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Journal of Risk and Insurance, 2023
Identifying insurance fraud is a difficult task due to the complex nature of the fraud itself, the diversity of techniques employed, the rarity of fraud cases observed in data sets, and the relatively limited allocation of human, financial, and time ...
Denisa Banulescu-Radu +1 more
semanticscholar +1 more source
Identifying insurance fraud is a difficult task due to the complex nature of the fraud itself, the diversity of techniques employed, the rarity of fraud cases observed in data sets, and the relatively limited allocation of human, financial, and time ...
Denisa Banulescu-Radu +1 more
semanticscholar +1 more source
Deep Learning in Insurance Fraud Detection: Techniques, Datasets, and Emerging Trends
Journal of Banking and Financial DynamicsInsurance fraud represents a significant financial burden globally, with annual losses exceeding $200 billion across healthcare, auto, and life insurance sectors.
Tiejiang Sun, Mengdie Wang, Xu Han
semanticscholar +1 more source
A Hybrid Federated Learning Model for Insurance Fraud Detection
2023 IEEE International Conference on Communications Workshops (ICC Workshops), 2023Mission-critical systems are significant for the survival of any organization. Financial systems, communication systems, and electricity grid systems are some examples of mission-critical applications.
Supriya Y +3 more
semanticscholar +1 more source
Smart h‐Chain: A blockchain based healthcare framework with insurance fraud detection
Transactions on Emerging Telecommunications Technologies, 2023In today's smart applications, very frequently used data like electronic health records (EHR's) are highly sensitive and soft target to the unauthorized agencies. Data management, integrity, and security issues plague EHR systems.
S. Mahapatra, Ditipriya Sinha
semanticscholar +1 more source
Journal of Computer Science and Technology Studies
Healthcare fraud in the United States results in billions of dollars in financial losses annually, necessitating advanced technological solutions for fraud detection and risk management. Machine learning (ML) has emerged as a powerful tool in identifying
Raktima Dey +4 more
semanticscholar +1 more source
Healthcare fraud in the United States results in billions of dollars in financial losses annually, necessitating advanced technological solutions for fraud detection and risk management. Machine learning (ML) has emerged as a powerful tool in identifying
Raktima Dey +4 more
semanticscholar +1 more source
On the Cost-efficiency of Automobile Insurance Fraud Detection Methods: A Meta-analysis
Global Business Review, 2023We suggest an improved cost savings calculation method in case of automobile insurance fraud detection. Moreover, we compare the cost saving ability of 77 fraud detection methods using heat maps and compare the cost saving ability of traditional ...
Botond Benedek +2 more
semanticscholar +1 more source
Insurance Taxation and Insurance Fraud
Journal of Public Economic Theory, 2000It is common practice in the United States to impose a sales tax on insurance premiums. Insurance benefits are not taxed, and it is typically argued that they should not be taxed because they compensate for a loss. In this paper I present a case where the taxation of insurance benefits is preferable to the taxation of premiums.
openaire +1 more source
Evaluating Sampling Techniques for Healthcare Insurance Fraud Detection in Imbalanced Dataset
Jurnal Ilmiah Teknik Elektro Komputer dan Informatika, 2023Detecting fraud in the healthcare insurance dataset is challenging due to severe class imbalance, where fraud cases are rare compared to non-fraud cases. Various techniques have been applied to address this problem, such as oversampling and undersampling
Joanito Agili Lopo, Kristoko Dwi Hartomo
semanticscholar +1 more source
ANALYSIS OF THE IMPLEMENTATION OF THE NATIONAL HEALTH INSURANCE FRAUD PREVENTION PROGRAM
Journal of Health Management, Administration and Public Health Policies (HealthMAPs)The National Health Insurance (JKN) Program The National Health Insurance (JKN) organized by the Social Security Administration Agency (BPJS) Kesehatan is one of the Indonesian government's strategic efforts to realize an inclusive and equitable health ...
A. Safitri +4 more
semanticscholar +1 more source
Enhancing Auto Insurance Fraud Detection Using Convolutional Neural Networks
International Joint Conference on Computer Science and Software EngineeringWith the increasing number of vehicles in the global fleet, the size of the auto insurance market is projected to reach $1.3 billion USD by 2030. While this growth in the issuance of auto insurance policies brings prosperity to the industry, it also ...
Ratchanon Wongpanti, Sirion Vittayakorn
semanticscholar +1 more source