Auto insurance fraud detection: Machine learning and deep learning applications

IF 1.9 3区 经济学 Q2 BUSINESS, FINANCE
Journal of Risk and Insurance Pub Date : 2026-05-31 Epub Date: 2026-03-19 DOI:10.1111/jori.70046
Meryem Yankol-Schalck
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引用次数: 0

Abstract

Insurance fraud detection remains a challenging task due to severe data imbalance, evolving fraudulent behaviors, and the high false-negative rates exhibited by several state-of-the-art machine learning models. Traditional approaches often struggle to generalize real-world data and capture complex, non-linear feature interactions in insurance claims. This study aims to improve fraud detection performance by leveraging recent advances in deep learning. A comprehensive comparison between traditional machine learning models and deep learning techniques is performed on two distinct datasets using resampling strategies. The study proposes three convolutional neural network-based architectures to improve detection accuracy. Furthermore, a hybrid machine learning deep learning (ML-DL) framework is introduced to more effectively leverage discriminative features. Experimental results demonstrate that deep learning models would vary on each dataset due to the presence of variations in data characteristics, while the proposed hybrid ML–DL model achieves the best overall performance, highlighting its effectiveness in improving fraud prediction accuracy.

汽车保险欺诈检测:机器学习和深度学习应用
由于严重的数据不平衡、不断演变的欺诈行为以及几种最先进的机器学习模型所表现出的高假阴性率,保险欺诈检测仍然是一项具有挑战性的任务。传统的方法往往难以概括现实世界的数据,并在保险索赔中捕捉复杂的非线性特征相互作用。本研究旨在通过利用深度学习的最新进展来提高欺诈检测性能。在使用重采样策略的两个不同数据集上,对传统机器学习模型和深度学习技术进行了全面比较。该研究提出了三种基于卷积神经网络的架构来提高检测精度。此外,引入了混合机器学习深度学习(ML-DL)框架,以更有效地利用判别特征。实验结果表明,由于数据特征存在差异,深度学习模型在每个数据集上都会有所不同,而本文提出的混合ML-DL模型的整体性能最好,突出了其在提高欺诈预测精度方面的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.50
自引率
15.80%
发文量
43
期刊介绍: The Journal of Risk and Insurance (JRI) is the premier outlet for theoretical and empirical research on the topics of insurance economics and risk management. Research in the JRI informs practice, policy-making, and regulation in insurance markets as well as corporate and household risk management. JRI is the flagship journal for the American Risk and Insurance Association, and is currently indexed by the American Economic Association’s Economic Literature Index, RePEc, the Social Sciences Citation Index, and others. Issues of the Journal of Risk and Insurance, from volume one to volume 82 (2015), are available online through JSTOR . Recent issues of JRI are available through Wiley Online Library. In addition to the research areas of traditional strength for the JRI, the editorial team highlights below specific areas for special focus in the near term, due to their current relevance for the field.
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