Insurance Fraud Detection using Network Analytics (Power BI)

Project Overview

This repository contains an end-to-end Insurance Fraud Analytics project built using Microsoft Power BI. The solution focuses on detecting organized fraud using network-based indicators rather than isolated claims.

Dataset

• 5,000 simulated insurance claims
• Entities: Claimants, Providers, Agents
• Fraud indicators: Fraud score, shared phone and bank flags, claim history

Key Features

• Star schema data model optimized for analytics
• Advanced DAX measures for fraud scoring and investigation prioritization
• Network centrality proxies (provider degree analysis)
• Investigation funnel from total claims to high-priority cases

Dashboards

1. Executive Fraud Overview
2. Fraud Risk & Anomaly Analysis
3. Provider & Agent Network Risk
4. Network Indicators (Centrality Proxy)
5. Investigation Prioritization

Tools & Technologies

• Microsoft Power BI
• DAX
• Excel

Business Impact

• Early detection of organized fraud rings
• Reduced SIU investigation workload
• Explainable and scalable analytics

Author

Vijay Kumar Naik