{"title":"基于大数据和机器学习的决策支持系统,重塑保险理赔流程","authors":"Rachana Jaiswal , Shashank Gupta , Aviral Kumar Tiwari","doi":"10.1016/j.techfore.2024.123829","DOIUrl":null,"url":null,"abstract":"<div><div>Based on actuarial science theory, decision-making theory, and anonymous big data, this study employs machine learning to advance insurance claim forecasting, aiming to enhance pricing accuracy, mitigate adverse selection risks, and optimize operational efficiency for improved customer satisfaction and global competitiveness. The study utilized the Boruta algorithm with LightGBM for feature selection, analyzing a 57-dimensional dataset and identifying an optimal subset of 24 features. The improved LightGBM model achieved superior results (AUC ∼ 0.9272 and accuracy ∼ 92.94 %), surpassing other models evaluated. Beyond operational improvements, the proposed model holds the potential to contribute to various United Nations SDGs, such as promoting financial inclusion (SDG 1; SDG 10), reducing fraud, improving public safety (SDG 3; SDG 11; SDG 13), and encouraging sustainable practices (SDG 9; SDG 11). By utilizing data-driven insights to make more informed and accurate decisions, insurance companies can provide better services to their policyholders and contribute to a more equitable and sustainable society.</div></div>","PeriodicalId":48454,"journal":{"name":"Technological Forecasting and Social Change","volume":"209 ","pages":"Article 123829"},"PeriodicalIF":12.9000,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Big data and machine learning-based decision support system to reshape the vaticination of insurance claims\",\"authors\":\"Rachana Jaiswal , Shashank Gupta , Aviral Kumar Tiwari\",\"doi\":\"10.1016/j.techfore.2024.123829\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Based on actuarial science theory, decision-making theory, and anonymous big data, this study employs machine learning to advance insurance claim forecasting, aiming to enhance pricing accuracy, mitigate adverse selection risks, and optimize operational efficiency for improved customer satisfaction and global competitiveness. The study utilized the Boruta algorithm with LightGBM for feature selection, analyzing a 57-dimensional dataset and identifying an optimal subset of 24 features. The improved LightGBM model achieved superior results (AUC ∼ 0.9272 and accuracy ∼ 92.94 %), surpassing other models evaluated. Beyond operational improvements, the proposed model holds the potential to contribute to various United Nations SDGs, such as promoting financial inclusion (SDG 1; SDG 10), reducing fraud, improving public safety (SDG 3; SDG 11; SDG 13), and encouraging sustainable practices (SDG 9; SDG 11). By utilizing data-driven insights to make more informed and accurate decisions, insurance companies can provide better services to their policyholders and contribute to a more equitable and sustainable society.</div></div>\",\"PeriodicalId\":48454,\"journal\":{\"name\":\"Technological Forecasting and Social Change\",\"volume\":\"209 \",\"pages\":\"Article 123829\"},\"PeriodicalIF\":12.9000,\"publicationDate\":\"2024-10-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Technological Forecasting and Social Change\",\"FirstCategoryId\":\"91\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0040162524006279\",\"RegionNum\":1,\"RegionCategory\":\"管理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"BUSINESS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Technological Forecasting and Social Change","FirstCategoryId":"91","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0040162524006279","RegionNum":1,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"BUSINESS","Score":null,"Total":0}
Big data and machine learning-based decision support system to reshape the vaticination of insurance claims
Based on actuarial science theory, decision-making theory, and anonymous big data, this study employs machine learning to advance insurance claim forecasting, aiming to enhance pricing accuracy, mitigate adverse selection risks, and optimize operational efficiency for improved customer satisfaction and global competitiveness. The study utilized the Boruta algorithm with LightGBM for feature selection, analyzing a 57-dimensional dataset and identifying an optimal subset of 24 features. The improved LightGBM model achieved superior results (AUC ∼ 0.9272 and accuracy ∼ 92.94 %), surpassing other models evaluated. Beyond operational improvements, the proposed model holds the potential to contribute to various United Nations SDGs, such as promoting financial inclusion (SDG 1; SDG 10), reducing fraud, improving public safety (SDG 3; SDG 11; SDG 13), and encouraging sustainable practices (SDG 9; SDG 11). By utilizing data-driven insights to make more informed and accurate decisions, insurance companies can provide better services to their policyholders and contribute to a more equitable and sustainable society.
期刊介绍:
Technological Forecasting and Social Change is a prominent platform for individuals engaged in the methodology and application of technological forecasting and future studies as planning tools, exploring the interconnectedness of social, environmental, and technological factors.
In addition to serving as a key forum for these discussions, we offer numerous benefits for authors, including complimentary PDFs, a generous copyright policy, exclusive discounts on Elsevier publications, and more.