首页>
外国专利>
Insurance Fraud Detection and Prevention System
Insurance Fraud Detection and Prevention System
展开▼
机译:保险欺诈检测与预防系统
展开▼
页面导航
摘要
著录项
相似文献
摘要
A computer-implemented method and system for detecting possible occurrences of fraud in insurance claim data is disclosed. Historical claims data is obtained over a period of time for an insurance company. The fraud frequency rate and percentage loss rate for the insurance company are calculated. The fraud frequency rate and percentage loss rate for the insurance company are compared to insurance industry benchmarks for the fraud frequency rate and the percentage loss rate. Based on the comparison to the industry benchmarks, the computer system determines whether to perform predictive modeling analysis if the insurance company is within a first range of the benchmarks, to perform statistical analysis on the claim data if the insurance company is below the first range of the benchmarks or perform forensic analysis if the insurance company is above the first range of the benchmarks. Statistical analysis, predictive modeling or forensic analysis are then performed based on the benchmarks to determine possible occurrences of fraud within the insurance claim data.
展开▼