers, and pattern alerts. This happens in near real-time, providing investigators with cross-carrier intelligence at the point of claim intake.

Key capabilities

ClaimSearch provides: prior claim history searches (how many claims has this person filed?), address-based searches (multiple claims from the same address?), provider searches (is this medical provider associated with unusual claim volume?), vehicle history (claims associated with this VIN across all carriers), and Special Investigation alerts (flags placed by other carriers' SIU teams). The database covers personal and commercial auto, property, casualty, and workers' compensation claims.

Limitations

ClaimSearch is only as good as the data contributed by member companies. Not all carriers contribute consistently, and data entry quality varies. The system identifies matches and patterns but does not make fraud determinations - that requires investigation. Additionally, a high number of prior claims does not automatically indicate fraud; it must be evaluated in context. ClaimSearch is a detection tool, not an investigation tool.

Key points

  • Largest shared claims database: 1.5+ billion records from 1,100+ companies
  • Cross-references claimants, addresses, providers, and vehicles across carriers
  • Provides prior claim history, duplicate detection, and pattern alerts
  • Near real-time matching at point of claim intake
  • Detection tool only - identified patterns still require investigation
How Hesper AI helps

Hesper AI queries ISO ClaimSearch as part of every investigation, automatically pulling prior claim history and cross-carrier matches. When ClaimSearch identifies patterns, the AI agent investigates them - verifying whether matches indicate genuine fraud rather than coincidence, and documenting findings for the SIU team.

Related glossary terms

National Insurance Crime Bureau (NICB)Claims TriageNetwork Analysis (Fraud Detection)

Frequently asked questions

The majority of U.S. property-casualty insurers contribute to and use ISO ClaimSearch, with over 1,100 contributing companies. However, participation is not mandatory - some smaller carriers or self-insured organizations may not contribute data. Many states encourage or require participation as part of anti-fraud program requirements.

ISO ClaimSearch retains claims data going back decades, with the most comprehensive coverage from the mid-1990s onward. The database currently contains over 1.5 billion claim records. Historical depth is valuable for detecting long-running fraud patterns and serial claimants who operate over many years.

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