Journal of the Korea Society of Computer and Information (한국컴퓨터정보학회논문지)

Korean Society of Computer Information (한국컴퓨터정보학회)
권호 표지
DOI QR코드

DOI QR Code

A Study on Conspired Insurance Fraud Detection Modeling Using Social Network Analysis

  • Kim, Tae-Ho (Graduate School of Information Security, Korea University) ;
  • Lim, Jong-In (Graduate School of Information Security, Korea University)
  • Received : 2020.02.14
  • Accepted : 2020.03.19
  • Published : 2020.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

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.

최근 보험사기는 의료인, 정비업체, 보험설계사 등 분야별 전문가와 보험가입자가 공모하여 조직화, 지능화되는 형태로 계획적이고 은밀하게 이루어지고 있어 그 혐의를 입증하는 것이 점점 더 어려워지고 있다. 자동차사고의 경우 고의를 입증하기가 쉽지 않으며 특히 수사권이 없는 보험사가 혐의를 입증하기는 현실적으로 한계를 가지고 있다. 본 논문에서는 공모형 보험사기 적발을 위한 Social Network Analysis(SNA), 혐의그룹 개체간 관계 시각화 기법 등 공모형 보험사기 혐의자 적발 기법을 통해 기존에는 알아내기 어려웠던 조직형, 공모형 보험사기 파악이 획기적으로 개선될 수 있다는 점을 살펴보고 조직적 공모형 보험사기 적발을 위한 데이터 분석기법의 발전적 연구 방향을 모색해 보고자 한다.

Keywords

References

  1. Gwangju metropolitan police agency, "Insurance crime white paper", 2017.12
  2. Financial supervisory service press release, " Insurance fraud detected 800 billion won and reported reward 2.4 billion won in 2018", 2019.4.23.
  3. Mi-Suk Park, "The Reform Measures for Investiga tion in the Area of Financial Unlawful Act", Korean Institute of Criminology, 2002.12.
  4. Jong-Seong Eun, "A study on the aspects of insuran ce and measures to cope with", Korea Business Law Association, pp. 13-38, 2001.10.
  5. Semin Park "A Study on the Analysis on the Current Countermeasure for the Insurance Fraud and Its Reform Measure" Korean legal Center pp. 140-177, Jun. 2009
  6. Seong-Hee Kim and Rho-Sa Chang, "The Study on the Research Trend of Social Network Analysis and the its Applicability to Information Science" Jonornal of The Korean Society for Information Management, pp. 71-87, Dec. 2010
  7. Sang-kuk Kim "Social Network Analysis and Industrial engineering" Industrial Engineering Magazine, pp. 24-32, Mar. 2011
  8. Uchang Park , "Relational Approach for Social Network Analysis" Jounal of KIIT, pp. 143-151, Sep. 2012
  9. Sung-Je Park, Je-Uk Lee "Big Data era of social network analysis techniques and the use of the sports field strategy " The Korea Journal of Sports Science," pp. 933-946, Vol. 23. 2014
  10. Jimin Park and Seong-Woong Yoon and Sang-Hoon Lee "Finding Relevant Peoples in the Gated Community based on Social Network Analysis" Korea Information science society, pp. 150-152, Dec. 2014
  11. Min-Sik Lee , "Co-Offending Structure in Drug Crime : A Network Approach " Korean Institute of Criminology , pp. 231-263, Jun. 2007
  12. Soojung Lee, "Improving Performance of Jaccard Coefficient for Collaborative Filtering", Journal of the Korea Society of Computer and Information 21(11), pp.121-126, 2016.11 https://doi.org/10.9708/jksci.2016.21.11.121
  13. Minjae Kim, Sangjin Lee, "Measures of Abnormal User Activities in Online Comments Based on Cosine Similarity", Journal of the Korea Institute of Information Security & Cryptology 24(2), pp. 335-343, 2014.4 https://doi.org/10.13089/JKIISC.2014.24.2.335
  14. Sung-Je Park, Jea-Woog Lee, "Structure and use knowledge map of sports field through text mining and social network analysis", Korean Journal of Sports Science 26(4), pp.639-653, 2017.8 https://doi.org/10.35159/kjss.2017.08.26.4.639
  15. Jay-Bok Lee, "Legislative Measures to Combat for the Prevention of Life Insurance Crime", Korea Business Law Association, pp. 111-143, 2001.10
  16. Wasserman, Stanley, Faust, Katherine, Granovetter, Mark, "Social Network Analysis- Methods and Applications", Cambridge Univ, 1994.11