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Informing the development of a fraud prevention toolset through a situated analysis of fraud investigation expertise

Ormerod, Thomas C. and Ball, Linden J. and Morley, Nicola J. (2012) Informing the development of a fraud prevention toolset through a situated analysis of fraud investigation expertise. Behaviour & information technology, 31 (4). pp. 371-381. ISSN 0144-929X

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Abstract

Insurance fraud is a growing problem. This article describes a project that aimed to specify and develop a suite of computer-based tools to support the early detection and subsequent investigation of potentially fraudulent claims. System requirements were informed by ethnographic studies focusing on: (1) understanding current fraud detection practices and (2) characterising fraud investigation expertise. Tools were designed that sift claims for potential problem cases and assist in the processes of investigation and detection of new fraud types by providing anomaly capture, argumentation and visualisation environments. The resulting tools capitalise upon expertise and embody processes that can subsequently be used by inexperienced claims handlers to detect and deal with fraudulent claims.

Item Type: Article
Journal or Publication Title: Behaviour & information technology
Uncontrolled Keywords: insurance fraud ; cognitive ethnography ; anomaly capture ; computer-based tools ; decision support systems
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: Faculty of Science and Technology > Psychology
ID Code: 54092
Deposited By: ep_importer_pure
Deposited On: 10 May 2012 15:16
Refereed?: Yes
Published?: Published
Last Modified: 17 Sep 2013 08:31
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/54092

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