Name
Title | ||
|---|---|---|
Application of Classification Methods to Individual Disability Income Insurance Fraud Detection |
Abstract | ||
|---|---|---|
As the number of electronic insurance claims increases each year, it is difficult to detect insurance fraud in a timely manner by manual methods alone. The objective of this study is to use classification modeling techniques to identify suspicious policies to assist manual inspections. The predictive models can label high-risk policies and help investigators to focus on suspicious records and accelerate the claim-handling process.The study uses health insurance data with some known suspicious and normal policies. These known policies are used to train the predictive models. Missing values and irrelevant variables are removed before building predictive models. Three predictive models: Naïve Bayes (NB), decision tree, and Multiple Criteria Linear Programming (MCLP), are trained using the claim data. Experimental study shows that NB outperformed decision tree and MCLP in terms of classification accuracy. |
Year | DOI | Venue |
|---|---|---|
2007 | 10.1007/978-3-540-72588-6_136 | International Conference on Computational Science (3) |
Keywords | Field | DocType |
classification methods,insurance fraud,suspicious record,electronic insurance claim,predictive model,classification accuracy,fraud detection,suspicious policy,experimental study,decision tree,health insurance data,claim data,individual disability income insurance,linear program,missing values,classification,prediction model | Decision tree,Actuarial science,Naive Bayes classifier,Computer science,Health insurance,Income protection insurance,Missing data,Insurance fraud,Multiple criteria linear programming | Conference |
Volume | ISSN | Citations |
4489 | 0302-9743 | 4 |
PageRank | References | Authors |
0.50 | 1 | 7 |
Name | Order | Citations | PageRank |
|---|---|---|---|
| Yi Peng | 1 | 1303 | 78.20 |
| Gang Kou | 2 | 2527 | 191.95 |
| Alan Sabatka | 3 | 4 | 0.50 |
| Jeff Matza | 4 | 4 | 0.50 |
| Zhengxin Chen | 5 | 341 | 43.34 |
| Deepak Khazanchi | 6 | 468 | 31.19 |
| Yu Shi | 7 | 3208 | 264.97 |