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How Natural Language Processing (NLP) is Used to Detect Fraudulent Transactions and Claims

Published at
12/5/2024
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How Natural Language Processing (NLP) is Used to Detect Fraudulent Transactions and Claims

The level of financial fraud has dramatically increased in recent years, ranging from credit card deception to insurance fraud. This surge highlights the urgent need to develop innovative procedures for identifying such cases. One of the most effective tools in combating fraud is Natural Language Processing (NLP), a powerful branch of artificial intelligence that focuses on understanding human language using computers. NLP enables companies to process large volumes of data, such as 60,000 emails or thousands of contracts, to detect unusual patterns or signs of fraud automatically. For individuals looking to harness these advanced techniques, enrolling in a data science course in Chennai can provide the skills needed to excel in this field.

NLP stands for natural language processing, as illustrated by the following data.
Natural Language Processing (NLP) is a branch of AI that lets machines process, analyse, and even produce text. NLP is an interface between interpersonal communication and machine comprehension which makes the computer analyse the text, understand its meaning, and even dialogue. It consists of processes like tokenisation, POS tagging, sentiment analysis, NER, and others to handle language data.
Although NLP has various uses, the analysis of unstructured text data is very helpful in identifying fraud. Fraudulent activities involve the usage of language, misrepresentation, or discrepancy in documentation. Through the identified textual features, NLP proves to advance the previous sign of intent detection by such a marginal level that a human-compiled checklist would overlook.
How NLP Detects Fraudulent Transactions
Analyzing Transaction Descriptions: Credit card companies and banks utilised NLP to analyse descriptions connected to payment transactions. Fraudulent transactions can have some lingual characteristics, including high severity of language differentiation, low frequency of complex words, and essential morphological changes. NLP systems can alert any of these discrepancies for further review and analysis as well. For example, while a certain transaction description such as “PCHSOPRS121” can look nothing like a real transaction in the form of ‘Order shoes for $109.99’, yet, it is an attempt at a transaction in a code that has no meaning to the outside world.
Behavioral Analysis of Customer Communications: There are a lot of customer-related interactions that happen over the phone, e-mail, chat, and others, and NLP can be applied to them to detect such suspicious actions. There are typical features in the use of language during a fraud, for example, употребление стишных существительных, idiots, inconsistency, or high level of activity during the conversation,(shifts in tone and pace of voice, etc. To be more specific, analysing the tone, sentiment, and structure of such communications allows NLP models to detect fraudulent actors. For example, when a customer becomes argumentative or is asked to verify an issue through the system and keeps on changing their tune, this will be deemed as possible fraud.
Real-Time Transaction Monitoring: NLP can also be applied to continuous surveillance of financial transactions. As the transaction data is processed along with customer interaction, the NLP system can identify new fraud schemes close to real time. For instance, when a user starts multiple transactions that contain terms that are unnatural PDFs with suspicious descriptions or even requests refunds for vague reasons, the NLP system can notify other systems and stop these transactions.
Semantic Analysis of Transaction Context: NLP can also capture the context of the transaction, including whether the merchant has a prior interaction with the customer or previous transactions that suggest fraud, among others. By using transaction records and comparing the given customer spending profile and his/her spending habits, the NLP systems are capable of detecting massive frauds.
NLP for Detecting Fraudulent Insurance Claims
The insurance industry, with major emphases on health, auto, and home insurance, is another area in which NLP can be used to detect fraud. It involves dishonesty and therefore, those making the claims come up with all sorts of decent or overly elaborate stories to cover up. These anomalies are picked by the NLP models by parsing the documents containing insurance claims, policyholder communications, and social media updates, among others.
Textual Analysis of Claim Descriptions: Chapman and Vieweg note how one technique used by NLP in detecting fraudulent insurance claims is the natural language of the claim. The criminals themselves can be very general and/or even contradictory when describing the situation. NLP algorithms can then match the wording of the claim with standard modes of interaction and identify and report more suspicious claims. For instance, when a claimant writes or say more than is necessary or provides information that is unnecessarily elaborate or redundant and does not accord with the gravity of the injury or the incident in question, an alert is raised.
Detecting Inconsistencies and Contradictions: One of the primary attributions of fraud claims is that they are not consistent in their approach. NLP can compare the content of all the documents related to the claim, including health records reports, police documents, and the claimant report, to come up with a contradiction. For instance, if a claimant who has filed a certain injury claim describes the injury differently from what is documented in the patient’s record, the NLP systems will surely make the claim an area of interest. As a result, using NLP, insurers can dodge false claims that contradict facts and figures.
Sentiment Analysis: Another NLP method used to identify feelings presented by the claimants is sentiment analysis. There have been instances where fraudsters may display symptoms of distress, extremism, y, and high self-assurance when presenting /filing claims. NLP can examine the tone of the writing of a claimant’s statements or, if records of phone communication, then study emotional signs in their voice that may indicate falsehood. For example, if a claimant looks frustrated or angry when preparing a claim and his or her story changes after being confronted with facts, the case may be referred for a second look.
Social Media and Public Data Monitoring: Some insurance companies have also adopted NLP in sorting huge amounts of data or data coming from social media to check for irregularities or indications of fraud. It is common to find fraudsters who make fake claims of what they are not on social media or upload pictures and information that deny what they are bragging about. Using NLP to analyze tweets, review comments, applications, and public records, insurance firms can gather useful information and verify some information given by applicants.

The Advantages of Non-supervised Learning for Fraud Buster
Speed and Efficiency: Compared to the time needed for manual reviewing of large volumes of text data, NLP can quickly work with unstructured data and respond to fraudulence.
Accuracy: By analyzing small discrepancies in the language used in the text the NLP algorithm lowers rates of false positives and makes fraudulent detection more accurate.
Cost-Effectiveness: This is because when using NLP for the actual detection of fraud, little discretion is required, which means that financial institutions and insurance companies will save both time and money.
Scalability: Their capabilities only improve with the expanding data; therefore, NLP systems can handle immense transaction and claim volumes to support organizations’ fraud detection scaling up.
Conclusion
Natural Language Processing (NLP) has been widely adopted as an effective method to combat fraud in transactions and insurance claims. Specifically, through the analysis of language patterns, disparities, and emotional signals, NLP systems are the only possibility to reveal cheaters exceptionally fast and efficiently. Apart from the detection of fraud, NLP, due to its capability to analyse large quantities of unstructured information, plays a very important role in creating a more reliable and protected internet space.

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