Application of neural networks to the detection of fraud in workers’ compensation insurance : application to a Portuguese insurer

Project Work presented as the partial requirement for obtaining a Master's degree in Statistics and Information Management, specialization in Risk Analysis and ManagementInsurance relies on a complex trust-based relationship in which a policyholder pays in advance to be protected in the future. In Portugal, workers’ compensation insurance is mandatory which may restrict the course of action of both players. Insurers face significant losses, not only due to its core business, but also due to the swindles of claimants and policyholders. Insureds may not have in the market what they really want to acquire which may encourage fraudulent actions. Traditional fraud detection methods are no longer adequately protecting institutions in a world with increasingly sophisticated fraud techniques. This work focuses on creating an artificial neural network which will learn with insurance data and evolve continuously over time, anticipating fraudulent behaviours or actors, and contribute to institutions risk protection strategies