Analysis of Health Insurance Claims Factors using The Stochastic Restricted Maximum Likelihood Estimation (SRMLE) Binary Logistic Regression Model

(Case Study: Health Insurance Claims at XYZ Company in 2023)

Abstract

The health insurance claim approval process is a crucial aspect for insurance companies. Inaccuracy in predicting claim status can pose financial risks to the company and reduce policyholder trust. This study aims to identify the factors that influence the approval or rejection of health insurance claims. In this type of data analysis, the problem of multicollinearity among predictor variables is often encountered, which can lead to unstable parameter estimates. To address this issue, this study utilizes a binary logistic regression model with the Stochastic Restricted Maximum Likelihood Estimation (SRMLE) method, which is better suited to handle such conditions. The data used in this research includes the variables of total claim amount, premium price, number of insured individuals, employee age, and the number of previous claims recorded at XYZ Company. The results of the factor analysis, through the developed logistic regression model, show that the variables of total claim amount, premium price, and the number of insured individuals are significant factors influencing the probability of claim approval.