The SIGNAL insurance companies have developed an expert system for the support of its customer sales service. It was introduced at the end of 1993 and is currently used by approxi...
ABSTRACT: Knowledge systems for scientific and engineering endeavors must be able to insure the accuracy, completeness, and validity of their contents. When designed as such, these...
A. H. Liszka, William A. Stubblefield, Stephen D. ...
This paper describes an effective medical claim fraud/abuse detection system based on data mining used by a Chilean private health insurance company. Fraud and abuse in medical cla...
We describe a data mining system to detect frauds that are camouflaged to look like normal activities in domains with high number of known relationships. Examples include accounti...
The efficacy of expert systems often depends on the accuracy and completeness of the problem specification negotiated with the user. Therefore, efficient user interfaces are needed...