• Journal of Information Technology Services
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• v.6 no.2
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• pp.1-18
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• 2007

Many researches have been done in insurance fraud as the amount and frequency of insurance fraud have been increasing continuously. In particular, the development of insurance fraud detection system using large database management techniques including data mining or link analysis based on visual method have been the main research topic in insurance fraud. However, this kinds of detection system were very ineffective to find unintentional insurance fraud happened by accident even though it was so good to find intentional and organized crime insurance fraud. Therefore, this research suggests insurance fraud as an ethical decision making and applies TPB(Theory of Planned Behavior) for the finding of reasons and prevention strategies of unintentional insurance fraud happened by accident. The results of research show that TPB is very appropriate model to explain the behavior of insurance fraud and that insurance agents force to do insurance fraud as affecting perceived behavior control. Therefore, education and pubic relations for insurance fraud are very effective for preventing insurance fraud and developing insurance service industry.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.16 no.3
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• pp.1006-1027
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• 2022

In the crowdfunding market, various crowdfunding platforms can offer founders the possibilities to collect funding and launch someone's next campaign, project or events. Especially, healthcare crowdfunding is a field that is growing rapidly on health-related problems based on online platforms. One of the largest platforms, GoFundMe, has raised US$ 5 billion since 2010. Unfortunately, while providing crucial help to care for many people, it is also increasing risk of fraud. Using the largest platform of crowdfunding market, GoFundMe, we conduct an exhaustive search of detection on fraud from October 2016 to September 2019. Data sets are based on 6 main types of medical focused crowdfunding campaigns or events, such as cancer, in vitro fertilization (IVF), leukemia, health insurance, lymphoma and, surgery type. This study evaluated a detect of fraud process to identify fraud from non-fraud healthcare crowdfunding campaigns using various machine learning technics.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.17 no.12
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• pp.3218-3241
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• 2023

Financial fraud undermines the sustainable development of financial markets. Financial statements can be regarded as the key source of information to obtain the operating conditions of listed companies. Current research focuses more on mining financial digital data instead of looking into text data. However, text data can reveal emotional information, which is an important basis for detecting financial fraud. The audit opinion of the financial statement is especially the fair opinion of a certified public accountant on the quality of enterprise financial reports. Therefore, this research was carried out by using the data features of 4,153 listed companies' financial annual reports and audits of text opinions in the past six years, and the paper puts forward a financial fraud detection model integrating audit opinions. First, the financial data index database and audit opinion text database were built. Second, digitized audit opinions with deep learning Bert model was employed. Finally, both the extracted audit numerical characteristics and the financial numerical indicators were used as the training data of the LightGBM model. What is worth paying attention to is that the imbalanced distribution of sample labels is also one of the focuses of financial fraud research. To solve this problem, data enhancement and Focal Loss feature learning functions were used in data processing and model training respectively. The experimental results show that compared with the conventional financial fraud detection model, the performance of the proposed model is improved greatly, with Area Under the Curve (AUC) and Accuracy reaching 81.42% and 78.15%, respectively.

• Asia pacific journal of information systems
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• v.28 no.4
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• pp.308-319
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• 2018

This paper aims at providing valuable insights on Financial Fraud Detection on a mobile money transactional activity. We have predicted and classified the transaction as normal or fraud with a small sample and massive data set using Azure and Spark ML, which are traditional systems and Big Data respectively. Experimenting with sample dataset in Azure, we found that the Decision Forest model is the most accurate to proceed in terms of the recall value. For the massive data set using Spark ML, it is found that the Random Forest classifier algorithm of the classification model proves to be the best algorithm. It is presented that the Spark cluster gets much faster to build and evaluate models as adding more servers to the cluster with the same accuracy, which proves that the large scale data set can be predictable using Big Data platform. Finally, we reached a recall score with 0.73, which implies a satisfying prediction quality in predicting fraudulent transactions.

• International Journal of Computer Science & Network Security
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• v.24 no.4
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• pp.1-10
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• 2024

In the era of big data, the growth of e-commerce transactions brings forth both opportunities and risks, including the threat of data theft and fraud. To address these challenges, an automated real-time fraud detection system leveraging machine learning was developed. Four algorithms (Decision Tree, Naïve Bayes, XGBoost, and Neural Network) underwent comparison using a dataset from a clothing website that encompassed both legitimate and fraudulent transactions. The dataset exhibited an imbalance, with 9.3% representing fraud and 90.07% legitimate transactions. Performance evaluation metrics, including Recall, Precision, F1 Score, and AUC ROC, were employed to assess the effectiveness of each algorithm. XGBoost emerged as the top-performing model, achieving an impressive accuracy score of 95.85%. The proposed system proves to be a robust defense mechanism against fraudulent activities in e-commerce, thereby enhancing security and instilling trust in online transactions.

• The Journal of Information Systems
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• v.18 no.4
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• pp.41-57
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• 2009

Although financial information is a great influence upon determining of the group which use them, detection of management fraud and earning manipulation is a difficult task using normal audit procedures and corporate credit evaluation processes, due to the shortage of knowledge concerning the characteristics of management fraud, and the limitation of time and cost. These limitations suggest the need of systemic process for !he effective risk of earning manipulation for credit evaluators, external auditors, financial analysts, and regulators. Moot researches on management fraud have examined how various characteristics of the company's management features affect the occurrence of corporate fraud. This study examines financial characteristics of companies engaged in fraudulent financial reporting and suggests a model and system for detecting GAAP violations to improve reliability of accounting information and transparency of their management. Since the detection of management fraud has limited proven theory, this study used the detecting method of outlier(upper, and lower bound) financial ratio, as a real-field application. The strength of outlier detecting method is its use of easiness and understandability. In the suggested model, 14 variables of the 7 useful variable categories among the 76 financial ratio variables are examined through the distribution analysis as possible indicators of fraudulent financial statements accounts. The developed model from these variables show a 80.82% of hit ratio for the holdout sample. This model was developed as a financial outlier detecting system for a financial institution. External auditors, financial analysts, regulators, and other users of financial statements might use this model to pre-screen potential earnings manipulators in the credit evaluation system. Especially, this model will be helpful for the loan evaluators of financial institutes to decide more objective and effective credit ratings and to improve the quality of financial statements.

• International Journal of Computer Science & Network Security
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• v.21 no.6
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• pp.200-206
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• 2021

Fraud in e-commerce transaction increased in the last decade especially with the increasing number of online stores and the lockdown that forced more people to pay for services and groceries online using their credit card. Several machine learning methods were proposed to detect fraudulent transaction. Neural networks showed promising results, but it has some few drawbacks that can be overcome using optimization methods. There are two categories of learning optimization methods, first-order methods which utilizes gradient information to construct the next training iteration whereas, and second-order methods which derivatives use Hessian to calculate the iteration based on the optimization trajectory. There also some training refinements procedures that aims to potentially enhance the original accuracy while possibly reduce the model size. This paper investigate the performance of several NN models in detecting fraud in e-commerce transaction. The backpropagation model which is classified as first learning algorithm achieved the best accuracy 96% among all the models.

• Journal of Intelligence and Information Systems
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• v.21 no.1
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• pp.161-177
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• 2015

With the rapid evolution of technology, the size, number, and the type of databases has increased concomitantly, so data mining approaches face many challenging applications from databases. One such application is discovery of fraud patterns from agricultural product wholesale transaction instances. The agricultural product wholesale market in Korea is huge, and vast numbers of transactions have been made every day. The demand for agricultural products continues to grow, and the use of electronic auction systems raises the efficiency of operations of wholesale market. Certainly, the number of unusual transactions is also assumed to be increased in proportion to the trading amount, where an unusual transaction is often the first sign of fraud. However, it is very difficult to identify and detect these transactions and the corresponding fraud occurred in agricultural product wholesale market because the types of fraud are more intelligent than ever before. The fraud can be detected by verifying the overall transaction records manually, but it requires significant amount of human resources, and ultimately is not a practical approach. Frauds also can be revealed by victim's report or complaint. But there are usually no victims in the agricultural product wholesale frauds because they are committed by collusion of an auction company and an intermediary wholesaler. Nevertheless, it is required to monitor transaction records continuously and to make an effort to prevent any fraud, because the fraud not only disturbs the fair trade order of the market but also reduces the credibility of the market rapidly. Applying data mining to such an environment is very useful since it can discover unknown fraud patterns or features from a large volume of transaction data properly. The objective of this research is to empirically investigate the factors necessary to detect fraud transactions in an agricultural product wholesale market by developing a data mining based fraud detection model. One of major frauds is the phantom transaction, which is a colluding transaction by the seller(auction company or forwarder) and buyer(intermediary wholesaler) to commit the fraud transaction. They pretend to fulfill the transaction by recording false data in the online transaction processing system without actually selling products, and the seller receives money from the buyer. This leads to the overstatement of sales performance and illegal money transfers, which reduces the credibility of market. This paper reviews the environment of wholesale market such as types of transactions, roles of participants of the market, and various types and characteristics of frauds, and introduces the whole process of developing the phantom transaction detection model. The process consists of the following 4 modules: (1) Data cleaning and standardization (2) Statistical data analysis such as distribution and correlation analysis, (3) Construction of classification model using decision-tree induction approach, (4) Verification of the model in terms of hit ratio. We collected real data from 6 associations of agricultural producers in metropolitan markets. Final model with a decision-tree induction approach revealed that monthly average trading price of item offered by forwarders is a key variable in detecting the phantom transaction. The verification procedure also confirmed the suitability of the results. However, even though the performance of the results of this research is satisfactory, sensitive issues are still remained for improving classification accuracy and conciseness of rules. One such issue is the robustness of data mining model. Data mining is very much data-oriented, so data mining models tend to be very sensitive to changes of data or situations. Thus, it is evident that this non-robustness of data mining model requires continuous remodeling as data or situation changes. We hope that this paper suggest valuable guideline to organizations and companies that consider introducing or constructing a fraud detection model in the future.

• Journal of Digital Convergence
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• v.20 no.2
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• pp.241-250
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• 2022

Due to the COVID-19 pandemic, with increased 'untact' services and with unstable household economy, the bike insurance fraud is expected to surge. Moreover, the fraud methodology gets complicated. However, the fraud detection model for bike insurance is absent. we deal with the issue of skewed class distribution and reflect the criterion of fraud detection expert. We utilize a balanced random-forest algorithm to develop an efficient bike insurance fraud detection model. As a result, while the predictive performance of balanced random-forest model is superior than it of non-balanced model. There is no significant difference between the variables used by the experts and the confirmatory models. The important variables to detect frauds are turned out to be age and gender of driver, correspondence between insured and driver, the amount of self-repairing claim, and the amount of bodily injury liability.

• Journal of the Korea Institute of Information Security & Cryptology
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• v.29 no.1
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• pp.149-164
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• 2019

Digital Transformation and the Fourth Industrial Revolution, electronic financial services should be provided safely in accordance with rapidly changing technology changes in the times of change. However, telecommunication finance fraud (voice phishing) accidents are currently ongoing, and various efforts are being made to eradicate accidents such as legal amendment and improvement of policy system in order to cope with continuous increase, intelligence and advancement of accidents. In addition, financial institutions are trying to prevent fraudulent accidents by improving and upgrading the abnormal financial transaction detection system, but the results are not very clear. Despite these efforts, telecommunications and financial fraud incidents have evolved to evolve against countermeasures. In this paper, we propose an intelligent over - the - counter financial transaction system modeled through scenario - based Rule model and artificial intelligence algorithm to prevent financial transaction accidents by voice phishing. We propose an implementation model of artificial intelligence abnormal financial transaction detection system and an optimized countermeasure model that can block and respond to analysis and detection results.