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%.
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.
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.
The article derives a formula for predicting claims uncertainty using the GCC method.
problem Claims reserving uncertainty in non-life insurance modeling.
method Generalized Cape Cod (GCC) method, derived an analytical formula for MSEP.
result Derives an analytical formula for the mean squared error of prediction (MSEP) of the GCC method.
A new method for predicting insurance claims with statistical guarantees.
problem Creating accurate prediction intervals for insurance claims.
method Model-agnostic framework using split conformal prediction for frequency-severity modeling.
result Shows effectiveness on simulated and real datasets using various models.
The article proposes a method to make valid insurance claim predictions without relying on specific models.
problem Prediction of insurance claims using statistical models can be unreliable due to model misspecification, selection effects, and lack of finite-sample validity.
method The article employs conformal prediction, a machine learning strategy that is model-free and tuning-parameter-free, ensuring finite-sample validity.
result The proposed method guarantees valid predictions at a pre-assigned coverage probability level and performs well in insurance applications, including meeting Solvency II requirements.
Models use embeddings and attention for better claim severity prediction.
problem Improving predictive modeling of claim severity with categorical data.
method Developed neural networks and attention-based architectures with embeddings.
result Attention-based models enhance predictive performance with contextual augmentation.
EBM improves car insurance claim severity and frequency prediction while maintaining interpretability.
problem Balancing predictive accuracy and interpretability in insurance claim modeling.
method Combines GAM and cyclic gradient boosting, providing interpretable predictions.
result EBM outperforms benchmark models in claim severity and frequency prediction.
We contribute the largest publicly available dataset of naturally occurring factual claims for the purpose of automatic claim verification. It is collected from 26 fact checking websites in English, paired with textual sources and rich metadata, and labelled for veracity by human expert journalists. We present an in-de…
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.
Method guarantees coherent factuality for language model outputs in reasoning tasks.
problem Ensuring correctness of language model outputs in reasoning tasks.
method Developed a conformal-prediction-based method applied to subgraphs within a deducibility graph.
result Achieved coherent factuality across target coverage levels, 90% on stricter definition.
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.
New methods for quantifying insurance claim cost uncertainty using LightGBM and GLMs.
problem Quantifying prediction uncertainty in insurance claim costs.
method Proposed non-conformity measures for GLMs and GBMs with Tweedie loss.
result Locally weighted Pearson residuals outperform other methods in maintaining nominal coverage with smallest average width.
Unified comparison of gradient boosting algorithms for insurance claims.
problem Improving predictive accuracy and computational efficiency in insurance claim prediction.
method Unified notation and comprehensive numerical study comparing 12 gradient boosting algorithms on 5 datasets.
result No trade-off between model adequacy and predictive accuracy.
We present FAKTA which is a unified framework that integrates various components of a fact checking process: document retrieval from media sources with various types of reliability, stance detection of documents with respect to given claims, evidence extraction, and linguistic analysis. FAKTA predicts the factuality of…
Insurance companies must manage millions of claims per year. While most of these claims are non-fraudulent, fraud detection is core for insurance companies. The ultimate goal is a predictive model to single out the fraudulent claims and pay out the non-fraudulent ones immediately. Modern machine learning methods are we…
Bayesian CART models improve insurance claims frequency prediction and interpretation.
problem Improving accuracy and interpretability in insurance pricing models.
method Introducing Bayesian CART models for claims frequency, implementing MCMC algorithm for posterior tree exploration, and using DIC for model selection.
result Bayesian CART models can better classify policy-holders into risk groups.
SARD improves deep learning clinical prediction performance.
problem Deep learning models struggle to match linear models in healthcare predictions.
method Reverse Distillation to initialize deep models, combined with contextual and temporal embeddings.
result SARD outperforms state-of-the-art methods on clinical prediction outcomes.
Study improves motor insurance claim prediction using geographic data.
problem Limited location identifiers in public actuarial datasets.
method Zone-level modeling framework with environmental and orthoimagery data.
result Geographic information improves MTPL claim prediction accuracy.
Study uses healthcare claims data to identify Covid-19 risk factors without prior selection.
problem Identify risk factors for severe Covid-19 cases.
method Fine-grained hierarchical information from medical classification systems used to analyze over 33,000 covariates.
result Method has better predictive ability than pre-specified morbidity groups.
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.
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.
Enhanced Tweedie model for insurance claims using CatBoost.
problem Accurately modeling aggregate claims with zero-inflated data.
method Refined Tweedie model with boosting methods in CatBoost.
result Marked improvement in model performance for insurance analytics.
Deep neural network predicts health costs better than traditional models.
problem Accurate prediction of healthcare costs for optimal cost management.
method Developed a deep neural network to predict future health care costs from health insurance claims records.
result Deep neural network outperformed ridge regression and Morbi-RSA models in cost prediction.
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.
Bayesian neural networks are vulnerable to adversarial attacks.
problem Adversarial robustness of Bayesian neural networks.
method Examination of adversarial robustness through three tasks: label prediction, adversarial example detection, and semantic shift detection.
result Bayesian neural networks are highly susceptible to adversarial attacks.
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.
Study finds whitepaper narratives do not predict market factor structure.
problem Predicting market behavior from cryptocurrency whitepaper claims.
method Zero-shot NLP classification combined with CP tensor decomposition of market data.
result Weak alignment between whitepaper claims and market statistics and latent factors.
Study improves flood loss risk models using historical data and rainfall data.
problem Predicting financial losses from flooding events.
method Used neural networks, decision trees, and kernel-based regressors on NFIP dataset, incorporating rainfall data.
result Extreme Gradient Boosting provided the best results, and bias correction improved model performance.
The paper examines how insurers can select claims for fraud investigation, proposing a randomized approach.
problem Inconsistent learning from biased claim selection.
method Formalizes selection in binary regression, proposes a randomized alternative, and defines consistency.
result The randomized selection strategy is consistent, while the traditional strategy is not.
In this paper we examine the claims reserving problem using Tweedie's compound Poisson model. We develop the maximum likelihood and Bayesian Markov chain Monte Carlo simulation approaches to fit the model and then compare the estimated models under different scenarios. The key point we demonstrate relates to the compar…
Study predicts doubling of U.S. maize insurance claims due to climate change.
problem Climate change increases U.S. maize loss probability, impacting insurance claims.
method Neural Network Monte Carlo simulations to predict crop loss metrics.
result Doubling of annual probability of maize Yield Protection insurance claims by mid-century.
Cancer analysis and prediction is the utmost important research field for well-being of humankind. The Cancer data are analyzed and predicted using machine learning algorithms. Most of the researcher claims the accuracy of the predicted results within 99%. However, we show that machine learning algorithms can easily pr…
We critically review recent claims that financial crashes can be predicted using the idea of log-periodic oscillations or by other methods inspired by the physics of critical phenomena. In particular, the October 1997 `correction' does not appear to be the accumulation point of a geometric series of local minima.
Due to escalating healthcare costs, accurately predicting which patients will incur high costs is an important task for payers and providers of healthcare. High-cost claimants (HiCCs) are patients who have annual costs above $\$250,000$ and who represent just 0.16% of the insured population but currently account for 9%…
Risk prediction is central to both clinical medicine and public health. While many machine learning models have been developed to predict mortality, they are rarely applied in the clinical literature, where classification tasks typically rely on logistic regression. One reason for this is that existing machine learning…
Our article considers the class of recently developed stochastic models that combine claims payments and incurred losses information into a coherent reserving methodology. In particular, we develop a family of Heirarchical Bayesian Paid-Incurred-Claims models, combining the claims reserving models of Hertig et al. (198…
Enhanced conformal methods improve validity of LLM outputs.
problem Lack of conditional validity and high false rejection rates in LLM validity guarantees.
method Adaptive conditional conformal procedure and improved scoring function differentiation.
result Demonstrated improved validity and utility on real datasets.
FL improves insurance claims loss prediction without sharing data.
problem Limited data volume and variety due to privacy concerns.
method Federated Learning (FL) to update a global model using local data insights.
result Improved claims loss forecasting compared to individual models.
Within Reinforcement Learning, there is a growing collection of research which aims to express all of an agent's knowledge of the world through predictions about sensation, behaviour, and time. This work can be seen not only as a collection of architectural proposals, but also as the beginnings of a theory of machine k…
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.
Causal thinking improves healthcare decisions from EHRs.
problem Shortcuts in data lead to biased healthcare decisions.
method Step-by-step framework for valid decision making from EHRs.
result Valid decision making requires careful analysis of EHR data.
Techniques such as ensembling and distillation promise model quality improvements when paired with almost any base model. However, due to increased test-time cost (for ensembles) and increased complexity of the training pipeline (for distillation), these techniques are challenging to use in industrial settings. In this…
In this paper we study the asymptotic decay of finite time ruin probabilities for an insurance company that faces heavy-tailed claims, uses predictable investment strategies and makes investments in risky assets whose prices evolve according to quite general semimartingales. We show that the ruin problem corresponds to…
New analysis shows transformer models can't learn effectively.
problem Transformer models learning in context can't achieve general predictive accuracy.
method Empirical evidence and mathematical analysis of transformer architecture limitations.
result Transformers cannot achieve general predictive accuracy due to architectural limitations.
CANN models improve insurance claim count predictions using telematics data.
problem Improving insurance claim count predictions with telematics data.
method Combining classical actuarial models with neural networks for telematics data.
result CANN models outperform traditional models in predicting insurance claims.
In this essay, I attempt to provide supporting evidence as well as some balance for the thesis on `Transforming socio-economics with a new epistemology' presented by Hollingworth and Mueller (2008). First, I review a personal highlight of my own scientific path that illustrates the power of interdisciplinarity as well …