Machine learning improves mortality prediction for elderly Medicare patients.
problem Improving mortality prediction for elderly Medicare patients using limited data.
method Developed and tested machine learning classifiers on Medicare claims data.
result Machine learning classifiers outperform logistic regression, especially with improved feature sets.
Developed a cost and revenue model for HEMS to estimate breakeven transport volumes under different reimbursement and labor cost assumptions.
problem Estimating breakeven transport volumes for HEMS under varying reimbursement and labor cost assumptions.
method Developed a two-part model: cost framework and actuarial revenue model using healthcare encounter data and payer reimbursement rates.
result Estimated breakeven transport volumes under different reimbursement and labor cost assumptions.
Bayesian method corrects timing misalignment in recurrent event studies.
problem Estimating differences in event rates under two treatments with timing misalignment.
method g-computation procedure with joint semiparametric Bayesian model.
result Correctly estimates average causal effects under right-censoring.
Study develops a predictive model to reduce hospital readmissions.
problem Inaccurate readmission risk prediction models in clinical settings.
method Used Genetic Algorithm and Greedy Ensemble to optimize a readmission risk prediction model.
result Developed a useful risk prediction model for reducing unplanned readmissions.
Reinforcement learning improves insurance claims reserving by learning from all claim trajectories.
problem Traditional reserving models learn only from settled claims, missing valuable data from ongoing claims.
method Formulated as a Markov decision process, uses reinforcement learning to update OCL estimates sequentially.
result Soft Actor-Critic implementation achieves competitive claim-level accuracy and strong aggregate performance.
The study analyzes how bonus-malus systems and delayed claims settlement affect insurance companies' financial stability.
problem Analyzing the impact of bonus-malus systems and delayed claims settlement on insurance companies' financial stability.
method Examined a discrete-time risk model with time-varying premiums, evaluating two types of claims and settlement delays.
result Delayed settlement of by-claims leads to lower ruin probabilities under specific assumptions.
Deep Claim predicts payer responses from claims data using deep learning.
problem Predicting payer responses from claims data to improve healthcare performance.
method Learning complex dependencies in claim inputs to create a compact representation, then using deep learning to predict responses.
result Deep Claim improves claim denial prediction by 22.21%.
Model predicts wound and episode-level readmission risk and time to re-admit.
problem Identify patients at high risk of re-admission to prevent wound recurrences and reduce healthcare costs.
method Data-driven analysis of wound care and episode-level patient data.
result Model achieves high recall and precision for predicting re-admission risk and time.
This paper presents an example of how demographical characteristics of patients influence their susceptibility to certain medical conditions. In this paper, we investigate the association of health conditions to age of patients in a heterogeneous population. We show that besides the symptoms a patients is having, the a…
New method for individual claims reserving using machine learning.
problem Traditional claims reserving methods are limited in individual claim prediction.
method Restructured data utilization for CL prediction, using multi-period factors.
result Neural networks applied for individual claims reserving.
The tail of the distribution of a sum of a random number of independent and identically distributed nonnegative random variables depends on the tails of the number of terms and of the terms themselves. This situation is of interest in the collective risk model, where the total claim size in a portfolio is the sum of a …
Two machine learning models detect anomalies in ER claims, saving up to 40% in improper payments.
problem Improper health insurance payments from fraud and upcoding.
method Two machine learning models: an upcoding model based on severity code distributions and a random forest model for claim sorting.
result Random forest model saved 12% to 40% in improper payments compared to a baseline approach.
A self-attention model improves fraud detection in health care claims.
problem Fraud detection in health care claims with hierarchical data structures.
method Piecewise feed forward neural networks and self-attention neural networks.
result Self-attention model outperforms other models on a dataset of two million health care claims.
Optimizes insurance processing capacity to minimize costs.
problem Processing delays and backlogs in insurance claims.
method Optimal capacity selection to minimize delay-adjusted and fixed costs.
result Minimizes claims costs by balancing processing capacity and delays.
New model bridges pricing and reserving for insurance claims.
problem Incomplete claim data due to reporting and settlement delays.
method Develops an occurrence and development model to estimate both claims and premiums.
result Effective resolution of pricing and reserving inconsistencies.
This study compares the largest claims from two insurance portfolios using stochastic orderings.
problem Comparing the largest claims from two heterogeneous insurance portfolios.
method Used various stochastic orderings and established sufficient conditions associated with model parameters.
result Established sufficient conditions for comparing the largest claims from two insurance portfolios.
This work fine-tunes GPT-2 for generating patent claims.
problem Generating coherent patent claims automatically.
method Fine-tuning OpenAI GPT-2 on patent claim language structure.
result Demonstrated the first machine-generated patent claims.
In this paper, we build an organization of high-dimensional datasets that cannot be cleanly embedded into a low-dimensional representation due to missing entries and a subset of the features being irrelevant to modeling functions of interest. Our algorithm begins by defining coarse neighborhoods of the points and defin…
Model detects insurance fraud using social network analysis.
problem Fraudulent insurance claims by exaggeration or intentional damage.
method Network construction linking claims and parties, BiRank algorithm for fraud score computation, feature extraction from network and claims, supervised model building.
result Network features improve fraud detection performance.
We consider trading in a financial market with proportional transaction costs. In the frictionless case, claims are maximal if and only if they are priced by a consistent price process--the equivalent of an equivalent martingale measure. This result fails in the presence of transaction costs. A properly maximal claim i…
Investor maximizes utility from an unknown claim using robust optimization.
problem Maximizing utility from an unknown contingent claim.
method Robust optimization with quantile formulation and variational inequalities.
result Optimal trading strategy and utility indifference price determined.
Model predicts individual insurance claim reserves using activation patterns.
problem Accurately predicting individual claim reserves in insurance contracts.
method Multinomial logistic regression to model claim activation and development.
result The model generates accurate predictions of total and per coverage reserves.
BERT learns claim descriptions to identify patent novelty.
problem Identifying novel patent claims among existing documents.
method Training BERT on concatenated claims and descriptions, scoring BERT's output.
result BERT identifies relevant X documents for patent novelty.
A new model integrates claim history and covariates for non-life insurance reserving.
problem Lack of information in traditional reserving models for non-life insurance claims.
method Hierarchical reserving model integrating claim history and covariates.
result Flexibility and robustness of the hierarchical reserving model demonstrated.
Paper introduces EEMs for pricing contingent claim returns.
problem Computing expected future prices of contingent claims.
method Dynamic change of measure approach to construct EEMs.
result EEMs provide physical and pricing expectations of contingent claim prices.
A new method for modeling insurance claim frequencies using random proportions.
problem Inaccurate fitting of classical distributions to insurance claim frequency data.
method Modeling claim frequencies using random proportions of insurance contracts and applying goodness-of-fit tests.
result A new statistical approach for better modeling insurance claim frequencies.
The paper introduces bonus-malus systems with varying deductibles for different claim types and policyholder levels.
problem Designing bonus-malus systems with varying deductibles for policyholders of different claim types.
method Introducing bonus-malus systems with varying deductibles for policyholders in different levels and claim types, investigating restrictions and allocation principles.
result Possible introduction of varying deductibles for policyholders in the highest bonus-malus level, considering two allocation principles.
The paper introduces BCART models for aggregate claim amount, improving frequency-severity and joint modeling.
problem Modeling aggregate claim amount with frequency-severity and joint dependencies.
method Developed three types of BCART models: frequency-severity, sequential, and joint models. Used various distributions for claim severity data.
result Weibull distribution outperforms gamma and lognormal for right-skewed, heavy-tailed claim severity data.
Study approximates risk process with non-stationary claims using Hawkes process.
problem Approximating risk process with non-stationary claims.
method Gaussian approximation and functional central limit theorem.
result Established diffusion approximation for ruin probability.
FiNCAT tool automatically identifies financial numerals in documents.
problem Differentiating between in-claim and out-of-claim numerals in financial documents.
method Extracts context embeddings of numerals using BERT, then uses Logistic Regression to classify.
result Achieved a Macro F1 score of 0.8223 on validation set.
Study on risk model with claims, dividends, and random probabilities.
problem Analyzing a risk model with claims, delayed claims, and randomized dividends.
method Discrete time Compound Beta-Binomial Risk Model with recursive expressions for Gerber-Shiu function.
result Recursive relations for ruin-related quantities obtained.
LLMs help automate extraction of actuarial variables from unstructured claims data.
problem Manual processing of unstructured claims data is time-consuming and inconsistent.
method Two-stage processing architecture using LLMs, modular Python pipeline.
result LLM-based extraction achieved high accuracy and practical actuarial value.
New method simplifies individual claims reserving.
problem Insufficient flexibility and robustness in existing methods.
method Building on classical chain-ladder method, introduces new perspective.
result Advances toward a new standard for micro-level reserving.
Using a suitable change of probability measure, we obtain a novel Poisson series representation for the arbitrage- free price process of vulnerable contingent claims in a regime-switching market driven by an underlying continuous- time Markov process. As a result of this representation, along with a short-time asymptot…
Study tackles imbalanced data in car insurance claims prediction.
problem Predicting rare events (claims) in car insurance with imbalanced data.
method Various machine learning techniques (logistic-regression, decision tree, random forest, xgBoost, feed-forward network) applied to imbalanced dataset.
result Comparison of machine learning algorithms' performance in claim occurrence prediction.
Time-aware fact-checking improves veracity predictions for time-sensitive claims.
problem Fact-checking decisions should consider temporal information of claims and evidence.
method Investigated four temporal ranking methods to optimize evidence ranking for fact-checking models.
result Time-aware evidence ranking surpasses relevance assumptions and improves veracity predictions for time-sensitive claims.
We derive asymptotic expansions for the prices of a variety of European and barrier-style claims in a general local-stochastic volatility setting. Our method combines Taylor series expansions of the diffusion coefficients with an expansion in the correlation parameter between the underlying asset and volatility process…
We create a large dataset for fact checking claims and improve prediction accuracy.
problem Fact checking claims from multiple sources is challenging.
method We created a comprehensive dataset and developed a novel method for automatic veracity prediction.
result Our model achieves a Macro F1 of 49.2%, showing significant performance improvements.
Unified methods for hedging impermanent loss in decentralized exchanges.
problem Hedging impermanent loss in liquidity provision at decentralized exchanges.
method Static and dynamic approaches using arbitrage-based methods for valuation and risk management.
result Unified valuation and hedging formulas for IL protection claims.
We investigate, focusing on the ruin probability, an adaptation of the Cramer-Lundberg model for the surplus process of an insurance company, in which, conditionally on their intensities, the two mixed Poisson processes governing the arrival times of the premiums and of the claims respectively, are independent. Such a …
Audit shows risk claims from distributional reinforcement learning agents are often false.
problem Evaluating the risk claims made by distributional reinforcement learning agents.
method Combines a decision-relevant screening metric, ground truth from Monte Carlo, and statistical methods to audit risk claims.
result 40-95% of the strongest risk claims are refuted, indicating the learned risk reflects a training artifact rather than environment stochasticity.
Wojciech Kamiński disproved a spiral claim for conformal geodesics.
problem Proving that conformal geodesics cannot spiral.
method Provided a counterexample and illustrated proof failure.
result Lemma 4.6 proof was flawed.
Methodology calculates car insurance premiums for partial damage losses.
problem Estimating premiums for partial damage losses in automobile insurance.
method Used generalized linear models to analyze claim frequency and severity.
result Identified key variables influencing claim frequency and severity.
Study uses SVM to predict weather-induced home insurance claims and losses.
problem Assessing future weather-induced home insurance claims and losses for disaster preparedness.
method Support Vector Machine (SVM) regression for forecasting future claim dynamics.
result Illustrates SVM approach in forecasting weather-induced home insurance claims in a Canadian city.
Paper proposes deep learning for fake claim detection on social media.
problem Spread of false information on social media.
method Extended LIAR dataset with sentiment analysis; BERT-Base model for classification.
result 70% accuracy in classifying claims as genuine or fake.
Researchers develop a pricing method for contingent claims under partial information and short selling constraints.
problem Pricing contingent claims with partial information and short selling restrictions.
method Derive a dual problem using conjugate duality theory and conditions for strong duality.
result Characterization of contingent claim prices involving martingale and super-martingale conditions.
This paper suggests claim history will be deprecated in future auto insurance rates.
problem The role of historical claim records in auto insurance rates.
method Proposes a new risk variable elimination method and real-time road risk model design.
result Claim history will be considered a 'noise' factor and deprecated in Pay-How-You-Drive models.
Improved disability insurance model with collective health claims.
problem Enhance disability insurance model with collective health claims.
method Expand classic semi-Markov model with collective health claims, solve many-body problem using mean-field approach.
result Mean-field approach simplifies complex model into a transparent pricing method.