DEVICE AND METHOD FOR INSURANCE UNFAIR CLAIM AND UNFAIR PATTERN DETECTION BASED ON ARTIFICIAL INTELLIGENCE

摘要

According to an embodiment of the present invention, an apparatus for detecting a fraudulent insurance claim and a fraudulent pattern based on artificial intelligence includes: a data preprocessing part deriving property variables by standardizing insurance claim history data; an abnormal value detection part detecting a normal pattern and a fraudulent pattern from an abnormal group detected based on an abnormality detection algorithm into which the property variables are inputted; a new pattern classification part detecting a new pattern of a fraudulent claim by performing unsupervised learning into which the normal and fraudulent patterns are inputted; a new pattern detection part detecting a pattern of a new fraudulent claim by building a pattern determination model based on supervised learning into which the new pattern of the fraudulent claim and a pre-classified insurance claim pattern are inputted; and a fraudulent claim determination part determining whether a new insurance claim history is fraudulent by building a fraudulent claim detection model based on supervised learning into which the property variables and the normal claim data are inputted.