Prediction of Insurance Claims for Health Sector using Machine Learning Techniques

Nowadays, health issues play a tremendous role in day-to-day life and the medical expenditure to get treatment becomes more difficult for the ordinary people. Health insurance has become a vital aspect of people's lives. In this massive community, to access healthcare services such as insurance policies, LIC, ICICI, HDFC ERGO, Star Healthcare are benefits for claiming an amount for their medical expenses. The dataset encompasses three categories, such as generalized data, hospitalized data and claim data. Each record in the dataset represents an individual's health insurance charges along with corresponding demographic and health-related characteristics. In this paper, Machine Learning techniques are used to group the claim amount that has been adopted by the individuals based on the hospitalized expenditure and insurance charges paid by the individuals. In the health sector, machine learning techniques are used to forecast insurance claims by building predictive models from historical data on claims, patient demographics, treatment types, and results. By predicting future claims based on trends seen in the data, these models help insurance firms better manage risk and allocate resources. In case of a fresher to this concept, it feels challenging to understand whereas generating as a pattern can be more flexible to acquire knowledge about how much amount has been claimed.