ISO Claims Partners

What ISO Claims Partners does

ISO Claims Partners provides Medicare compliance and claims resolution services to property/casualty (P&C) insurance companies. The firm addresses the regulatory and operational complexity P&C carriers face when Medicare beneficiaries are involved in insurance claims — encompassing Medicare Secondary Payer (MSP) compliance, Section 111 reporting, and ongoing claim portfolio resolution. Its customer base is concentrated in US P&C insurers, and its work is structurally tied to CMS-mandated obligations and long-tail claim settlement timelines, which produce a recurring services workflow rather than a transactional product sale.

Founded in 1971 and headquartered in North Reading, Massachusetts, ISO Claims Partners is a subsidiary within the Verisk Analytics ecosystem, with its web presence delivered through the Verisk brands domain (verisk.com/insurance/brands/iso-claims-partners/). The firm operates with 51-100 employees, indicating a focused, specialist services unit rather than a large-scale platform. Senior leadership includes John M. Williams as Senior Vice President. The firm's business model is B2B professional services sold to carrier claim departments; specific pricing structures, contract terms, and revenue figures are not publicly disclosed. Its core technology, products, and service packaging are not detailed in the source data beyond the functional compliance/claims-resolution service line.

Name

ISO Claims Partners

Legal name

ISO Claims Partners

Website

https://verisk.com

Company type

Private

Founded year

1971

Operating status

Operating

Headcount range

51–100 employees

Short description

ISO Claims Partners provides Medicare compliance and claims resolution services to US property/casualty insurance carriers, operating as a Verisk Analytics subsidiary specializing in MSP compliance and Section 111 reporting workflows.

Ownership category

akta.pro rank

Product category

Insurance Claims Services — Medicare Compliance

NAICS

Claims Adjusting (524291), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Medicare Plan Administration & Third-Party Services (TPA/BPO, Enrollment, Billing) (FSAIAGAI)

Keywords

• Medicare compliance services
• Claims resolution services
• Property casualty insurance
• Medicare Secondary Payer
• Insurance claims administration

Headquarters

HQ city

North Reading

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales

Core offering

ISO Claims Partners provides Medicare compliance and claims resolution services to property/casualty insurance companies. The firm helps P&C carriers satisfy Medicare Secondary Payer (MSP) obligations, including Section 111 reporting, ongoing Medicare entitlement monitoring, and resolution of claims involving Medicare beneficiaries. Services are delivered as outsourced specialty support rather than as licensable software.

Differentiator

Problem solved

Functional benefit

Products and services

• Medicare Compliance and Claims Resolution Services for P&C Insurers Outsourced Medicare Secondary Payer (MSP) compliance and claims resolution services delivered to property/casualty insurance carriers. Covers Section 111 reporting to CMS, ongoing Medicare entitlement monitoring for injured claimants, and resolution of conditional-payment matters arising in injury settlements. Intended for P&C claims, compliance, and vendor-procurement teams that lack in-house capacity to manage MSP obligations at scale.

Ideal customer profiles1 record

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Recent moves3 records

Expansion highlights2 records

Broad incumbents

• The Hartford (Claims & TPA Operations): The Hartford's claims operations handle workers' comp and P&C claims including Medicare coordination, and at times outsource or partner with TPA specialists. It is a broad incumbent buyer and adjacent operator comparable to ISO Claims Partners' carrier customer base.
• WTW (Willis Towers Watson): WTW provides risk management, insurance brokerage, and Medicare-related advisory services to large employers and insurers. As a broader consulting-driven incumbent, it overlaps with ISO Claims Partners in Medicare compliance and secondary payer advisory work for P&C buyers.
• Optum (UnitedHealth Group): Optum operates a broad healthcare analytics and compliance services portfolio that includes Medicare-related risk adjustment, secondary payer coordination, and claims services. It is a broad incumbent that intersects with ISO Claims Partners' Medicare compliance work from a much larger healthcare-data scale.

Direct peers

• Allsup: Allsup provides Medicare compliance, MSA, and disability advocacy services to insurers and employers, directly competing in the same Medicare Secondary Payer compliance niche as ISO Claims Partners. Its service mix and buyer base (P&C carriers, employers, claimants) closely mirror those of ISO Claims Partners.
• Sedgwick: Sedgwick is a major third-party claims administrator for P&C and workers' comp insurers that also operates Medicare compliance and MSA services. It competes directly with ISO Claims Partners for the same carrier compliance mandates and uses scale to offer integrated claims handling plus Medicare coordination.
• Gallagher Bassett: Gallagher Bassett is a large third-party claims administrator for P&C insurers offering integrated claims and Medicare/workers' comp compliance support. It competes with ISO Claims Partners for outsourced claims management and Medicare coordination mandates from carriers.
• Crawford & Company: Crawford & Company is a global claims management firm serving P&C insurers with end-to-end claims handling and a dedicated Medicare compliance/ MSA practice (through its Broadspire and specialty units). It is directly comparable to ISO Claims Partners in providing Medicare resolution services to P&C carriers.
• Broadspire: Broadspire, a Crawford company, provides third-party claims administration and Medicare compliance/case management services to P&C and workers' comp insurers. It is a direct competitor to ISO Claims Partners in delivering outsourced Medicare resolution services.

Emerging players

• MedRisk: MedRisk specializes in managed care services for workers' compensation including Medicare compliance coordination. It overlaps with ISO Claims Partners in workers' comp Medicare-related claim handling but focuses more narrowly on physical medicine and ancillary services within that framework.
• Zelis Healthcare: Zelis provides healthcare claims cost management, provider network, and Medicare-related payment integrity services to insurers. It intersects with ISO Claims Partners in serving P&C and workers' comp insurers with secondary payer and compliance-related workflows.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights5 records

Customer concentration

• Facebookfacebook.com/ISOClaimsPartners

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about ISO Claims Partners