AI Empowered Health Insurance Fraud Detection

Authors

  • Shraddha PG Student, Department of Computer Science and Engineering (MCA), Visvesvaraya Technological University, CPGS Kalaburagi, Karnataka, India.
  • Ashwini Assistant Professor, Department of Computer Science and Engineering (MCA), Visvesvaraya Technological University, CPGS Kalaburagi, Karnataka, India.

Keywords:

Health Insurance Fraud, Artificial Intelligence (AI), Anomaly Detection, Pattern Recognition

Abstract

The project titled aims to develop an advanced system for identifying and preventing fraudulent activities within the health insurance sector. By leveraging the power of artificial intelligence and machine learning algorithms, this system is designed to analyse vast amounts of data from insurance claims, detecting patterns and anomalies indicative of fraudulent behavior. The proposed solution focuses on enhancing the accuracy and efficiency of fraud detection processes, minimizing false positives, and significantly reducing the financial losses incurred by insurance companies. The system also provides a robust framework for continuous learning and adaptation to emerging fraud tactics, ensuring long-term reliability and effectiveness in safeguarding the integrity of health insurance claims.

Published

04-08-2025

How to Cite

Shraddha, & Ashwini. (2025). AI Empowered Health Insurance Fraud Detection. Journal of Scientific Research and Technology, 3(8), 37–43. Retrieved from https://jsrtjournal.com/index.php/JSRT/article/view/298