Index System

The Index System page, available for selection from the Options menu, allows you to view records of submissions to and reports from a third-party index bureau for the prevention of claim fraud. Sedgwick partners with the Insurance Services Office (ISO) ClaimSearch® service, which collects claim reports from numerous insurance agencies and third party administrators. The ISO ClaimSearch system provides a single point of entry for claim input and a report delivery system that equips claims personnel with essential data for researching prior loss histories, identifying claims patterns, and detecting potentially fraudulent claims.

Note: Please refer to the Claim Header Information help file for documentation regarding fields appearing in the header information of the Index System page.

The table below describes the information found on the Index Summary tab:

Index Summary Tab
Field	Description
Date	The date the document was sent to the Index System
Report	The type of submission sent to ISO. Options are: Initial: This request type applies to claims sent to ISO for the first time. The claim is added to their database and a search of all claims is performed to locate possible matches. Replacement: After an initial request is acknowledged by ISO, data added or modified in any fields considered "searchable" by ISO requires a replacement of the Initial data in their system. A search for matches is not performed for this type of record unless the claimant's name, address, or Social Security Number was updated. Update: At least one "key field" was changed in JURIS, requiring the claim to be resubmitted to ISO. The key fields are the claim number, the client's ISO customer code, the date of loss, and the policy number. ISO does not search for matches on submissions of this type. Re-Search: Sent periodically, either automatically or manually, this request type applies to claims previously submitted and indexed. Changes to claim information are not required for submissions of this type. These submissions always initiate another search for matches with ISO. When both key field and searchable fields are changed, a record is sent with both Update and Replacement statuses.
Search	Indicates whether the submission initiated a search for matches with ISO. See the Report descriptions above for more about which submissions initiate a search.
Type	Indicates how the submission to ISO was initiated; options are Automatic (system-generated) and Manual (user-generated)
Status	Displays the submission's current status. Options are: Pending: Claim was manually queued for submission to ISO but has not yet been sent. Claims are sent daily and should not remain in this status for more than a day. Edit/Fail: Missing or invalid claim or parameter data prevented the claim from being submitted to ISO. Sent: Claim data was submitted to ISO but a response has not yet been received Received: Claim was received by ISO and a response was received ISO Reject: Submission was rejected by ISO due to missing or invalid information; JURIS programming is made aware of these issues and they are corrected without examiner intervention. Wait: A manual indexing request cannot be submitted because the 12-month mandatory waiting period following an initial index has not expired.
Result	Indicates the number of matching criteria, or No Match, when the Status is Received. Note: Matches found subsequent to earlier matches are not included in this count. Example: The first match returns 2 Matches. A subsequent match report returns one new match (plus the previous two). The Result field only displays 1 Match for this newest search.
Match Reason	Displays the claim's data that ISO found a match to in their system. Options are: Address is similar Drivers License number is identical License plate number is identical Similar Location of Loss Name is similar Name combination Phone number is identical Tax Identification number is identical Social Security number is identical Vehicle identification number is identical
Index Summary Tab - Detail
Report Type	The type of report submitted to ISO. Refer to Report field description above for possible report types.
Report Date	The date of the specific transmission displayed
Customer Code	Unique number assigned by ISO to Sedgwick or the client for identifying the ISO client submitting the file
Searchable Fields	Fields ISO compares to other claims in their database when searching for matches. Searchable fields are: Name: Claimant's last and first name SSN: Claimant's Social Security Number Address: Claimant's home address A Replacement report is submitted to ISO when these fields differ from previous submissions.

The Index Report tab displays a list of all responses from ISO with claim data matches. Click the name of the Match File to view the ISO ClaimSearch Match Report in .pdf format.

The table below describes the information found on the Index Report tab:

Index Report Tab
Field	Description
Date	The date the document was sent to the Index System
Report	The type of submission sent to ISO. Options are: Initial: This request type applies to claims sent to ISO for the first time. The claim is added to their database and a search of all claims is performed to locate possible matches. Replacement: After an initial request is acknowledged by ISO, data added or modified in any fields considered "searchable" by ISO requires a replacement of the Initial data in their system. A search for matches is not performed for this type of record unless the claimant's name, address, or Social Security Number was updated. Update: At least one "key field" was changed in JURIS, requiring the claim to be resubmitted to ISO. The key fields are the claim number, the client's ISO customer code, the date of loss, and the policy number. ISO does not search for matches on submissions of this type. Re-Search: Sent periodically, either automatically or manually, this request type applies to claims previously submitted and indexed. Changes to claim information are not required for submissions of this type. These submissions always initiate another search for matches with ISO. When both key field and searchable fields are changed, a record is sent with both Update and Replacement statuses.
Type	Indicates how the submission to ISO was initiated; options are Automatic (system-generated) and Manual (user-generated)
Match Count	Indicates the number of matching criteria, or No Match, when the Status is Received. Note: Matches found subsequent to earlier matches are not included in this count. Example: The first match returns 2 Matches. A subsequent match report returns one new match (plus the previous two). The Result field only displays 1 Match for this newest search.
Match Reason	Displays the claim's data that ISO found a match to in their system. Options are: Address is similar Drivers License number is identical License plate number is identical Similar Location of Loss Name is similar Name combination Phone number is identical Tax Identification number is identical Social Security number is identical Vehicle identification number is identical
Match File	The name of the match file. Click the name of the Match File to view the ISO ClaimSearch Match Report in .pdf format. Note: You must have Adobe Acrobat Reader installed to view the ISO ClaimSearch Match Report. It is available for free from Adobe.com

Tip: You can sort data in ascending or descending order by clicking on the desired column heading.