Mathematics and Modeling in Finance (Jul 2022)

Using local outlier factor to detect fraudulent claims in auto insurance

  • Maryam Esna-Ashari,
  • Farzan Khamesian,
  • Farbod Khanizadeh

DOI
https://doi.org/10.22054/jmmf.2022.15751
Journal volume & issue
Vol. 2, no. 1
pp. 167 – 182

Abstract

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Given the significant increase in fraudulent claims and the resulting financial losses‎, ‎it is important to adopt a scientific approach to detect and prevent such cases‎. ‎In fact‎, ‎not equipping companies with an intelligent system to detect suspicious cases has led to the payment of such losses‎, ‎which may in the short term lead to customer happiness but eventually will have negative financial consequences for both insurers and insured‎. ‎Since data labeled fraud is really limited‎, ‎this paper‎, ‎provides insurance companies with an algorithm for identifying suspicious cases‎. ‎This is obtained with the help of an unsupervised algorithm to detect anomalies in the data set‎. ‎The use of this algorithm enables insurance companies to detect fraudulent patterns that are difficult to detect even for experienced experts‎. ‎According to the outcomes‎, ‎the frequency of financial losses‎, ‎the time of and the type of incident are the most important factors to in detecting suspicious cases‎.

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