• Journal of Information Technology Services
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• v.6 no.2
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• pp.1-18
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• 2007

Many researches have been done in insurance fraud as the amount and frequency of insurance fraud have been increasing continuously. In particular, the development of insurance fraud detection system using large database management techniques including data mining or link analysis based on visual method have been the main research topic in insurance fraud. However, this kinds of detection system were very ineffective to find unintentional insurance fraud happened by accident even though it was so good to find intentional and organized crime insurance fraud. Therefore, this research suggests insurance fraud as an ethical decision making and applies TPB(Theory of Planned Behavior) for the finding of reasons and prevention strategies of unintentional insurance fraud happened by accident. The results of research show that TPB is very appropriate model to explain the behavior of insurance fraud and that insurance agents force to do insurance fraud as affecting perceived behavior control. Therefore, education and pubic relations for insurance fraud are very effective for preventing insurance fraud and developing insurance service industry.

• Journal of Intelligence and Information Systems
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• v.20 no.3
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• pp.93-108
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• 2014

To support business decision making, interests and efforts to analyze and use transaction data in different perspectives are increasing. Such efforts are not only limited to customer management or marketing, but also used for monitoring and detecting fraud transactions. Fraud transactions are evolving into various patterns by taking advantage of information technology. To reflect the evolution of fraud transactions, there are many efforts on fraud detection methods and advanced application systems in order to improve the accuracy and ease of fraud detection. As a case of fraud detection, this study aims to provide effective fraud detection methods for auction exception agricultural products in the largest Korean agricultural wholesale market. Auction exception products policy exists to complement auction-based trades in agricultural wholesale market. That is, most trades on agricultural products are performed by auction; however, specific products are assigned as auction exception products when total volumes of products are relatively small, the number of wholesalers is small, or there are difficulties for wholesalers to purchase the products. However, auction exception products policy makes several problems on fairness and transparency of transaction, which requires help of fraud detection. In this study, to generate fraud detection rules, real huge agricultural products trade transaction data from 2008 to 2010 in the market are analyzed, which increase more than 1 million transactions and 1 billion US dollar in transaction volume. Agricultural transaction data has unique characteristics such as frequent changes in supply volumes and turbulent time-dependent changes in price. Since this was the first trial to identify fraud transactions in this domain, there was no training data set for supervised learning. So, fraud detection rules are generated using outlier detection approach. We assume that outlier transactions have more possibility of fraud transactions than normal transactions. The outlier transactions are identified to compare daily average unit price, weekly average unit price, and quarterly average unit price of product items. Also quarterly averages unit price of product items of the specific wholesalers are used to identify outlier transactions. The reliability of generated fraud detection rules are confirmed by domain experts. To determine whether a transaction is fraudulent or not, normal distribution and normalized Z-value concept are applied. That is, a unit price of a transaction is transformed to Z-value to calculate the occurrence probability when we approximate the distribution of unit prices to normal distribution. The modified Z-value of the unit price in the transaction is used rather than using the original Z-value of it. The reason is that in the case of auction exception agricultural products, Z-values are influenced by outlier fraud transactions themselves because the number of wholesalers is small. The modified Z-values are called Self-Eliminated Z-scores because they are calculated excluding the unit price of the specific transaction which is subject to check whether it is fraud transaction or not. To show the usefulness of the proposed approach, a prototype of fraud transaction detection system is developed using Delphi. The system consists of five main menus and related submenus. First functionalities of the system is to import transaction databases. Next important functions are to set up fraud detection parameters. By changing fraud detection parameters, system users can control the number of potential fraud transactions. Execution functions provide fraud detection results which are found based on fraud detection parameters. The potential fraud transactions can be viewed on screen or exported as files. The study is an initial trial to identify fraud transactions in Auction Exception Agricultural Products. There are still many remained research topics of the issue. First, the scope of analysis data was limited due to the availability of data. It is necessary to include more data on transactions, wholesalers, and producers to detect fraud transactions more accurately. Next, we need to extend the scope of fraud transaction detection to fishery products. Also there are many possibilities to apply different data mining techniques for fraud detection. For example, time series approach is a potential technique to apply the problem. Even though outlier transactions are detected based on unit prices of transactions, however it is possible to derive fraud detection rules based on transaction volumes.

• Korean Security Journal
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• no.53
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• pp.37-59
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• 2017

This study aims to contribute to the early detection of occupational fraud in the Korean financial industry by analyzing fraud symptoms. Firstly, the definition, cause of occupational fraud, and fraud symptoms were discussed through literature review. Secondly, survey data were collected from the employees of the financial industry such as bank, insurance, and securities companies to conduct statistical analysis. The result of analysis showed that the symptoms of 'excessive stock investment' and 'unsettled life style' were statistically significant predictors of fraud detection experience. Plus, 'tips and complaints' were the most frequent method for detecting occupational fraud in the Korean financial industry. The financial institutions can minimize the loss of occupational fraud by early detection through educating their employees and vendors on these important symptoms of occupational fraud.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.16 no.3
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• pp.1006-1027
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• 2022

In the crowdfunding market, various crowdfunding platforms can offer founders the possibilities to collect funding and launch someone's next campaign, project or events. Especially, healthcare crowdfunding is a field that is growing rapidly on health-related problems based on online platforms. One of the largest platforms, GoFundMe, has raised US$ 5 billion since 2010. Unfortunately, while providing crucial help to care for many people, it is also increasing risk of fraud. Using the largest platform of crowdfunding market, GoFundMe, we conduct an exhaustive search of detection on fraud from October 2016 to September 2019. Data sets are based on 6 main types of medical focused crowdfunding campaigns or events, such as cancer, in vitro fertilization (IVF), leukemia, health insurance, lymphoma and, surgery type. This study evaluated a detect of fraud process to identify fraud from non-fraud healthcare crowdfunding campaigns using various machine learning technics.

• International Journal of Computer Science & Network Security
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• v.21 no.9
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• pp.31-40
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• 2021

The increasing number of credit card fraud cases has become a considerable problem since the past decades. This phenomenon is due to the expansion of new technologies, including the increased popularity and volume of online banking transactions and e-commerce. In order to address the problem of credit card fraud detection, a rule-based approach has been widely utilized to detect and guard against fraudulent activities. However, it requires huge computational power and high complexity in defining and building the rule base for pattern matching, in order to precisely identifying the fraud patterns. In addition, it does not come with intelligence and ability in predicting or analysing transaction data in looking for new fraud patterns and strategies. As such, Data Mining and Machine Learning algorithms are proposed to overcome the shortcomings in this paper. The aim of this paper is to highlight the important techniques and methodologies that are employed in fraud detection, while at the same time focusing on the existing literature. Methods such as Artificial Neural Networks (ANNs), Support Vector Machines (SVMs), naïve Bayesian, k-Nearest Neighbour (k-NN), Decision Tree and Frequent Pattern Mining algorithms are reviewed and evaluated for their performance in detecting fraudulent transaction.

• The Korean Journal of Applied Statistics
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• v.35 no.5
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• pp.593-601
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• 2022

We call "fruad" the cases that are not frequently occurring but cause significant losses. Fraud detection is commonly encountered in various applications, including wafer production in the semiconductor industry. It is not trivial to directly extend the standard binary classification methods to the fraud detection context because the misclassification cost is much higher than the normal class. In this article, we propose the functional fraud detection support vector machine (F²DSVM) that extends the fraud detection support vector machine (FDSVM) to handle functional covariates. The proposed method seeks a classifier for a function predictor that achieves optimal performance while achieving the desired sensitivity level. F²DSVM, like the conventional SVM, has piece-wise linear solution paths, allowing us to develop an efficient algorithm to recover entire solution paths, resulting in significantly improved computational efficiency. Finally, we apply the proposed F²DSVM to the defective wafer detection problem and assess its potential applicability.

• Journal of the Korea Institute of Information Security & Cryptology
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• v.25 no.6
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• pp.1525-1540
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• 2015

Due to a rapid advancement in the electronic commerce technology, the payment method varies from cash to electronic settlement such as credit card, mobile payment and mobile application card. Therefore, financial fraud is increasing notably for a purpose of personal gain. In response, financial companies are building the FDS (Fraud Detection System) to protect consumers from fraudulent transactions. The one of the goals of FDS is identifying the fraudulent transaction with high accuracy by analyzing transaction data and personal information in real-time. Data mining techniques are providing great aid in financial accounting fraud detection, so it have been applied most extensively to provide primary solutions to the problems. In this paper, we try to provide an overview of the research on data mining based fraud detection. Also, we classify researches under few criteria such as data set, data mining algorithm and viewpoint of research.

• Journal of the Korean Institute of Intelligent Systems
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• v.11 no.5
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• pp.400-405
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• 2001

This paper addresses an effective approach of training neural networks classifiers for credit card fraud detection. The proposed approach uses evolutionary programming to trails the neural networks classifiers based on maximization of the detection rate of fraudulent usages on some ranges of the rejection rate, loot minimization of mean square error(MSE) that Is a common criterion for neural networks learning. This approach enables us to get classifier of satisfactory performance and to offer a directive method of handling various conditions and performance measures that are required for real fraud detection applications in the classifier training step. The experimental results on "real"credit card transaction data indicate that the proposed classifiers produces classifiers of high quality in terms of a relative profit as well as detection rate and efficiency.

• Journal of the Korea Society of Computer and Information
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• v.25 no.3
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• pp.117-127
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• 2020

Recently, proving insurance fraud has become increasingly difficult because it occurs intentionally and secretly via organized and intelligent conspiracy by specialists such as medical personnel, maintenance companies, insurance planners, and insurance subscribers. In the case of car accidents, it is difficult to prove intentions; in particular, an insurance company with no investigation rights has practical limitations in proving the suspicions. This paper aims reveal that the detection of organized and conspired insurance fraud, which had previously been difficult, could be dramatically improved through conspiring insurance fraud detection modeling using social network analysis and visualization of the relation between suspected group entities and by seeking developmental research possibilities of data analysis techniques.

• Industrial Engineering and Management Systems
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• v.9 no.2
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• pp.141-156
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• 2010

Despite all attempts to prevent fraud, it continues to be a major threat to industry and government. Traditionally, organizations have focused on fraud prevention rather than detection, to combat fraud. In this paper we present a role mining inspired approach to represent user behaviour in Enterprise Resource Planning (ERP) systems, primarily aimed at detecting opportunities to commit fraud or potentially suspicious activities. We have adapted an approach which uses set theory to create transaction profiles based on analysis of user activity records. Based on these transaction profiles, we propose a set of (1) anomaly types to detect potentially suspicious user behaviour, and (2) scenarios to identify inadequate segregation of duties in an ERP environment. In addition, we present two algorithms to construct a directed acyclic graph to represent relationships between transaction profiles. Experiments were conducted using a real dataset obtained from a teaching environment and a demonstration dataset, both using SAP R/3, presently the predominant ERP system. The results of this empirical research demonstrate the effectiveness of the proposed approach.