If one is interested in managing fraud, one must measure the fraud rate to be able to assess the degree of the problem and the effectiveness of the fraud management technique. This paper offers a robust new method for estimating fraud rate, PRIDIT-FRE (PRIDIT-based Fraud Rate Estimation),...

We present an unsupervised learning method for classifying consumer insurance claims according to their suspiciousness of fraud versus nonfraud. The predictor variables contained within a claim file that are used in this analysis can be binary, ordinal categorical, or continuous variates. They...

This article presents a conceptual framework for operationalizing strategic enterprise risk management (ERM) in a general firm. We employ a risk-constrained optimization approach to study the capital allocation decisions under ERM. Given the decision maker's risk appetite, the problem of...

This paper examines the effectiveness of using a hedging strategy involving a basis derivative instrument to reduce the negative financial consequences of weather-related risks. We examine the effectiveness of using this basis derivative strategy for both summer and winter seasons, using both...

This research uses an indirect methodology to examine the effects of health insurance mergers and acquisitions by analyzing the impact of insurers' scale of operations and group affiliation status on benefits, costs, and efficiency from the perspective of various stakeholders. The analysis can...

The recent final rule on Medicaid managed care establishes the minimum medical loss ratio (MLR) requirement for Medicaid managed care and contains several provisions to strengthen delivery and payment reforms and improve efficiency and quality of care. Accordingly, this research examines the...

Economic, political, and demographic changes, technological advances, two crashes of the economy, ethical scandals, and other developments in the business environment have strained the roles and enrollments of American universities' business schools. The b-schools have not responded adequately....