Fraud Detection with Process Mining & ML

Combines process mining and machine learning to detect fraud in car insurance claims. Event logs following the standard claims workflow (First Notification of Loss → Assign Claim → Claim Decision → Set Reserve → Payment Sent → Close Claim) are analyzed in Celonis to uncover bottlenecks, reworks, and suspicious deviations across thousands of records. A 21-feature dataset (categorical: case/client/policy/accident attributes; numerical: claim amounts, client age, processing duration, activity counts) feeds a Python/scikit-learn model, with SMOTE for class imbalance, to classify claims as valid, fraudulent, or violations.