مطالعات مدیریت کسب و کار هوشمند (Aug 2023)

A model for detecting abnormal claims in crop insurance using deep learning

  • Yaqub Ahmadlou,
  • Alireza pourebrahimi,
  • jafar tanha,
  • Ali Rajabzadeh Ghatari

DOI
https://doi.org/10.22054/ims.2023.69377.2213
Journal volume & issue
Vol. 12, no. 45

Abstract

Read online

Fraud cases have increased in recent years, especially in important and sensitive financial and insurance fields. Therefore, to deal with such frauds, there is a need for different measures than traditional inspection methods. Agricultural insurance is also not exempted from this threat due to its nature and wide extent and every year a lot of money is spent on paying fake damages. This research was presented with the aim of providing a model to discover unrealistic damage claims in agricultural insurance by using data mining and machine learning techniques. It was used to build a deep learning model. The data used was obtained from the Agricultural Insurance Fund and related to wet and rainfed wheat insurance policies of Khuzestan province, for which compensation was paid in the 2018-2019 crop year. After preparing and preprocessing the data, using deep learning to discover unusual cases, the action and results were evaluated by the experts of the Agricultural Insurance Fund. After analyzing the results, it was found that 1% of the damages paid were related to unrealistic requests and more care should be taken in paying the damages. The accuracy of the model in detecting unusual cases for wet and dry wheat was 53.53 and 63.37 percent, respectively. In the review of the results, it was found that 5 categories of unusual behavior have led to the payment of unrealistic damages, and the behavior of not providing damage documentation was more frequent than the others.

Keywords