Cost-Sensitive design of claim fraud screens

  • Authors:
  • Stijn Viaene;Dirk Van Gheel;Mercedes Ayuso;Montserrat Guillén

  • Affiliations:
  • Vlerick Leuven Gent Management School, Gent, Belgium;Dept. of Applied Economics, K.U. Leuven, Leuven, Belgium;Dept. d’Econometria, Universitat de Barcelona, Barcelona, Spain;Dept. d’Econometria, Universitat de Barcelona, Barcelona, Spain

  • Venue:
  • ICDM'04 Proceedings of the 4th international conference on Advances in Data Mining: applications in Image Mining, Medicine and Biotechnology, Management and Environmental Control, and Telecommunications
  • Year:
  • 2004

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Abstract

In this paper we perform an exploratory study on the design of claim fraud detection for a typical property and casualty (P&C) insurance company using cost-sensitive classification. We contrast several cost incorporation scenarios based on different assumptions concerning the available cost information at claim screening time. Our empirical trials are based on a data set of real-life Spanish closed automobile insurance claims that were previously investigated for suspicion of fraud by domain experts and for which we obtained detailed cost information. The reported results show the added value of cost-sensitive claim fraud screening and provide guidance on how to operationalize this strategy.