Description: The presenters will provide insights into fraud and abuse risk in the health insurance industry, including an examination of traditional and predictive modeling techniques for both prevention and detection. Emphasis will be placed on current and emerging risks. Canadian examples and perspectives will be offered, but the applications for attendees to use in practice are non-nation specific.

Description: Article from The Actuary September 1992 – Volume 26, No. 7 is about research papers for FSA credit, specifically mentions The Application of Fuzzy Sets to Group Health Underwriting

Description: This 1972 report provides morbidity of Group Weekly Indemnity insurance for years labeled 1967, 1968, 1969, 1970, and 1971.

Description: This paper addresses pricing stop loss insurance by employee for two benefits combined when the available information included a claims probability distribution for each benefit and the correlation coefficient between the benefits. From Actuarial Research Clearing House 1991, VOL. 1