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Fraud Rules Engine

Documentation of rule-based fraud detection logic and decision trees for identifying suspicious activities across multiple channels.

Overview

This repository contains comprehensive documentation of rule-based fraud detection systems, including decision trees, scoring methodologies, and trigger conditions. The rules engine approach combines automated detection with configurable thresholds to balance fraud prevention with customer experience.

Rule Categories

Transaction Rules

  • High-Value Transactions: Flags transactions exceeding predefined thresholds
  • Velocity Checks: Multiple transactions in short time periods
  • Round Dollar Amounts: Unusually round transaction amounts (potential testing)
  • Declined Transaction Patterns: Multiple declined attempts followed by successful transaction

Account Behavior Rules

  • Address Changes: Recent address modification followed by large purchase
  • Payment Method Changes: New payment methods added and immediately used
  • Account Takeover Indicators: Login from new device/location with immediate changes
  • Dormant Account Activity: Sudden activity on previously inactive accounts

Geographic Rules

  • Impossible Travel: Transactions from distant locations in unrealistic timeframes
  • High-Risk Locations: Transactions from known fraud hotspots
  • IP/BIN Mismatch: Card-issuing country doesn't match transaction IP location

Pattern Recognition Rules

  • Sequential Account Numbers: Testing with incrementing card numbers
  • Rapid Account Creation: Multiple accounts from same device/IP
  • Suspicious Email Patterns: Free email providers with random character strings

Decision Tree Logic

Transaction Received
├─ Amount > $5000?
│  ├─ Yes → Score +30
│  └─ No → Continue
├─ First transaction on account?
│  ├─ Yes → Score +20
│  └─ No → Continue
├─ Shipping address = billing address?
│  ├─ No → Score +15
│  └─ Yes → Continue
├─ Device fingerprint matches history?
│  ├─ No → Score +25
│  └─ Yes → Continue
│
Total Score:
├─ 0-20: Auto-approve
├─ 21-50: Manual review
└─ 51+: Auto-decline

Risk Scoring System

  • Low Risk (0-20): Proceed with transaction
  • Medium Risk (21-50): Queue for fraud analyst review
  • High Risk (51-75): Decline with option for customer verification
  • Critical Risk (76+): Auto-decline and flag account

Rule Maintenance

  • Rules reviewed quarterly based on fraud trends
  • Thresholds adjusted using ROC curve analysis
  • False positive rates monitored and optimized
  • New rules added based on emerging fraud patterns

Integration Points

  • Real-time transaction screening
  • Batch processing for account reviews
  • Case management system for manual review queue
  • Reporting dashboard for rule performance metrics

About

Rule-based FWA and fraud detection logic, decision trees, and scoring models for healthcare claims and financial transactions

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