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01_introduction.md
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## I. **Introduction: The Invisible Fraud**
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Insurance fraud is among the most pervasive and costly crimes in the modern world — and among the least visible. In the United States alone, estimates place the financial toll between **\$80 billion to \$300 billion annually**, depending on the method of calculation and sector. Yet beyond the numbers lie deeper, more human costs:
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* Inflated premiums for innocent policyholders
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* Strained relationships between claimants and adjusters
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* Erosion of trust in legal, medical, and financial systems
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Despite decades of countermeasures, the dominant tools of detection remain narrow in scope:
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* **Actuarial heuristics** to flag statistical anomalies
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* **Rules-based filters** for inconsistent reporting
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* **Behavioral red flags** that rely on gut instinct or training modules
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These models function, but they fall short — especially against skilled deceivers.
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What’s missing is *language*. Not keyword search or semantic fingerprinting,
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but the recursive structures of narrative — how **truth and deceit organize themselves** differently, fractally, and often unconsciously.
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> **This paper introduces a novel forensic linguistic framework** for detecting *intentional deception* embedded within:
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>
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> * Claim narratives
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> * Adjuster–claimant dialogue
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> * Supporting documentation and metadata
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It is not merely a system of detection.
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It is a **witness-bearing instrument** — one that listens for echoes, contradictions, and recursive distortions in the way language reveals **psychological intent**.
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> *This paper is an artifact. It does not simply measure fraud. It reads its echoes in language.*
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---
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outline.md
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## 🧾 **Outline: "The Recursive Claim: A Forensic Linguistic Framework for Detecting Deceptive Patterns in Insurance Fraud Investigations"**
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*“To speak a lie is to fracture the field. This paper measures the break.”*
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---
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### I. **Introduction: The Invisible Fraud**
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* The scale of insurance fraud in the U.S. and globally: unseen costs, human consequences.
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* Limitations of current detection models: actuarial, rules-based, and behavioral red flags.
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* Call to action: The need for a recursive, language-based forensic method.
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* Thesis: This paper introduces a novel forensic linguistic framework designed to detect **intentional deception** in claim narratives, adjuster communications, and claimant behavior.
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> *This paper is an artifact. It does not simply measure fraud. It reads its echoes in language.*
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---
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### II. **Theoretical Framework**
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#### A. Recursive Linguistic Analysis (RLA)
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* Core principle: Patterns of deception manifest in recursive inconsistencies, disfluencies, and denials.
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* Grounding in cognitive linguistics, pragmatics, and affective computing.
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* Influence from **Witness Fracture**, extended toward institutional and corporate forensic use.
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#### B. Pattern Resonance Theory
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* How repetition, deflection, minimization, and overjustification fracture coherence.
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* Introduction of micro-patterns such as:
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* **Narrative Overcontrol**
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* **Empathic Bypass**
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* **Temporal Drift**
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* **Claimant Displacement**
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---
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### III. **Methodology**
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#### A. Dataset
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* Anonymized insurance claim transcripts, emails, and call center logs.
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* Mix of known fraudulent and validated claims for training and testing.
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* Human-AI recursive review loop to validate pattern resonance scores.
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#### B. Analytical Tools
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* NLP-based pattern extraction
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* Sentiment trajectory mapping (honest vs. manipulative arcs)
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* Syntax entropy and disfluency detection
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* "Truth collapse" scoring using **Recursive Witness Dynamics**
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#### C. Classification Model
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* Patterns grouped into **3 Recursive Zones**:
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* Zone I: Unintentional Incoherence (low risk)
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* Zone II: Adaptive Rationalization (medium risk)
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* Zone III: Deliberate Narrative Fabrication (high risk)
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---
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### IV. **Case Studies**
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* Side-by-side forensic breakdown of two similar claims:
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* One honest, one fraudulent
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* Breakdown of:
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* Lexical hedging
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* Emotional flatness or hyper-control
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* Excessive narrative reconstruction
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* **Recursive Signature** pattern table presented per case
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> *A liar must remember the lie. A witness must remember the truth. The former leaves residue in language.*
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---
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### V. **Applications and Implications**
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* Integration with insurance claim adjuster training and AI triage tools
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* Deployment in hybrid human-AI analysis environments
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* Potential impact:
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* Reduced false positives (trauma survivors often flagged)
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* Ethical alignment with empathy-first design
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* Future: Possible alignment with legal admissibility frameworks for forensic language evidence
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---
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### VI. **Discussion: The Ethics of Knowing**
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* On the risk of mislabeling honest pain as fraud
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* The role of the Empathic Technologist in field justice
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* How recursive forensics differs from predictive surveillance
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* Toward a new ethic of **Cognitive Integrity Witnessing**
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---
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### VII. **Conclusion: A New Eye for Deception**
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* Summary of framework
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* Call for adoption and further testing in public-private field trials
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* Framed as part of *The Empathic Technologist* series
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* Ending quote (optional):
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> *“Every false claim is a fracture in the field. To repair it, we must first listen to the silence between words.”*
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---
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### Appendices
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* Appendix A: Recursive Pattern Lexicon for Insurance Fraud
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* Appendix B: Sample Annotated Claim Transcripts
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* Appendix C: Alignment Mapping to DARVO, gaslighting, and manipulation techniques
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---
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