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A Robust Unsupervised Method for Fraud Rate Estimation

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  • Jing Ai
  • Patrick L. Brockett
  • Linda L. Golden
  • Montserrat Guillén

Abstract

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Suggested Citation

  • Jing Ai & Patrick L. Brockett & Linda L. Golden & Montserrat Guillén, 2013. "A Robust Unsupervised Method for Fraud Rate Estimation," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 80(1), pages 121-143, March.
    • Handle: RePEc:bla:jrinsu:v:80:y:2013:i:1:p:121-143
    DOI: j.1539-6975.2012.01467.x
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    References listed on IDEAS

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    1. Jörg Schiller, 2006. "The Impact of Insurance Fraud Detection Systems," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 73(3), pages 421-438, September.
    2. Jing Ai & Patrick Brockett & Linda Golden, 2009. "Assessing Consumer Fraud Risk in Insurance Claims," North American Actuarial Journal, Taylor & Francis Journals, vol. 13(4), pages 438-458.
    3. Steven B. Caudill & Mercedes Ayuso & Montserrat Guillén, 2005. "Fraud Detection Using a Multinomial Logit Model With Missing Information," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 72(4), pages 539-550, December.
    4. Dilip Mookherjee & Ivan Png, 1989. "Optimal Auditing, Insurance, and Redistribution," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 104(2), pages 399-415.
    5. G. Dionne & F. Giuliano & P. Picard, 2002. "Optimal auditing for insurance fraud," THEMA Working Papers 2002-32, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
    6. Pierre Picard, 2012. "Economic Analysis of Insurance Fraud," Working Papers hal-00725561, HAL.
    7. Jean Pinquet & Mercedes Ayuso & Montserrat Guillén, 2007. "Selection Bias and Auditing Policies for Insurance Claims," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 74(2), pages 425-440, June.
    8. Andrew Yim, 2009. "Efficient Committed Budget for Implementing Target Audit Probability for Many Inspectees," Management Science, INFORMS, vol. 55(12), pages 2000-2018, December.
    9. Viaene, Stijn & Ayuso, Mercedes & Guillen, Montserrat & Van Gheel, Dirk & Dedene, Guido, 2007. "Strategies for detecting fraudulent claims in the automobile insurance industry," European Journal of Operational Research, Elsevier, vol. 176(1), pages 565-583, January.
    10. Dionne, Georges & Gagne, Robert, 2002. "Replacement Cost Endorsement and Opportunistic Fraud in Automobile Insurance," Journal of Risk and Uncertainty, Springer, vol. 24(3), pages 213-230, May.
    11. M. Martin Boyer, 2007. "Resistance (to Fraud) Is Futile," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 74(2), pages 461-492, June.
    12. Georges Dionne & Florence Giuliano & Pierre Picard, 2009. "Optimal Auditing with Scoring: Theory and Application to Insurance Fraud," Management Science, INFORMS, vol. 55(1), pages 58-70, January.
    13. Randall A. Heron & Erik Lie, 2009. "What Fraction of Stock Option Grants to Top Executives Have Been Backdated or Manipulated?," Management Science, INFORMS, vol. 55(4), pages 513-525, April.
    14. Picard, Pierre, 1996. "Auditing claims in the insurance market with fraud: The credibility issue," Journal of Public Economics, Elsevier, vol. 63(1), pages 27-56, December.
    15. Crocker, Keith J & Tennyson, Sharon, 2002. "Insurance Fraud and Optimal Claims Settlement Strategies," Journal of Law and Economics, University of Chicago Press, vol. 45(2), pages 469-507, October.
    16. Stijn Viaene & Guido Dedene, 2004. "Insurance Fraud: Issues and Challenges," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 29(2), pages 313-333, April.
    17. Townsend, Robert M., 1979. "Optimal contracts and competitive markets with costly state verification," Journal of Economic Theory, Elsevier, vol. 21(2), pages 265-293, October.
    18. Georges Dionne & Robert Gagné, 2001. "Deductible Contracts Against Fraudulent Claims: Evidence From Automobile Insurance," The Review of Economics and Statistics, MIT Press, vol. 83(2), pages 290-301, May.
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    Cited by:

    1. Urbina, Jilber & Guillén, Montserrat, 2013. "An application of capital allocation principles to operational risk," MPRA Paper 75726, University Library of Munich, Germany, revised Dec 2013.
    2. Andersson, Jonas & Olden, Andreas & Rusina, Aija, 2020. "Fraud detection by a multinomial model: Separating honesty from unobserved fraud," Discussion Papers 2020/15, Norwegian School of Economics, Department of Business and Management Science.
    3. Chen, Faan & Li, Yaxin & Feng, Qianqian & Dong, Zehao & Qian, Yiming & Yan, Yi & Ho, Mun S. & Ma, Qianchen & Zhang, Dashan & Jin, Yuanzhe, 2023. "Road safety performance rating through PSI-PRIDIT: A planning tool for designing policies and identifying best practices for EAS countries," Socio-Economic Planning Sciences, Elsevier, vol. 85(C).
    4. Behnaz Amerirad & Matteo Cattaneo & Ron S. Kenett & Elisa Luciano, 2023. "Adversarial Artificial Intelligence in Insurance: From an Example to Some Potential Remedies," Risks, MDPI, vol. 11(1), pages 1-17, January.
    5. Ina Garnefeld & Andreas Eggert & Markus Husemann-Kopetzky & Eva Böhm, 2019. "Exploring the link between payment schemes and customer fraud: a mental accounting perspective," Journal of the Academy of Marketing Science, Springer, vol. 47(4), pages 595-616, July.

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