Insurance fraud can be committed by either the buyer or the seller of an insurance policy.
The seller may offer policies from non-existent companies, fail to submit premiums, and churn policies to create more commissions. The buyer exaggerate claims, falsify medical history, post-date policies, sell their policy to for cash when they are diagnosed with a terminal disease, or fake their death or kidnapping. We will focus on the buyer insurance fraud in this post.
Historically, insurers have relied on linear regression of a small number of risk factors, largely reported by the policy-holder on a trust basis, to determine an insurance premium. However, a good prediction model of individual future insurance costs is becoming a business essential as competition in the insurance industry and low customer switching costs have become key drivers for insurers to build a pricing structure which covers their incurred costs.