융합정보논문지 (Journal of Convergence for Information Technology)

중소기업융합학회 (Convergence Society for SMB)
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기계학습을 이용한 블록체인 기반의 보험사기 예측 모델 연구

A Study on the Blockchain-Based Insurance Fraud Prediction Model Using Machine Learning

  • Lee, YongJoo (Division of Software, Chungbuk National University)
  • 투고 : 2021.04.29
  • 심사 : 2021.06.20
  • 발행 : 2021.06.28
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⟨ 이전 논문 다음 논문 ⟩

초록

정보기술의 발달로 보험사기의 규모는 매년 급증하고 있고, 그 방법도 공모 형태로 조직화되고 고도화되고 있다. 이를 예측하고 검출하기 위한 다양한 형태의 예측모델이 연구되고 있지만 보험관련 정보는 매우 민감하여 공유와 접근에 위험이 높고 법적인 혹은 기술적인 제약이 많다. 이 논문에서는 최근 4차 산업 혁명의 등장으로 가장 각광받는 기술 중 하나인 블록체인을 기반으로 한 기계학습 보험사기 예측모델을 제안한다. 블록체인 기술을 활용하여 안전하고 신뢰받는 보험청구 정보 공유시스템을 실현하고, 보다 효율적이고 정확한 사기예측을 위하여 사회관계분석이론을 적용하여 각 관계에 가중치를 부여하고 기계학습 사기 예측패턴을 4단계로 나누어 제안하였다. 사기 가능성이 높은 보험청구건은 보다 앞선 단계에서 높은 예측 율로 검출되는 효과를 가지며 가능성이 낮은 청구 건은 사후에 참고하여 관리할 수 있도록 차등 적용하였다. 제안하는 모델의 중요 매커니즘은 이더리움(Ethereum) 로컬 네트워크를 구성하여 검증 하였고, 향후 보다 정교한 성능평가가 요구된다.

With the development of information technology, the size of insurance fraud is increasing rapidly every year, and the method is being organized and advanced in conspiracy. Although various forms of prediction models are being studied to predict and detect this, insurance-related information is highly sensitive, which poses a high risk of sharing and access and has many legal or technical constraints. In this paper, we propose a machine learning insurance fraud prediction model based on blockchain, one of the most popular technologies with the recent advent of the Fourth Industrial Revolution. We utilize blockchain technology to realize a safe and trusted insurance information sharing system, apply the theory of social relationship analysis for more efficient and accurate fraud prediction, and propose machine learning fraud prediction patterns in four stages. Claims with high probability of fraud have the effect of being detected at a higher prediction rate at an earlier stage, and claims with low probability are applied differentially for post-reference management. The core mechanism of the proposed model has been verified by constructing an Ethereum local network, requiring more sophisticated performance evaluations in the future.

키워드

과제정보

This work was supported by Institute for information & communications Technology Promotion(IITP) grant funded by the Korea government(MSIT) (No. 2019-0-00708, Integrated Development Environment for Autonomic IoT Applications based on Neuromorphic Architecture).

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