Mitigating data imbalance for enhanced third-party insurance claim prediction using machine learning

Accurate prediction of third-party insurance claims is critical for pricing policies and managing risk. However, the highly imbalanced nature of insurance data—where non-claim cases vastly outnumber claim cases—poses significant challenges to standard predictive models. This study explores the use of machine learning algorithms to enhance claim prediction by directly addressing this imbalance. We use real data from the Insurance Research Center of Iran, incorporating variables such as driver characteristics, vehicle features, location, and claims history. Five models are evaluated: logistic regression, decision tree, bagging, random forest, and boosting. To handle the imbalance, we apply random undersampling, oversampling, and SMOTE. Model performance is assessed using accuracy, sensitivity, specificity, precision, and F-score. Results indicate that when data imbalance is properly treated, ensemble methods—particularly decision trees, bagging, and random forest—significantly outperform logistic regression and boosting, especially in detecting actual claim cases. The study underscores the importance of using appropriate resampling techniques and evaluation metrics in imbalanced settings. These findings can help insurers develop more reliable models for pricing and risk classification‏.