Dealing with the topic of economic crime in insurance is very complex and therefore challenging. One first challenges concerns definition crime. Namely, represents a multi-layered phenomenon which must, terms basic features, be adapted to specific requirements given society. forms crime, common practice, certainly refers abuse field insurance. The most common, at same time only form foreseen by...

A case study on the theoretical and practical value of using process mining for the detection of fraudulent behavior in the procurement process Abstract This thesis presents the results of a six month research period on process mining and fraud detection. This thesis aimed to answer the research question as to how process mining can be utilized in fraud detection and what the benefits of using ...

In this paper we investigate the privacy dimension of collaborative fraud detection envisioned for outsourcing scenarios. Firstly, we investigate the privacy requirements derived from privacy law and present the resulting judicial argument for pseudonymizing audit data generated for the purpose of fraud detection. Second, we summarize the requirements for such pseudonymization derived from the ...

The European iWebCare project (FP6-2004-IST-4-028055) aims at designing and developing a flexible fraud detection web services platform, which will be able to serve e-government processes of fraud detection and prevention, in order to ensure quality and accuracy and minimize loss of health care funds. This paper discusses the approach this project adopts and which involves the introduction of a...

In today’s technological age, fraud has become more complicated, and increasingly more difficult to detect, especially when it is collusive in nature. Different fraud surveys showed that the median loss from collusive fraud is much greater than fraud perpetrated by a single person. Despite its prevalence and potentially devastating effects, collusion is commonly overlooked as an organizational ...

<span>Fraud in healthcare insurance claims is one of the significant research challenges that affect growth services. The frauds are happening through subscribers, companies and providers. development a decision support to automate claim data from service provider offset patient’s challenges. In this paper, novel hybridized big statistical machine learning technique, named MapReduce based...

Fraud detection has received considerable attention from many academic research and industries worldwide due to its increasing popularity. Insurance datasets are enormous, with skewed distributions high dimensionality. Skewed class distribution volume considered significant problems while analyzing insurance datasets, as these issues increase the misclassification rates. Although sampling appro...

Credit card plays a very important rule in today's economy. It becomes an unavoidable part of household, business and global activities. Although using credit cards provides enormous benefits when used carefully and responsibly,significant credit and financial damagesmay be causedby fraudulent activities. Many techniques have been proposed to confront thegrowthin credit card fraud. However, all...