Richard A. Derrig

A Comparison of State‐of‐the‐Art Classification Techniques for Expert Automobile Insurance Claim Fraud Detection

Several state-of-the-art binary classification techniques are experimentally evaluated in the context of expert automobile insurance claim fraud detection. The predictive power of logistic regression, C4.5 decision tree, k-nearest neighbor, Bayesian learning multilayer perceptron neural network, least-squares support vector machine, naive Bayes, and tree-augmented naive Bayes classification is contrasted. For most of these algorithm types, we report on several operationalizations using alternative hyperparameter or design choices. We compare these in terms of mean percentage correctly classified (PCC) and mean area under the receiver operating characteristic (AUROC) curve using a stratified, blocked, ten-fold cross-validation experiment. We also contrast algorithm type performance visually by means of the convex hull of the receiver operating characteristic (ROC) curves associated with the alternative operationalizations per algorithm type. The study is based on a data set of 1,399 personal injury protection claims from 1993 accidents collected by the Automobile Insurers Bureau of Massachusetts. To stay as close to real-life operating conditions as possible, we consider only predictors that are known relatively early in the life of a claim. Furthermore, based on the qualification of each available claim by both a verbal expert assessment of suspicion of fraud and a ten-point-scale expert suspicion score, we can compare classification for different target/class encoding schemes. Finally, we also investigate the added value of systematically collecting nonflag predictors for suspicion of fraud modeling purposes. From the observed results, we may state that: (1) independent of the target encoding scheme and the algorithm type, the inclusion of nonflag predictors allows us to significantly boost predictive performance; (2) for all the evaluated scenarios, the performance difference in terms of mean PCC and mean AUROC between many algorithm type operationalizations turns out to be rather small; visual comparison of the algorithm type ROC curve convex hulls also shows limited difference in performance over the range of operating conditions; (3) relatively simple and efficient techniques such as linear logistic regression and linear kernel least-squares support vector machine classification show excellent overall predictive capabilities, and (smoothed) naive Bayes also performs well; and (4) the C4.5 decision tree operationalization results are rather disappointing; none of the tree operationalizations are capable of attaining mean AUROC performance in line with the best. Visual inspection of the evaluated scenarios reveals that the C4.5 algorithm type ROC curve convex hull is often dominated in large part by most of the other algorithm type hulls.

A case study of applying boosting naive Bayes to claim fraud diagnosis

We apply the weight of evidence reformulation of AdaBoosted naive Bayes scoring due to Ridgeway et al. (1998) to the problem of diagnosing insurance claim fraud. The method effectively combines the advantages of boosting and the explanatory power of the weight of evidence scoring framework. We present the results of an experimental evaluation with an emphasis on discriminatory power, ranking ability, and calibration of probability estimates. The data to which we apply the method consists of closed personal injury protection (PIP) automobile insurance claims from accidents that occurred in Massachusetts (USA) during 1993 and were previously investigated for suspicion of fraud by domain experts. The data mimic the most commonly occurring data configuration, that is, claim records consisting of information pertaining to several binary fraud indicators. The findings of the study reveal the method to be a valuable contribution to the design of intelligible, accountable, and efficient fraud detection support.

Auto claim fraud detection using Bayesian learning neural networks

This article explores the explicative capabilities of neural network classifiers with automatic relevance determination weight regularization, and reports the findings from applying these networks for personal injury protection automobile insurance claim fraud detection. The automatic relevance determination objective function scheme provides us with a way to determine which inputs are most informative to the trained neural network model. An implementation of MacKays, (1992a,b) evidence framework approach to Bayesian learning is proposed as a practical way of training such networks. The empirical evaluation is based on a data set of closed claims from accidents that occurred in Massachusetts, USA during 1993. e framework approach to Bayesian learning is proposed as a practical way of training such networks. The empirical evaluation is based on a data set of closed claims from accidents that occurred in Massachusetts, USA during 1993.

Boosting Naive Bayes for Claim Fraud Diagnosis

In this paper we apply the weight of evidence reformulation of AdaBoosted naive Bayes scoring due to Ridgeway et al. (1998) for the diagnosis of insurance claim fraud. The method effectively combines the advantages of boosting and the modelling power and representational attractiveness of the probabilistic weight of evidence scoring framework. We present the results of an experimental comparison with an emphasis on both discriminatory power and calibration of probability estimates. The data on which we evaluate the method consists of a representative set of closed personal injury protection automobile insurance claims from accidents that occurred in Massachusetts during 1993. The findings of the study reveal the method to be a valuable contribution to the design of effective, intelligible, accountable and efficient fraud detection support.