Concepedia

Claim Pattern Analysis

Claim Pattern Analysis is a methodological framework in insurance claim investigation that systematically identifies, categorizes, and evaluates recurrent behavioral, transactional, or contextual indicators within claims data to distinguish potentially fraudulent or anomalous claims from legitimate ones.

35

Publications

1.4K

Citations

83

Authors

41

Institutions

Publications per year

2017–2026

15

Parents

Publications

35

A Fraud Detection Approach with Data Mining in Health Insurance

Cuneyt Asuk · Procedia - Social and Behavioral Sciences · 2012 · 152 citations · Full text

, , +15

An analysis of customer retention and insurance claim patterns using data mining: a case study

Robert J. Willis, Michael J. Brooks · Journal of the Operational Research Society · 2000 · 134 citations

, , +14

Modelling different types of automobile insurance fraud behaviour in the Spanish market

Manuel Artı́s, Mercedes Ayuso, Montserrat Guillén · Insurance Mathematics and Economics · 1999 · 112 citations

, , +16

Using text mining and natural language processing for health care claims processing

Fred Popowich · ACM SIGKDD Explorations Newsletter · 2005 · 71 citations

, , +15

Applying Data Mining Techniques to a Health Insurance Information System

Marisa Viveros, John P. Nearhos, Michael Rothman · Very Large Data Bases · 1996 · 70 citations

, , +12

1–5 of 35

Authors

83

  1. EA
    Emiliano A. Valdez

    University of Connecticut, United States

    2 publications · 25 citations

    2

    h-index

  2. VR
    Venkata Ramana Saddi

    Sri Eshwar College of Engineering

    2 publications · 62 citations

    2

    h-index

  3. JL
    J. Logeshwaran

    Sri Eshwar College of Engineering

    2 publications · 62 citations

    2

    h-index

  4. GG
    Guojun Gan

    University of Connecticut, United States

    2 publications · 25 citations

    2

    h-index

  5. TS
    Tony Siu Tung Wong

    University of Hong Kong, Hong Kong SAR China

    1 publications · 39 citations

    1

    h-index

1–5 of 83

Institutions

41

  1. Sri Eshwar College of Engineering

    Coimbatore, India

    2 h-index

    2 publications

    62 citations

  2. University of Amsterdam

    Amsterdam, The Netherlands

    2 h-index

    3 publications

    89 citations

  3. Université Libre de Bruxelles

    Brussels, Belgium

    2 h-index

    2 publications

    49 citations

  4. University of Connecticut

    Storrs, United States

    2 h-index

    7 publications

    88 citations

  5. Guru Gobind Singh Indraprastha University

    Delhi, India

    1 h-index

    1 publications

    47 citations

  6. Swiss Re (Switzerland)

    Zurich, Switzerland

    1 h-index

    1 publications

    55 citations

  7. Universiti Teknologi Petronas

    Ipoh, Malaysia

    1 h-index

    3 publications

    93 citations

  8. University of Iceland

    Reykjavik, Iceland

    1 h-index

    4 publications

    52 citations

1–8 of 41

Venues

  1. Insurance Mathematics and Economics

    6 publications · 266 citations

    6

    h-index

  2. Risks

    2 publications · 25 citations

    2

    h-index

  3. Expert Systems with Applications

    2 publications · 59 citations

    2

    h-index

  4. Journal of the Operational Research Society

    OR · 2 publications · 146 citations

    2

    h-index

  5. SSRN Electronic Journal

    Repository · 2 publications · 68 citations

    2

    h-index

1–5