2022 3rd International Conference on Intelligent Engineering and Management (ICIEM)

Automobile Insurance Fraud Detection: An Overview

Ajay Kini Rohit Chelluru Kushang Naik
Computer Engineering Computer Engineering Computer Engineering
SRIEIT, Goa University SRIEIT, Goa University SRIEIT, Goa University
2022 3rd International Conference on Intelligent Engineering and Management (ICIEM) | 978-1-6654-6756-8/22/$31.00 ©2022 IEEE | DOI: 10.1109/ICIEM54221.2022.9853043

Shiroda, India Shiroda, India Shiroda, India

kini.ajay2315515@gmail.com chrohit2323@gmail.com kushang345@gmail.com

Dattdeep Naik Shailendra Aswale Pratiksha Shetgaonkar

Computer Engineering Computer Engineering Computer Engineering
SRIEIT, Goa University SRIEIT, Goa University SRIEIT, Goa University
Shiroda, India Shiroda, India Shiroda, India
naikdattdeep2k@gmail.com aswale.shailendra@gmail.com pratiksha.shetgaonkar@ritgoa.ac.in

Abstract— Frauds are committed in a highly professional way,
due to which companies sometimes fail to identify that any fraud
has occurred. Unprofessional frauds are also taking place, but
they can be identified easily by the companies. Detecting a fraud
traditionally is carried out using manual techniques, but by
using data mining and algorithms from machine leaning or deep
learning the detection process is automated and the frauds can
be detected in a more efficient and structured way with more
accuracy. The processing speed of information is gradually
increased by using various algorithms of machine learning. The
highlight of this survey paper is to compare different methods
based on their performance. The algorithms help by detecting
crucial patterns found in historical data and recognizing them if
found in input data. The survey provides proper understanding
of different methodologies used for automobile fraud detection.
Sometimes machine learning cannot be used to detect multiple
frauds involving behavior changes. We propose a vehicle
insurance fraud detection mechanism using LSTM RNN
networks. LSTM is commonly used in deep learning to design
time series information.
Keywords— Fraud detection, Automobile, Insurance, Random
Forest, K-Means, RNN, LSTM.
I. INTRODUCTION
Fraudulent claims have been increasing more due to
digitalization. The scammers somehow bypass the present
fraud detection systems and find loopholes and make
fraudulent claims. It causes a lot of problems for the existing
as well as new policyholders as the policy prices are increased
to cope up with the losses from fraudulent claims. It has been
observed that systems follow a supervised approach [1].
With the digitizing of services, there has been ease for
consumers but has been a challenging experience for
insurance companies for tracing the genuine claims.
However, this can be lowered by building a system using
cutting-edge technologies, but it requires high investment for
short-term implementation. But, in long term, this will be
useful for the smooth working of the system and for
efficiently carrying out the day-to-day claims by
policyholders.
Exploited accidents are the ones in which the damage
occurred in the past or the damage is intentionally increased
for claiming more amount. Fabricated accidents are the ones
that did not take place or the complaint has not been
registered. Staged accidents, where vehicle under policy
cover is used or the one which is rented for representing the
accident. Provoked accident, where the victim is not ready to
accept the fault and blames the other vehicle driver [2].
It is very difficult to fight against insurance fraud, it is a
challenging task to do. Every year companies or
organizations which provide insurance suffer a lot due to
false insurance claims. According to records, more than 21%
of vehicle insurance claims consist of questionable fraud, but
legal action is taken only on less than 3% of the suspected
fraud. Insurance fraud detection traditionally depends mostly
on the survey and expert inspection. Insurance fraud must be
detected before insurance claim payment. Detecting frauds
manually is a tedious task. Machine learning methods can
play big roles in detecting suspicious cases, which will help
to minimize losses, both to insurance organizations and
policyholders. Good predictive methods will find fault
insurance claims [3].
The frauds are categorized into different categories like
financial frauds, auto indemnity frauds, credit card frauds. It
is further classified into soft insurance fraud and hard
insurance fraud. When insurance is claimed for an accident
that actually has not occurred, then it reflects as hard
insurance. When the part of the accident is exaggerated to
claim more insurance reward, then it reflects as soft insurance
[4].
The frauds are classified into opportunistic/professional and
organized-group frauds. The organized-group frauds are
comparatively less than opportunistic/professional frauds.
Traditional methodologies are good, but they cannot be
extended beyond the limit to track opportunistic/professional
frauds. Opportunistic frauds are hard to track, but
professional frauds are much more complex to track [5].
As stated in [6], for survival, the insurance companies are
imposing losses on consumers by increasing the policy
premium. The importance to discover a structured

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 2022 3rd International Conference on Intelligent Engineering and Management (ICIEM)

methodology for fraud detection as early as possible is

necessary. Inability to detect fraud issues, the revenue of
insurance companies will be adversely affected. Also, If the
company is listed publicly, the market capitalization may
gradually decrease, which leads to lower bottom-line growth
annually. So, by looking at the holistic view it affects the
national economic growth. Due to low national growth, the
employment sector is adversely affected. In conclusion,
insurance fraud is a noticeable economic issue for insurance
companies and national economies. So, there is a need to look
into this problem.
This paper has been further divided into sections as follows:
Section II briefly surveys research work. Section III outlines
probable challenges and future research directions. In section
IV, proposed research work is presented and section V
concludes the paper.
II. LITERATURE REVIEW
The following section contains the list of methods to detect
insurance fraud detection. Further, the section is divided into
various sub-sections according to the methodology used.
A. Random Forest
As stated in [10], the random forest performance difference
over insurance claim and premium dataset was less and
proved that there is no need of gain ratio evaluation method
to increase performance.
As stated in [11], it is found that the random forest model was
effective on original dataset of a company. This model
doesn’t require much pre-treatment on collected dataset, but
should look for missing values.
The research work discussed in this sub-section is
summarized in Table I.
B. Logistic Regression
It comes under the type of supervised learning classification
method. Considering the number of categories, logistic
regression can be divided into Binomial, Multinomial, and
Ordinal. It comes under Binary classification. It operates on
the group rather than single individual values. Each outcome
is assigned a probability score using which a sample class is
determined. The hypothesis is simplified using regularization
in logistic regression and the cost function appended with
penalty term [13].

In classification, the maximum of all values is considered,
while, regression the average of the result of trees is
considered. It is used by beginners to create a strong model.
It consists of many decision trees. It can be used to manage
missing values quite efficiently [7].
According to [8], it displays accurate result without any
information planning, actual modelling or demonstrating. To
be explicit it is dependent on decision trees. The ultimate aim
is to develop various decision trees with subsets of the
dataset.
Mariya Mathew [9] proposed that estimation process is
created by increasing number of trees. Python library called
Scikit-learn (sklearn), is used in training the model. Dataset
from a moto insurance organisation is used to train the model.
According to [14], it is utilized to identify the bonds between
more than one independent variables with dependent
variable. Many studies consider Logistic Regression method
as benchmark for further work. It is basically undertaken
using many mathematical technologies for processing the
dataset with algorithms.
The model is developed considering the claim files of
insurers. Executives are interested in detailed examination.
Only 0.64% of vehicle insurance files were used. To
complete automatic examination profitability y is mandatory
[15].
The research work discussed in this sub-section is
summarized in Table II.

TABLE I. INSURANCE FRAUD DETECTION USING RANDOM FOREST

Ref Dataset Dataset Tools/ Methodologies Learning Data mining Merits Demerits Accuracy
Type Technologies approach category
[7] 28,994 NA FSA Random Supervised Classification FSA reduces Decision tree 96.73%
Samples Forest, One dimensionality is better
class support considering
vector machine recall
[8] NA Unlabelled Feature Random Supervised Classification Analyzes Data is chosen NA
determination Forest, KNN missing data randomly
[9] Motor Labelled AdaBoost Random Forest Supervised Classification Sums huge Overfitting 93.01%
insurance classifier, number of problem
dataset RMSE classification
trees
[10] Synthetic NA WEKA Random Supervised Classification Works good for Requires more 99.59%
dataset Forest, Naïve categorical and computational
Bayes, J48 continuous resources
variables

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 2022 3rd International Conference on Intelligent Engineering and Management (ICIEM)

[11] 1000 Labelled Classification, Random Forest Supervised Classification Highly efficient High training NA
Samples prediction in processing time
larger dataset
[12] Oracle NA RFM Random Forest Supervised Classification Deals with high Heterogeneity Precision: 71%
(Berger) (Recency, dimensionality of claims are
Frequency, not taken into Recall: 90%
Monetary) account Accuracy: NA
Model

C. Decision Tree
According to Janhavi Naik [18], it is an unsupervised
Decision trees are used to represent independent properties machine learning algorithm. Dataset is classified as clusters
and dependent properties in a tree-shaped structure. It is used and the basic aim is to define N centroids for each cluster to
to handle input and output variables. IF-THEN expressions be placed far from each other. Points from the dataset are
are the classification extracted from the decision trees and taken and associated with nearest centroids, when no points
they are logical ANDed [16]. are remaining N new centroids are re-calculated. A loop is
formed as a consequence of binding between nearest centroid
It is a machine learning algorithm that expresses independent
and dataset points. Finally, N new centroids change their
attribute with dependent attribute. The variety of applications
locations.
include instances from homeless security, customs
declaration fraud.
Ali Ghorbani [19] mentioned that the fraudulent cases are
The steps of classification and learning are typically fast, but taken from Iranian companies. Common ways are selected to
sometimes performance can decrease gradually. Applying simulate losses in a fake manner. The Cases having problem
C5.0 is considered as marginal improvement over C4.5 [17]. with their license are compared information is transferred into
a csv file.
Papers discussed in this sub-section are summarized in Table
III.
The research work discussed in this sub-section is
D. K-Means summarized in Table IV.
TABLE II. INSURANCE FRAUD DETECTION USING LOGISTIC REGRESSION
Learning Data mining
Ref Dataset Dataset Type Tools/Technologies Methodologies Merits Demerits Accuracy
Approach category
Unknown
923 Regularization Logistic Binary records are Maintaining data
[13] Labelled Supervised 69%
Samples Method Regression classification classified are is a tedious job
very fast
Solid
Logistic Binary Unknown inner
[14] NA Labelled Statistical methods Supervised generalizatio 95.1%
Regression classification structure
n
Adjuster’s decision, Some points of
Logistic Binary Simultaneou
[15] NA Labelled Threshold Supervised the fraud can be 47.1%
Regression classification s detection
comparison missed

TABLE III. INSURANCE FRAUD DETECTION USING DECISION TREE

Dataset Learning Data mining
Ref Dataset Tools Methodologies Merits Demerits Accuracy
Type Approach category
Churn
prediction Might be
Support vector Probabilistic Produces higher
[16] dataset/ Labelled Supervised Classification unstable at AUC: 7605
under-sampling neural network AUC
Insurance times
dataset
Scaling and
Class rules
normalization
[17] NA Labelled C4.5 Decision Tree Supervised Classification are easily NA
of data is not
generated
required
TABLE IV. INSURANCE FRAUD DETECTION USING K-MEANS
Dataset Learning Data mining
Ref Dataset Tools Methodologies Merits Demerits Accuracy
Type Approach category
Manually given
dataset based Statistical K-Means, Data Hybrid Fixed number
[18] Unlabelled Unsupervised Clustering NA
on real-time package Mining model of clusters
mechanism
New
Euclidean examples can Dependent on
[19] NA Unlabelled K-Means Unsupervised Clustering NA
distance be easily initial values
adapted

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 2022 3rd International Conference on Intelligent Engineering and Management (ICIEM)

E. RNN
Naïve Bayes is a powerful method for predicting class values
RNN is widely used in applications having sequential data,
of future. It is used for Binary classification. The reason
such as speech data, language, audio. The units of RNN are
behind the name is each property of a variable is independent
structured consequently. Internal memory is used to process
of the target variable. Fuzzy logic is also being used which is
inputs in RNN. The training time of RNN is more compared
used for abundant data. Time complexity is improved and it
to Feed-Forward Neural Networks (FFNNs), also it is more
is easy to implement. It has a considerable amount of
difficult to train than FFNNs [20].
accuracy. It is also proved to be reliable and also has many
According to [21], Deep learning techniques such as applications for identifying fraud [25].
recurrent neural networks are used in fraud detection as they
are marked as precise algorithms. RNN is marked as a Claim files were randomly selected from population files and
dynamic approach that can handle multiple transactions. a model was developed, which treated all possible fraud
Sequence classifier was introduced that is based on the LSTM cases. Insurance executives are interested in detailed
networks. investigations. According to [26], classified the frauds such
as inner vs outer and softer vs harder. To capitalize on soft vs
RNN’s are capable of processing long term dependencies.
hard, soft frauds were partially true whereas hard frauds were
They are feed-forward networks that has nodes which takes
completely fake.
present input and hidden node information of last steps [22].
The research work discussed in this sub-section is The conclusion from the analysis is that feature selection
summarized in Table V. method has considerable influence in determination of
anomalies in the insurance fraud detection dataset [27].
F. Miscellaneous
By referring to [24], Spectral Ranking of Anomalies (SRA) The research work discussed in this sub-section is
is the latest unsupervised method for anomaly detection. It summarized in Table VI.
has high precision compared to other unsupervised methods.
TABLE V. INSURANCE FRAUD DETECTION USING RNN
Learning Data mining
Ref Dataset Dataset Type Tools Methodologies Merits Demerits Accuracy
approach category
Real-world More suitable for
data for Semi- Neural solving
[20] NA LDA DNN, RNN NA NA
insurance supervised networks regression
company problems.
594643
Semi- Neural Information is Handling of
[21] Samples Structured Banksim LSTM RNN NA
supervised networks retained new patterns
(Kaggle)
Amazon Classifier trained
Tensorflow, RNN RBM Semi- Neural Failure to
[22] review/real Structured by augmented set NA
AutoEncoder GAN supervised networks generalize
world performed better
Structured/Un LR GBT RNN Semi- Neural Increased
[23] NA XGBoost NA NA
structured GNN supervised networks secretiveness

TABLE VI. INSURANCE FRAUD DETECTION USING MISCELLANEOUS

Dataset Learning Data mining
Ref Dataset Tools Methodologies Merits Demerits Accuracy
Type approach category
Real auto- Spectral
Higher speed
insurance Ranking of Not scalable to 0.35 for 10
[24] Unlabelled NA Unsupervised Clustering and fast alarm
dataset/Synt Anomalies large samples runs
rate
hetic dataset (SRA)
Fuzzy- Accuracy
reliable on
[25] NA Unlabelled rule based Fuzzy Logic Unsupervised Clustering decreases with NA
large dataset
technique large datasets
Automated
Data Functional Fraud control prevention of
[26] NA NA Unsupervised NA NA
mining classification is dynamic. fraud lacks
accountability
Minority Feature Without FSM, KNN: 99%
Better
[27] report open Labelled selection SVM, KNN Supervised Classification accuracy
Accuracy SVM: 82%
dataset method decreases

III. CHALLENGES AND FUTURE RESEARCH On the basis literature review in this paper following are
DIRECTIONS challenges and future research directions discussed briefly.
Automobile Insurance Fraud Detection is still an evolving

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 2022 3rd International Conference on Intelligent Engineering and Management (ICIEM)

area of research. Despite current study and research being

undertaken in this domain. In recent years, many challenges
and open key issues remain that require urgent attention. In
this section related to open issues and research, directions are
outlined for future explorations.
• Overlapping data: The majority of the fraud transactions
are made to look legitimate. The overlapping problems
can be solved by designing a fraud detection system
considering proper classifiers that will predict outcomes
with more accuracy.
• Noisy data: Data can consist of impurities that make it
inconsistent and difficult to use. The effectiveness and
efficiency of the classifier will be negatively affected.
Thus, reducing predictive capability. Data needs to be
used directly in the model.
• Skewed distribution: In Skewed distribution, there are
fewer samples. In this learning approach, there are
various types of problems that can occur like the
incapacity of learners in detecting patterns found in the
data. Further, the performance of the classifier is affected
by this imbalance class problem thus ignoring the
minority class.
• Misclassification cost: Sometimes there can be instances
where the transactions are genuine but are identified as
fraudulent (false positive). Similarly, fraudulent Figure 1. Conceptual Automobile Insurance Fraud Detection Framework.
transactions are not detected at all (false negative). The
latter case can be more expensive. Proper classification In this approach, for processing the received data, and fraud
has to be maximized while reducing false cases. detection the technologies used are python language and
• Difficulty in proving fraud: Detecting a fraud based on machine learning libraries like pandas, TensorFlow, etc.
suspicious activity is not a legal proof, one needs strong After identifying the suspicious groups using training and
legal evidence of fraud. There are predominant signs that testing, final results are outputted.
suggest degree of risk, but still fail as conclusive proof. In the above figure, Input can be of two types, namely Raw
If the insurers are seeking for detailed investigation, the Automobile insurance data or preexisting dataset. Next the
process can be much more expensive. collected input is given to data preprocessing phase where in
Data Normalization, Data Validation, Feature Extraction are
IV. PROPOSED APPROACH performed. Further a model is built and trained from the
contents extracted from previous phase. Multiple test cases
The future scope of this paper can be modifying the are tested in the model based on which output is generated.
algorithms with time complexities as it is not discussed
currently. Moreover, some of the unsupervised machine V. CONCLUSION
learning algorithms can be manipulated in such a way that it
gives best performance. This paper gives a clear overview and various technologies
have been compared used in automobile insurance fraud
Data collection- The dataset is taken from Kaggle, which is a detection. The traditional methodologies were used earlier for
raw dataset. Classify the data into individual and target this purpose, but now they are replaced with modern ones.
columns. Once data is received, validations are performed. Every method has its advantages and disadvantages. Some
Then check if the number of columns and data type are valid common methods like Random Forest, Decision Tree,
or not. Logistic Regression, K-Means, and others are summarized
Data Preprocessing- Dataset which is collected from the and key attributes are displayed in the form of tables. The
dataset should be Pre-processed for the elimination of deep learning methods are proven more accurate than
unwanted data by using tools like WEKA/python. WEKA traditional methods. In addition, different key challenges and
consists of options like Cluster, Visualize, Pre-process, research direction are outlined for further explorations.
Attribute and Classify.
In this paper, we have proposed the conceptual framework for
Automobile Insurance Fraud Detection, which will be

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 2022 3rd International Conference on Intelligent Engineering and Management (ICIEM)
implemented using the RNN model, TensorFlow, Python in
due course of time.
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