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"AWS Machine Learning Competency"

Fraudulent Claim Modeling

DataRobot predicts which insurance claims are most likely fraudulent based on claim characteristics.


P&C Insurance

Why DataRobot

Automate building an accurate model to predict the likelihood that a claim is fraudulent. With the results, you can create a rank-ordered queue of claims for fraud units to investigate.

  • Identify possible fraudulent insurance claims
  • Prioritize results for fraud units to investigate further
  • Don’t waste expense dollars investigating valid claims


Fraudulent claims are costly, but it is too expensive and inefficient to investigate every claim. Even if possible, investigating innocent customers could prove to be a very poor experience for the insured, leading some to leave the business.


Using DataRobot, you can automatically build extremely accurate predictive models to identify and prioritize likely fraudulent activity. Fraud units can then create a data-based queue, investigating only those incidents likely to require it. The resulting benefits are two-fold. First, your resources are deployed where you will see the greatest return on your investigative investment. Additionally, you optimize customer satisfaction by not challenging innocent claims.


  • Identify fraudulent claims to save significant company money
  • Optimize the resources needed to investigate fraudulent claims
  • Maintain high customer satisfaction

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