Insurance claims fraud detection model

For fraudulent claims, that would be a binary indicator for known fraudulent claims (no false positives) and known legitimate claims. Check to see if you have this data set and the time period for the data. You will need a representative sample of both types of claims. For a "suspicious claims" model, the dependent variable would be defined a little differently. You need a set of claims that were flagged as suspicious, investigated and found to be fraudulent.