Fraud Detection Roosevelt C. Mosley, Jr., FCAS, MAAA Nick Kucera Pinnacle Actuarial Resources Inc., Bloomington, IL ABSTRACT As it has been widely reported in the insurance trade news, fraudulent claims continue to be a significant issue in the insurance industry, costing policyholders billions of dollars. More companies are turning to analytics to help identifying claim fraud. Identifying claim fraud using predictive analytics, however, represents a unique challenge. 1. Most predictive…
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