When you file a claim after a car accident or work-related injury, the insurance company will begin to investigate.
At some point during its investigation, either during a recorded statement (attorney tip: never give one) or deposition, or as part of written discovery and interrogatories, the insurance company will ask you about past accidents and injuries. This is usually allowed under state and federal Rules of Evidence and the Rules of the Workers Compensation Commission.
It may be tempting to hide one or more of your past auto accidents or work injuries. Especially if the crash was a minor fender bender or the work-related injury required no treatment or time missed from work. Or if you did not file a workers comp claim or a civil action based on tort and negligence law because of the past accident.
But here is my advice: Don’t hide past insurance claims based on personal injury! Disclose them.
There are several reasons you should come clean and disclose past accidents or injuries. The purpose of this article is to discuss one of these reasons: the ISO Search. More specifically, ISO ClaimSearch.
The ISO Search is a tool used by insurance companies to investigate your claim history when you seek workers compensation benefits after an on-the-job injury or occupational disease or monetary damages because of another driver’s negligence. According to its website, ISO ClaimSearch is used by thousands of insurance companies and third party administrators: about 90 percent of the casualty/property insurance industry by premium volume.
Thanks to the ISO Search, the insurance claim adjuster may know about your past insurance claims before calling you, or within a day of your first telephone conversation or email. So it doesn’t make sense to hide past claims or injuries, particularly when that information is likely to come out anyway, hurting your credibility, and when you can still win your case despite pre-existing conditions such as degenerative disc disease or arthritis.
Keep reading to learn more about the information the insurance company or third party claim administrator (TPA) such as Sedgwick or Gallagher Bassett may be able to get about your past car accidents and workplace injuries – even if you don’t tell them about those incidents. And why you should ask for and review the ISO Report for accuracy.
If you have any questions about your rights under personal injury or workers compensation law, call me for a free consultation: (804) 251-1620 or (757) 810-5614. Come see why I’ve been voted one of the top attorneys for injured workers and auto accident victims in Virginia, and what results I can get for you.
Insurance Services Office, Inc. (ISO) is an organization owned by Verisk Analytics.
Founded in the 1970s, ISO provides multiple services to the property/casualty and workers compensation insurance industry. These services include the ISO ClaimSearch.
According to Verisk Analytics’s website, ISO ClaimSearch “is more than the world’s largest database of property/casualty claims – it’s also a robust claims intelligence platform. Its claims-matching technology is an essential first step in fraud detection, and the results can help facilitate fast-tracking. The platform also provides seamless access to integrated claims fraud-detection and investigative analysis tools.”
Put simply, ISO has data for more hundreds of millions of insurance claims, including tens of millions of workers comp claims. And when you make a new claim the insurer can search this database for information about past claims you have made – whether you made them in Virginia or another state.
One of the first things the insurance adjuster assigned to your case will do is try to get your:
The claim adjuster wants this information because this is the information used to run the ISO Search and to access data from your past workers compensation, auto accident, and personal injury claims.
The ISO ClaimSearch Report will include a list of all the claims you have filed.
And for each claim, the ISO Search Report may state:
Not from ISO.
ISO provides claim information to insurance companies and their agents only, not to plaintiffs or their attorneys.
You can, however, send a Request for Production of Documents to the insurance company asking for a copy of any ISO Search Reports it has received about you.
It depends on who you ask.
There are several ways that bodily injury and workers comp adjusters use the ISO ClaimSearch Report.
The claim adjuster will use the information from the ISO Search to determine:
Then the claim adjuster will use this information to find possible defenses to your workers comp or negligence claim or to persuade you to accept a lower offer during settlement mediation and negotiations.
All these are valid uses of the ISO Search Report. And I agree that the ISO Search Report is a useful tool when investigating an insurance claim and trying to determine its value. Where I disagree with many claim adjusters, however, is the amount of importance the ISO ClaimSearch Report should have in determining your credibility and trustworthiness, especially when you are upfront about past accidents, injuries, claims, and lawsuits.
Some insurance adjusters treat the ISO Search Report as the most important document in determining whether you – the injured worker or accident victim – are a good and credible person. If the ISO Report shows that you have made an insurance claim before (or several), then the adjuster may refer your claim for surveillance by a private investigator or refuse to offer a fair settlement amount for your injuries based on an incorrect belief that you are not telling the truth about your accident amount and injuries or are exaggerating your symptoms and the need for medical treatment.
I think this is wrong for several reasons.
First, the ISO Search Report itself is not admissible at your jury trial or workers comp hearing. The defense attorney representing the insurance company cannot introduce it as evidence and as proof that you suffered an injury in the past.
Rather, the defense attorney will use the information in the ISO Report to find information and documents about your past accidents and injuries and to try to persuade your treating physician to state that your ongoing disability and need for medical treatment is related to your past injuries, not the current claim, or to state that most of your permanent impairment is related to earlier accidents and injuries.
Second, the ISO Search Report may be full of errors. It may show several insurance claims that appear to have been made by you but were made by someone else.
These errors could happen for any one of a number of reasons. For example, the ISO Search Report may include a claim made by a different person with your same name or a claim that was made by or against a person who lived at one of the addresses you have lived at before – either during the same period or at a different time.
Third, if you are honest about past accidents and injuries and present evidence about why your most recent injury, symptoms, and restrictions are different, you can overcome a lengthy claims history.
Fourth, I may be able to keep prior claims and injuries out of evidence if you disclose them first. By telling the truth you take away the insurance carrier’s argument that your failure to disclose past claims shows that you are a liar.
The insurance company will investigate your claim as a normal part of its business. It is rarely, if ever, personal.
But that doesn’t mean you should sit by idly. There are steps you can take to protect your current claim from the impact of an ISO Search Report that turns up multiple claims and that protects any future claims you may have to file.
These steps include:
For more tips on how to put more money your pocket after an injury, call me for a free consultation: (804) 251-1620 or (757) 810-5614. Let’s get started on the path to physical, mental, and financial recovery.