Abstract— The term insurance fraud refers to the commission of any act with the intent to obtain an outcome that is favorable, but fraudulent during an insurance claim. Including single prescription medicines is extremely high, card repeatedly within a certain amount of time for medicine, etc. This paper is based on methods of hierarchical cluster analysis and generalized squared distance discriminate method to record medical coverage of transaction data at outliers for finding out the corresponding abnormal record which indicates potential fraud.
Keywords— medical insurance fraud, hierarchical cluster analysis, training sample, generalized square distance discrimination.
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