Health Insurance Fraud Detection through Data Mining

One of the challenges that insurers are facing is fraud. Fraud in health insurance involves intentional deception or misrepresentation intended for gaining some benefit. Data mining tools and techniques are applied to detect fraud in big data. In this paper, we present the concept of data mining and current techniques used in health insurance fraud detection, using supervised and unsupervised data mining approaches. This article provides a comprehensive review of different data mining techniques for detecting fraud in health insurance.