focuses attention on the insurance fraud problem in a setting where insurers repeatedly verify claims satisfied by service …

developed an optimal audit policy for the scoring methodology. Our application is meant for the audit of insurance fraud but can … Investigation Unit (SIU) when certain fraud indicators are observed. Fraud indicators are classified based on the degree to which … they reveal an increasing probability of fraud and this strategy remains optimal if the investigation policy is budget …

The purpose of this paper is to characterize the impact of fraud detection systems on the auditing procedure and the … claims through a costly audit (costly state verification). With fraud detection system insurers can depend their audit on the … signal of the system and auditing becomes more effective. This paper presents conditions under which insurance fraud and the …