Detection of insurance premium fraud or abuse using a predictive software system
US7813944B1 · kind B1 · utility
Assignee
Inventors
Key dates
| Filing date | Aug 12, 1999 |
| Grant date | Oct 12, 2010 |
| Priority date | — |
| Expiry date | Aug 12, 2019 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG06Q40/08
- WIPO fieldIT methods for management
- WIPO sectorElectrical engineering
Abstract
Detection of insurance premium fraud is provided by a predictive model, which uses derived variables to assess the likelihood of fraud for each policy. The predictive model produces a score, which is a measure of the likelihood of premium fraud or abuse. The predictive model is included in a system that accepts policies to be considered for scoring, selects which policies are appropriate for scoring, stores data about the policies in a database, uses the data to derive variables for the model, and processes and outputs the model scores and related information. A rule-based analysis, which detects specific inconsistencies in the data that are indicative of premium fraud, may also be part of the system. The model scores and red-flag indicators from the rule-based analysis may be further processed to provide customized output for users.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.