{"title":"Automobile Insurance Fraud Detection Based on PSO-XGBoost Model and Interpretable Machine Learning Method","authors":"Ning Ding , Xiao Ruan , Hao Wang , Yuan Liu","doi":"10.1016/j.insmatheco.2024.11.006","DOIUrl":null,"url":null,"abstract":"<div><div>Automobile insurance fraud has become a critical concern for the insurance industry, posing significant threats to socio-economic stability and commercial interests. To tackle these challenges, this paper proposes a PSO-XGBoost fraud detection framework and uses explainable artificial intelligence to interpret the predictions. The framework combines an XGBoost classifier with the particle swarm optimization algorithm and is validated through a comparative evaluation against other models. Traditional methods, including SVM, Naive Bayes, Logistic Regression, and BP Neural Network, demonstrate moderate accuracy, ranging from 54.1% to 68.6%, while more advanced models like Random Forest reach up to 78.4%. Compared to the standard XGBoost, the PSO-optimized model achieves 3% superior accuracy, achieving an impressive 95% success rate. Moreover, SHAP is used to extract and visually depict the contribution of each feature to the model's predictions. It turns out that the policyholder's claim amount is the most significant factor in detecting automobile insurance fraud, with other factors such as vehicle type, responsible party, and the insurer's age also considerably influencing the prediction performance. This paper therefore proves that combining the PSO-XGBoost model with SHAP approach can substantially improve the early warning and prevention of automobile insurance fraud.</div></div>","PeriodicalId":54974,"journal":{"name":"Insurance Mathematics & Economics","volume":"120 ","pages":"Pages 51-60"},"PeriodicalIF":1.9000,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insurance Mathematics & Economics","FirstCategoryId":"96","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167668724001112","RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
Automobile insurance fraud has become a critical concern for the insurance industry, posing significant threats to socio-economic stability and commercial interests. To tackle these challenges, this paper proposes a PSO-XGBoost fraud detection framework and uses explainable artificial intelligence to interpret the predictions. The framework combines an XGBoost classifier with the particle swarm optimization algorithm and is validated through a comparative evaluation against other models. Traditional methods, including SVM, Naive Bayes, Logistic Regression, and BP Neural Network, demonstrate moderate accuracy, ranging from 54.1% to 68.6%, while more advanced models like Random Forest reach up to 78.4%. Compared to the standard XGBoost, the PSO-optimized model achieves 3% superior accuracy, achieving an impressive 95% success rate. Moreover, SHAP is used to extract and visually depict the contribution of each feature to the model's predictions. It turns out that the policyholder's claim amount is the most significant factor in detecting automobile insurance fraud, with other factors such as vehicle type, responsible party, and the insurer's age also considerably influencing the prediction performance. This paper therefore proves that combining the PSO-XGBoost model with SHAP approach can substantially improve the early warning and prevention of automobile insurance fraud.
期刊介绍:
Insurance: Mathematics and Economics publishes leading research spanning all fields of actuarial science research. It appears six times per year and is the largest journal in actuarial science research around the world.
Insurance: Mathematics and Economics is an international academic journal that aims to strengthen the communication between individuals and groups who develop and apply research results in actuarial science. The journal feels a particular obligation to facilitate closer cooperation between those who conduct research in insurance mathematics and quantitative insurance economics, and practicing actuaries who are interested in the implementation of the results. To this purpose, Insurance: Mathematics and Economics publishes high-quality articles of broad international interest, concerned with either the theory of insurance mathematics and quantitative insurance economics or the inventive application of it, including empirical or experimental results. Articles that combine several of these aspects are particularly considered.