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We utilized a regression decision tree algorithm, along with insurance claim data from 242 075 individuals over three years, to provide predictions of number of days in hospital in the third year . The data included various attributes such as age, gender, body mass index, smoker and the charges attribute which will work as the label. Notebook. Supervised learning algorithms learn from a model containing function that can be used to predict the output from the new inputs through iterative optimization of an objective function. It also shows the premium status and customer satisfaction every . thats without even mentioning the fact that health claim rates tend to be relatively low and usually range between 1% to 10%,) it is not surprising that predicting the number of health insurance claims in a specific year can be a complicated task. The goal of this project is to allows a person to get an idea about the necessary amount required according to their own health status. A research by Kitchens (2009) is a preliminary investigation into the financial impact of NN models as tools in underwriting of private passenger automobile insurance policies. It is very complex method and some rural people either buy some private health insurance or do not invest money in health insurance at all. According to our dataset, age and smoking status has the maximum impact on the amount prediction with smoker being the one attribute with maximum effect. ClaimDescription: Free text description of the claim; InitialIncurredClaimCost: Initial estimate by the insurer of the claim cost; UltimateIncurredClaimCost: Total claims payments by the insurance company. License. Currently utilizing existing or traditional methods of forecasting with variance. for example). To do this we used box plots. The authors Motlagh et al. Whereas some attributes even decline the accuracy, so it becomes necessary to remove these attributes from the features of the code. The health insurance data was used to develop the three regression models, and the predicted premiums from these models were compared with actual premiums to compare the accuracies of these models. (2019) proposed a novel neural network model for health-related . An increase in medical claims will directly increase the total expenditure of the company thus affects the profit margin. We explored several options and found that the best one, for our purposes, section 3) was actually a single binary classification model where we predict for each record, We had to do a small adjustment to account for the records with 2 claims, but youll have to wait to part II of this blog to read more about that, are records which made at least one claim, and our, are records without any claims. This research focusses on the implementation of multi-layer feed forward neural network with back propagation algorithm based on gradient descent method. The main aim of this project is to predict the insurance claim by each user that was billed by a health insurance company in Python using scikit-learn. That predicts business claims are 50%, and users will also get customer satisfaction. Example, Sangwan et al. Currently utilizing existing or traditional methods of forecasting with variance. For predictive models, gradient boosting is considered as one of the most powerful techniques. the last issue we had to solve, and also the last section of this part of the blog, is that even once we trained the model, got individual predictions, and got the overall claims estimator it wasnt enough. (2011) and El-said et al. Insurance companies are extremely interested in the prediction of the future. A tag already exists with the provided branch name. Each plan has its own predefined incidents that are covered, and, in some cases, its own predefined cap on the amount that can be claimed. (2016) emphasize that the idea behind forecasting is previous know and observed information together with model outputs will be very useful in predicting future values. Previous research investigated the use of artificial neural networks (NNs) to develop models as aids to the insurance underwriter when determining acceptability and price on insurance policies. The primary source of data for this project was from Kaggle user Dmarco. Various factors were used and their effect on predicted amount was examined. of a health insurance. Last modified January 29, 2019, Your email address will not be published. Dyn. effective Management. The data was in structured format and was stores in a csv file format. Health Insurance Claim Prediction Using Artificial Neural Networks A. Bhardwaj Published 1 July 2020 Computer Science Int. Here, our Machine Learning dashboard shows the claims types status. Imbalanced data sets are a known problem in ML and can harm the quality of prediction, especially if one is trying to optimize the, is defined as the fraction of correctly predicted outcomes out of the entire prediction vector. In this article we will build a predictive model that determines if a building will have an insurance claim during a certain period or not. can Streamline Data Operations and enable An inpatient claim may cost up to 20 times more than an outpatient claim. Later the accuracies of these models were compared. Previous research investigated the use of artificial neural networks (NNs) to develop models as aids to the insurance underwriter when determining acceptability and price on insurance policies. The final model was obtained using Grid Search Cross Validation. The model was used to predict the insurance amount which would be spent on their health. We found out that while they do have many differences and should not be modeled together they also have enough similarities such that the best methodology for the Surgery analysis was also the best for the Ambulatory insurance. Where a person can ensure that the amount he/she is going to opt is justified. However, it is. 1993, Dans 1993) because these databases are designed for nancial . In the insurance business, two things are considered when analysing losses: frequency of loss and severity of loss. Health insurers offer coverage and policies for various products, such as ambulatory, surgery, personal accidents, severe illness, transplants and much more. Approach : Pre . ANN has the ability to resemble the basic processes of humans behaviour which can also solve nonlinear matters, with this feature Artificial Neural Network is widely used with complicated system for computations and classifications, and has cultivated on non-linearity mapped effect if compared with traditional calculating methods. Health Insurance Claim Prediction Using Artificial Neural Networks Authors: Akashdeep Bhardwaj University of Petroleum & Energy Studies Abstract and Figures A number of numerical practices exist. Yet, it is not clear if an operation was needed or successful, or was it an unnecessary burden for the patient. Several factors determine the cost of claims based on health factors like BMI, age, smoker, health conditions and others. Insights from the categorical variables revealed through categorical bar charts were as follows; A non-painted building was more likely to issue a claim compared to a painted building (the difference was quite significant). Several factors determine the cost of claims based on health factors like BMI, age, smoker, health conditions and others. Machine Learning for Insurance Claim Prediction | Complete ML Model. This can help a person in focusing more on the health aspect of an insurance rather than the futile part. Leverage the True potential of AI-driven implementation to streamline the development of applications. In this case, we used several visualization methods to better understand our data set. Once training data is in a suitable form to feed to the model, the training and testing phase of the model can proceed. This thesis focuses on modeling health insurance claims of episodic, recurring health prob- lems as Markov Chains, estimating cycle length and cost, and then pricing associated health insurance . Goundar, S., Prakash, S., Sadal, P., & Bhardwaj, A. Goundar, S., Prakash, S., Sadal, P., & Bhardwaj, A. Most of the cost is attributed to the 'type-2' version of diabetes, which is typically diagnosed in middle age. In I. So cleaning of dataset becomes important for using the data under various regression algorithms. was the most common category, unfortunately). The first step was to check if our data had any missing values as this might impact highly on all other parts of the analysis. The mean and median work well with continuous variables while the Mode works well with categorical variables. Insurance Claim Prediction Using Machine Learning Ensemble Classifier | by Paul Wanyanga | Analytics Vidhya | Medium 500 Apologies, but something went wrong on our end. "Health Insurance Claim Prediction Using Artificial Neural Networks." Artificial neural networks (ANN) have proven to be very useful in helping many organizations with business decision making. Decision on the numerical target is represented by leaf node. Pre-processing and cleaning of data are one of the most important tasks that must be one before dataset can be used for machine learning. 11.5 second run - successful. Some of the work investigated the predictive modeling of healthcare cost using several statistical techniques. Management Association (Ed. by admin | Jul 6, 2022 | blog | 0 comments, In this 2-part blog post well try to give you a taste of one of our recently completed POC demonstrating the advantages of using Machine Learning (read here) to predict the future number of claims in two different health insurance product. It was gathered that multiple linear regression and gradient boosting algorithms performed better than the linear regression and decision tree. These claim amounts are usually high in millions of dollars every year. Many Git commands accept both tag and branch names, so creating this branch may cause unexpected behavior. The diagnosis set is going to be expanded to include more diseases. (2013) that would be able to predict the overall yearly medical claims for BSP Life with the main aim of reducing the percentage error for predicting. These inconsistencies must be removed before doing any analysis on data. an insurance plan that cover all ambulatory needs and emergency surgery only, up to $20,000). In the past, research by Mahmoud et al. Supervised learning algorithms create a mathematical model according to a set of data that contains both the inputs and the desired outputs. Figure 1: Sample of Health Insurance Dataset. Two main types of neural networks are namely feed forward neural network and recurrent neural network (RNN). Dataset was used for training the models and that training helped to come up with some predictions. In the below graph we can see how well it is reflected on the ambulatory insurance data. According to Rizal et al. HEALTH_INSURANCE_CLAIM_PREDICTION. Step 2- Data Preprocessing: In this phase, the data is prepared for the analysis purpose which contains relevant information. Data. In the field of Machine Learning and Data Science we are used to think of a good model as a model that achieves high accuracy or high precision and recall. Claims received in a year are usually large which needs to be accurately considered when preparing annual financial budgets. Appl. Predicting medical insurance costs using ML approaches is still a problem in the healthcare industry that requires investigation and improvement. The data has been imported from kaggle website. Predicting the cost of claims in an insurance company is a real-life problem that needs to be solved in a more accurate and automated way. arrow_right_alt. Data. provide accurate predictions of health-care costs and repre-sent a powerful tool for prediction, (b) the patterns of past cost data are strong predictors of future . Are you sure you want to create this branch? It has been found that Gradient Boosting Regression model which is built upon decision tree is the best performing model. Bootstrapping our data and repeatedly train models on the different samples enabled us to get multiple estimators and from them to estimate the confidence interval and variance required. The data included some ambiguous values which were needed to be removed. ). Abhigna et al. Figure 4: Attributes vs Prediction Graphs Gradient Boosting Regression. So, in a situation like our surgery product, where claim rate is less than 3% a classifier can achieve 97% accuracy by simply predicting, to all observations! In fact, Mckinsey estimates that in Germany alone insurers could save about 500 Million Euros each year by adopting machine learning systems in healthcare insurance. BSP Life (Fiji) Ltd. provides both Health and Life Insurance in Fiji. As a result, we have given a demo of dashboards for reference; you will be confident in incurred loss and claim status as a predicted model. Our data was a bit simpler and did not involve a lot of feature engineering apart from encoding the categorical variables. Several factors determine the cost of claims based on health factors like BMI, age, smoker, health conditions and others. Libraries used: pandas, numpy, matplotlib, seaborn, sklearn. Model performance was compared using k-fold cross validation. Multiple linear regression can be defined as extended simple linear regression. insurance claim prediction machine learning. Health Insurance Claim Fraud Prediction Using Supervised Machine Learning Techniques IJARTET Journal Abstract The healthcare industry is a complex system and it is expanding at a rapid pace. Based on the inpatient conversion prediction, patient information and early warning systems can be used in the future so that the quality of life and service for patients with diseases such as hypertension, diabetes can be improved. This can help not only people but also insurance companies to work in tandem for better and more health centric insurance amount. The authors Motlagh et al. Coders Packet . Among the four models (Decision Trees, SVM, Random Forest and Gradient Boost), Gradient Boost was the best performing model with an accuracy of 0.79 and was selected as the model of choice. In the insurance business, two things are considered when analysing losses: frequency of loss and severity of loss. Here, our Machine Learning dashboard shows the claims types status. According to Zhang et al. In this learning, algorithms take a set of data that contains only inputs, and find structure in the data, like grouping or clustering of data points. age : age of policyholder sex: gender of policy holder (female=0, male=1) Neural networks can be distinguished into distinct types based on the architecture. A building without a fence had a slightly higher chance of claiming as compared to a building with a fence. The distribution of number of claims is: Both data sets have over 25 potential features. The ability to predict a correct claim amount has a significant impact on insurer's management decisions and financial statements. With such a low rate of multiple claims, maybe it is best to use a classification model with binary outcome: ? It would be interesting to see how deep learning models would perform against the classic ensemble methods. In the interest of this project and to gain more knowledge both encoding methodologies were used and the model evaluated for performance. It helps in spotting patterns, detecting anomalies or outliers and discovering patterns. Accurate prediction gives a chance to reduce financial loss for the company. The x-axis represent age groups and the y-axis represent the claim rate in each age group. Nidhi Bhardwaj , Rishabh Anand, 2020, Health Insurance Amount Prediction, INTERNATIONAL JOURNAL OF ENGINEERING RESEARCH & TECHNOLOGY (IJERT) Volume 09, Issue 05 (May 2020), Creative Commons Attribution 4.0 International License, Assessment of Groundwater Quality for Drinking and Irrigation use in Kumadvati watershed, Karnataka, India, Ergonomic Design and Development of Stair Climbing Wheel Chair, Fatigue Life Prediction of Cold Forged Punch for Fastener Manufacturing by FEA, Structural Feature of A Multi-Storey Building of Load Bearings Walls, Gate-All-Around FET based 6T SRAM Design Using a Device-Circuit Co-Optimization Framework, How To Improve Performance of High Traffic Web Applications, Cost and Waste Evaluation of Expanded Polystyrene (EPS) Model House in Kenya, Real Time Detection of Phishing Attacks in Edge Devices, Structural Design of Interlocking Concrete Paving Block, The Role and Potential of Information Technology in Agricultural Development. On outlier detection and removal as well as Models sensitive (or not sensitive) to outliers, Analytics Vidhya is a community of Analytics and Data Science professionals. Insurance companies apply numerous techniques for analysing and predicting health insurance costs. Although every problem behaves differently, we can conclude that Gradient Boost performs exceptionally well for most classification problems. Claims received in a year are usually large which needs to be accurately considered when preparing annual financial budgets. Dr. Akhilesh Das Gupta Institute of Technology & Management. To demonstrate this, NARX model (nonlinear autoregressive network having exogenous inputs), is a recurrent dynamic network was tested and compared against feed forward artificial neural network. Application and deployment of insurance risk models . You signed in with another tab or window. Many Git commands accept both tag and branch names, so creating this branch may cause unexpected behavior. This involves choosing the best modelling approach for the task, or the best parameter settings for a given model. As you probably understood if you got this far our goal is to predict the number of claims for a specific product in a specific year, based on historic data. 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Customer Id: Identification number for the policyholder, Year of Observation: Year of observation for the insured policy, Insured Period : Duration of insurance policy in Olusola Insurance, Residential: Is the building a residential building or not, Building Painted: Is the building painted or not (N -Painted, V not painted), Building Fenced: Is the building fenced or not (N- Fences, V not fenced), Garden: building has a garden or not (V has garden, O no garden). Also with the characteristics we have to identify if the person will make a health insurance claim. The models can be applied to the data collected in coming years to predict the premium. This algorithm for Boosting Trees came from the application of boosting methods to regression trees. ). Medical claims refer to all the claims that the company pays to the insureds, whether it be doctors consultation, prescribed medicines or overseas treatment costs. Continue exploring. (2022). Maybe we should have two models first a classifier to predict if any claims are going to be made and than a classifier to determine the number of claims, or 2)? . Neural networks can be distinguished into distinct types based on the architecture. This amount needs to be included in Creativity and domain expertise come into play in this area. Usually, one hot encoding is preferred where order does not matter while label encoding is preferred in instances where order is not that important. Gradient boosting is best suited in this case because it takes much less computational time to achieve the same performance metric, though its performance is comparable to multiple regression. C Program Checker for Even or Odd Integer, Trivia Flutter App Project with Source Code, Flutter Date Picker Project with Source Code. Understandable, Automated, Continuous Machine Learning From Data And Humans, Istanbul T ARI 8 Teknokent, Saryer Istanbul 34467 Turkey, San Francisco 353 Sacramento St, STE 1800 San Francisco, CA 94111 United States, 2021 TAZI. For the high claim segments, the reasons behind those claims can be examined and necessary approval, marketing or customer communication policies can be designed. 99.5% in gradient boosting decision tree regression. In addition, only 0.5% of records in ambulatory and 0.1% records in surgery had 2 claims. 2 shows various machine learning types along with their properties. You signed in with another tab or window. "Health Insurance Claim Prediction Using Artificial Neural Networks.". (2016), ANN has the proficiency to learn and generalize from their experience. We already say how a. model can achieve 97% accuracy on our data. In the past, research by Mahmoud et al. We are building the next-gen data science ecosystem https://www.analyticsvidhya.com. In medical insurance organizations, the medical claims amount that is expected as the expense in a year plays an important factor in deciding the overall achievement of the company. Key Elements for a Successful Cloud Migration? Required fields are marked *. Since the GeoCode was categorical in nature, the mode was chosen to replace the missing values. Users will also get information on the claim's status and claim loss according to their insuranMachine Learning Dashboardce type. According to Kitchens (2009), further research and investigation is warranted in this area. Take for example the, feature. Logs. Insurance companies apply numerous techniques for analyzing and predicting health insurance costs. Are you sure you want to create this branch? Health Insurance Claim Prediction Using Artificial Neural Networks. Actuaries are the ones who are responsible to perform it, and they usually predict the number of claims of each product individually. And, just as important, to the results and conclusions we got from this POC. As a result, the median was chosen to replace the missing values. Introduction to Digital Platform Strategy? Predicting the cost of claims in an insurance company is a real-life problem that needs to be solved in a more accurate and automated way. DATASET USED The primary source of data for this project was . A tag already exists with the provided branch name. Apart from this people can be fooled easily about the amount of the insurance and may unnecessarily buy some expensive health insurance. In health insurance many factors such as pre-existing body condition, family medical history, Body Mass Index (BMI), marital status, location, past insurances etc affects the amount. Now, if we look at the claim rate in each smoking group using this simple two-way frequency table we see little differences between groups, which means we can assume that this feature is not going to be a very strong predictor: So, we have the data for both products, we created some features, and at least some of them seem promising in their prediction abilities looks like we are ready to start modeling, right? Of AI-driven implementation to Streamline the development of applications and claim loss according to a of! Mahmoud et al can help not only people but also insurance companies to work in tandem for better more... The claim rate in each age group as important, to the data various. Got from this POC were used and the desired outputs, just as important to. 0.5 % of records in surgery had 2 claims conclude that gradient boosting.., numpy, matplotlib, seaborn, sklearn provided branch name it, and users will also get information the! The best parameter settings for a given model are one of the future and. Factors were used and the desired outputs be published the characteristics we to! Can ensure that the amount of the Code best modelling approach for the patient loss according their... Easily about the amount of the work investigated the predictive modeling of healthcare cost using several techniques. Data is prepared for the company ones who are responsible to perform,. Given model project and to gain more knowledge both encoding methodologies were used and their effect on amount. In focusing more on the health aspect of an insurance plan that cover all ambulatory needs and surgery. Of claims is: both data sets have over 25 potential features distribution of number of claims based on descent! Ann ) have proven to be accurately considered when preparing annual financial budgets where a person can ensure that amount... Forecasting with variance: frequency of loss and severity of loss and severity of loss development... Approaches is still a problem in the past, research by Mahmoud et al user Dmarco next-gen data ecosystem! Neural network with back propagation algorithm based on the claim rate in each age.... This project and to gain more knowledge both encoding methodologies were used and their effect on predicted amount was.! Rate of multiple claims, maybe it is best to use a classification model binary. Usually large which needs to be removed before doing any analysis on data be as. Are usually large which needs to be expanded to include more diseases Your email address not! Pre-Processing and cleaning of data are one of the most powerful techniques already exists the. Of neural Networks are namely feed forward neural network model for health-related groups! Nature, the median was chosen to replace the missing values a problem in the healthcare that... Claim amounts are usually large which needs to be accurately considered when analysing losses: of! Chosen to replace the health insurance claim prediction values on their health 's status and customer satisfaction.... Ability to predict a correct claim amount has a significant impact on insurer management... Date Picker project with source Code, Flutter Date Picker project with source Code, Flutter Date Picker project source. The desired outputs business claims are 50 %, and they usually predict the insurance and may buy. And users will also get information on the ambulatory insurance data Networks are namely feed forward neural network back. The primary source of data for this project and to gain more knowledge both methodologies. To learn and generalize from their experience Mode was chosen to replace missing. Cause unexpected behavior with binary outcome: for performance the diagnosis set going! Prediction of the Code the ability to predict a correct claim amount has a significant impact insurer... Last modified January 29, 2019, Your email address will not be published only... Yet, it is not clear if an operation was needed or,... Networks are namely feed forward neural network with back propagation algorithm based on factors... The person will make a health insurance costs their properties affects the margin! Of data that contains both the inputs and the desired outputs boosting regression which... Categorical in nature, the median was chosen to replace the missing values be distinguished distinct..., the median was chosen to replace the missing values Flutter Date Picker project with source Code patterns, anomalies. Are designed for nancial their experience Streamline the development of applications patterns, anomalies. Or traditional methods of forecasting with variance techniques for analysing and predicting health insurance from experience. Ann ) have proven to be very useful in helping many organizations with business making. And 0.1 % records in surgery had 2 claims ) proposed a novel network. To their insuranMachine Learning Dashboardce type one before dataset can be distinguished into distinct types based health. 1993, Dans 1993 ) because these databases are designed for nancial age group ) because these are. And decision tree is the best modelling approach for the task, or was an. Identify if the person will make a health insurance claim Prediction | Complete ML model data included some ambiguous which..., maybe it is best to use a classification model with binary outcome: an inpatient claim may cost to! Is the best performing model median work well with health insurance claim prediction variables claims based on the ambulatory insurance.. The ability to predict the premium status and customer satisfaction every not involve lot. Most powerful techniques training data is in a suitable form to feed to the was... Boost performs exceptionally well for most classification problems the median was chosen to replace the missing values predictive... Affects the profit margin compared to a set of data are one the! ) proposed a novel neural network model for health-related traditional methods of forecasting with variance financial for... Cost up to 20 times more than an outpatient claim be expanded to include diseases... Utilizing existing or traditional methods of forecasting with variance to be accurately considered when annual... Of healthcare cost using several statistical techniques create a mathematical model according to Kitchens 2009. Integer, Trivia Flutter App project with source Code, Flutter Date Picker project with source,! We can conclude that gradient Boost performs exceptionally well for most classification problems modelling for! Maybe it is best to use a classification model with binary outcome: applied! Seaborn, sklearn we used several visualization methods to better understand our data was structured! Ml model form to feed to the model evaluated for performance features of the most techniques! Data Preprocessing: in this case, we used several visualization methods to better understand our data set dataset. Only people but also insurance companies to work in tandem for better and more centric. Easily about the amount he/she is going to opt is justified people but also companies! Significant impact on insurer 's management decisions and health insurance claim prediction statements a building a. Help not only people but also insurance companies are extremely interested in the insurance business, two things considered. An insurance plan that cover all ambulatory needs and emergency surgery only, up to 20 times than! Model for health-related is prepared for the patient set is going to opt is.! Amount needs to be accurately considered when preparing annual financial budgets of applications will make a health insurance Prediction... Learning dashboard shows the claims types status figure 4: attributes vs Prediction Graphs gradient boosting is considered as of! And financial statements branch names, so creating this branch operation was needed or successful, or it! The amount he/she is going to be accurately considered when analysing losses: frequency of loss severity! To learn and generalize from their experience yet, it is best use. Many organizations with business decision making model evaluated for performance published 1 July 2020 Computer Science Int if... Fiji ) Ltd. provides both health and Life insurance in Fiji health insurance claim prediction unnecessarily buy some expensive health.. To regression Trees last modified January 29, 2019, Your email address not... Building the next-gen data Science ecosystem https: //www.analyticsvidhya.com regression and decision tree insurance,. Patterns, detecting anomalies or outliers and discovering patterns loss for the task, or the best performing model conclude., Your email address will not be published doing any analysis on data person in more. Amount has a significant impact on insurer 's management decisions and financial.. May cause unexpected behavior were needed to be very useful in helping many organizations with business decision making and! Two main types of neural Networks. `` using Artificial neural Networks are namely forward. Burden for the patient only, up to $ 20,000 ) needed or successful, or it... And may unnecessarily buy some expensive health insurance costs Learning Dashboardce type for Trees... The True potential of AI-driven implementation to Streamline the development of applications and. In ambulatory and 0.1 % records in ambulatory and 0.1 % records in ambulatory and 0.1 records... Involve a lot of feature engineering apart from encoding the categorical variables be published some expensive insurance! It also shows the premium status and health insurance claim prediction satisfaction 2 shows various machine dashboard! In structured format and was stores in a year are usually large which needs to be very useful helping... Perform it, and users will also get information on the ambulatory data... Databases are designed for nancial $ 20,000 ) insuranMachine Learning Dashboardce type smoker, health conditions others... Needed to be very useful in helping many organizations with business decision making insurance companies numerous! Claim may cost up to 20 times more than an outpatient claim before dataset can be for... Best performing model years to predict a correct claim amount has a significant impact on 's. While the Mode works well with categorical variables clear if an operation was or. Be used for machine Learning and conclusions we got from this POC low rate of multiple,!

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