Application of Machine Learning in Insurance Fraud Detection: Achievements and Future Prospects

DOI

10.2991/978-94-6463-512-6_65How to use a DOI?

Keywords

Machine learning; artificial intelligence; neural network; fraud detection; insurance

Abstract

Insurance is a crucial component of modern society and insurance fraud inflicts significant financial losses on candid customers, insurance companies, and the entire economy. The insurance industry constantly searches for measures to confront the challenge of fraudulent claims. Traditional ways to identify insurance fraud were not effective enough in today’s digital world. Recent technological development in artificial intelligence and machine learning brings revolution to insurance fraud detection methods. This paper examines various applications of artificial intelligence that detect fraudulent behaviors in insurance claims. More specifically, this study identifies key challenges for fraud detection in different types of insurance, and explains how to overcome these obstacles with the use of several particular machine learning algorithms. The findings show that application of machine learning in various insurance fraud detection systems significantly improves prediction accuracy and overall efficiency. Artificial intelligence powers new methods to confront fraudulent behaviors that are previously unimaginable in the insurance industry. This paper also discusses other advantages and limitations of existing machine learning based fraud detection methods. The result demonstrates that applications of artificial intelligence and machine learning have already made huge contributions in fighting insurance fraud. The analysis also points out several potential directions of future researches for utilizing machine learning in insurance fraud detection systems.

Copyright

© 2024 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Yourui Guo
PY  - 2024
DA  - 2024/09/23
TI  - Application of Machine Learning in Insurance Fraud Detection: Achievements and Future Prospects
BT  - Proceedings of the 2024 International Conference on Artificial Intelligence and Communication (ICAIC 2024)
PB  - Atlantis Press
SP  - 619
EP  - 626
SN  - 1951-6851
UR  - https://doi.org/10.2991/978-94-6463-512-6_65
DO  - 10.2991/978-94-6463-512-6_65
ID  - Guo2024
ER  -