• DocumentCode
    935236
  • Title

    A case study of applying boosting naive Bayes to claim fraud diagnosis

  • Author

    Viaene, Stijn ; Derrig, Richard A. ; Dedene, Guido

  • Author_Institution
    Dept. of Appl. Econ. Sci., Katholieke Univ., Leuven, Belgium
  • Volume
    16
  • Issue
    5
  • fYear
    2004
  • fDate
    5/1/2004 12:00:00 AM
  • Firstpage
    612
  • Lastpage
    620
  • Abstract
    We apply the weight of evidence reformulation of AdaBoosted naive Bayes scoring due to Ridgeway et al. (1998) to the problem of diagnosing insurance claim fraud. The method effectively combines the advantages of boosting and the explanatory power of the weight of evidence scoring framework. We present the results of an experimental evaluation with an emphasis on discriminatory power, ranking ability, and calibration of probability estimates. The data to which we apply the method consists of closed personal injury protection (PIP) automobile insurance claims from accidents that occurred in Massachusetts (USA) during 1993 and were previously investigated for suspicion of fraud by domain experts. The data mimic the most commonly occurring data configuration, that is, claim records consisting of information pertaining to several binary fraud indicators. The findings of the study reveal the method to be a valuable contribution to the design of intelligible, accountable, and efficient fraud detection support.
  • Keywords
    Bayes methods; data mining; fraud; insurance data processing; pattern classification; AdaBoosted naive Bayes scoring; Massachusetts; automobile insurance claims; binary fraud indicators; boosting naive Bayes; case study; closed personal injury protection; data mining; decision support; discriminatory power; evidence reformulation; fraud detection support; insurance claim fraud diagnosis; knowledge discovery; pattern recognition; probability estimates; ranking ability; weight of evidence scoring framework; Automobiles; Boosting; Communication industry; Computer aided software engineering; Costs; Industrial training; Injuries; Insurance; Personnel; Protection;
  • fLanguage
    English
  • Journal_Title
    Knowledge and Data Engineering, IEEE Transactions on
  • Publisher
    ieee
  • ISSN
    1041-4347
  • Type

    jour

  • DOI
    10.1109/TKDE.2004.1277822
  • Filename
    1277822