The first article of the journal features a paper entitled “Analytics for Insurance Fraud Detection: An Empirical Study”. The article proposes a method for data analytics that play a key role in detecting fraud. It is also stated that spending time and focusing on variables such as demographic information of the claimants, the characteristics of the claims, and auto insurance policy type can hugely help the insurance companies detect frauds.

Entitled “Indicators or Red Flags for Dealing with Suspected Claims”, the second article of the journal provides a list of insurance fraud indicators, the so-called ‘red flags’, and groups these indicators into three categories: general indicators, professional indicators, and professional/interrogative indicators. The presence of red flags does not necessarily mean that there is a fraud and it only calls for further investigation of the claim file.

The third article of this bimonthly journal deals with the insurance fraud detection program of South Korea. Entitled “Multiline Insurance Fraud Recognition System: A South Korean State Approach”, the paper focuses on the existing studies revolving around the experiences of some selected nation’s insurance industry in using advanced technologies and the state supports for the industry to fight against fraud cases. The results of the study show that the retrospective approaches that uncovers the individuals’ unethical attempts in earning profits by the means of insurance and rebukes any fraudulent acts, require cooperation from three parties: the insurance industry to scale up the market environment in a way that the original and credible claims are respected; the state to reform the legal ecosystem and to provide support in national and transnational levels in a way to treat insurance fraud as a ‘crime’; the academia to provide the theoretical fundamentals supported by empirical evidences in order to develop and leverage fraud prevention and detection programs.  

The full text of the articles are available at this link.