Fraud detection and prevention systems are based on various technological paradigms but the two prevailing approaches are rule-based reasoning and data mining. In this paper we claim that ontologies, an increasingly popular and widely accepted knowledge representation paradigm, can help both of these approaches be more efficient as far as fraud detection is concerned and we introduce a methodol...

Data mining has been increasing as one of the chief key features of many security initiatives. Often, used as a means for detection of fraud, assessing risk as well. Data mining involves the use of data analysis tools to discover unknown, valid patterns as well as relationships in large data sets. Decades have seen a massive growth in the use of credit cards as a transactional medium. Data mini...

Background & objectives: Nowadays, consumers are demanding more accurate and clear food information than ever before, and meat products are no exception. Given the relatively high cost of raw meat, the possibility of adulteration is not unthinkable. The importance of detecting fraud meat products is due to the inclusion of other types of meat or cheap carcass components or the non-compliance of...

BACKGROUND Despite the importance of health care fraud and the political, legislative and administrative attentions paid to it, combating fraud remains a challenge to the health systems. We aimed to identify, categorize and assess the effectiveness of the interventions to combat health care fraud and abuse. METHODS The interventions to combat health care fraud can be categorized as the interv...

Insurance fraud, which adds an estimated $85 billion per year to the total insurance bill in the United States, is an extremely serious problem for consumers, regulators, and insurance companies. This paper analyzes the effects of state legislation and market conditions on automobile insurance fraud from 1988 to 1999, a period exhibiting a substantial increase in the enactment of antifraud legi...

insurance industry experts believe that fraud is a destructive disaster in the insurance industry. over the years, many methods have been used in the literature for fraud detection, one of which is expert systems. fraud detection expert systems are based on the knowledge of experts in the field of insurance identify fraud. judgment of experts is mostly based on evidence, documents, qualitative ...

Detecting financial fraud is an important issue and ignoring this issue may cause financial and non-financial losses to individuals and organizations. The aim of this study is to test the ability of Beneish M-Score Model for detecting financial fraud among companies listed on Tehran stock exchange. The research sample consists of 137 companies listed on Tehran Stock Exchange for a period of 11 ...

Fraud is a significant problem in many industries, such as banking, insurance, telecommunication, and public service. Detecting and preventing fraud is difficult, because fraudsters develop new schemes all the time, and the schemes grow more and more sophisticated to elude easy detection. Many organizations have implemented fraud detection and prevention systems based on SAS data mining to help...

One of the management measures to reduce tax liabilities is non-payment of taxes through tax fraud. Because personality factors may play a role in explaining tax ethics, examining personality traits and aspects of tax fraud can help to better understand the factors that influence tax decisions. The main purpose of this study is to provide a model for detecting tax fraud based on the personality...