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Article . 2024
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European Actuarial Journal
Article . 2024 . Peer-reviewed
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Network analytics for insurance fraud detection: a critical case study

Authors: Deprez, Bruno; Vandervorst, Félix; Verbeke, Wouter; Verdonck, Tim; Baesens, Bart;

Network analytics for insurance fraud detection: a critical case study

Abstract

There has been an increasing interest in fraud detection methods, driven by new regulations and by the financial losses linked to fraud. One of the state-of-the-art methods to fight fraud is network analytics. Network analytics leverages the interactions between different entities to detect complex patterns that are indicative of fraud. However, network analytics has only recently been applied to fraud detection in the actuarial literature. Although it shows much potential, many network methods are not yet applied. This paper extends the literature in two main ways. First, we review and apply multiple methods in the context of insurance fraud and assess their predictive power against each other. Second, we analyse the added value of network features over intrinsic features to detect fraud. We conclude that (1) complex methods do not necessarily outperform basic network features, and that (2) network analytics helps to detect different fraud patterns, compared to models trained on claim-specific features alone.

sponsorship: Fonds Wetenschappelijk Onderzoek|1SHEN24N

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Keywords

Network Data, Science & Technology, Fraud analytics, Economics, Statistics & Probability, 0104 Statistics, 1502 Banking, Finance and Investment, Social Sciences, Business, Finance, Network data, Insurance, 4905 Statistics, Fraud Analytics, Business & Economics, 0102 Applied Mathematics, Physical Sciences, 3502 Banking, finance and investment, 4901 Applied mathematics, Supervised Learning, Mathematics, Supervised learning

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
Green