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Abstract

A system and method for financial fraud and analysis is disclosed. The system includes a financial claim data processing subsystem configured to process data associated with a financial claim, a financial feature selection subsystem configured to select one or more financial features from processed data, a financial claim fraud detection subsystem configured to examine one or more values representative of the one or more financial features selected and predict a financial claim fraud, an outlier fraud detection subsystem configured to detect at least one outlier fraud using an unsupervised machine learning technique, a financial claim fraud analysis subsystem configured to analyze the financial claim fraud predicted and the at least one outlier fraud detected based on a predefined set of fraud analysis rules, a fraud amount prediction subsystem configured to predict an amount of fraud analyzed by the financial claim fraud analysis subsystem.

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First Claim