SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK

Tuba Irmak

TR EN

SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK

Abstract

Sağlık sigortası primlerinin doğru tahmini, bireyler için gereksiz maliyetlerin önlenmesi ve sigorta şirketleri için sürdürülebilir kârlılığın sağlanması açısından kritik öneme sahiptir. Bu çalışmada, Kaggle'da açık erişimli "Insurance Premium Prediction" veri seti kullanılarak bireylerin yıllık sağlık sigortası prim tutarları makine öğrenmesi tabanlı regresyon yöntemleriyle tahmin edilmiştir. Doğrusal, örnek tabanlı, çekirdek tabanlı ve ağaç tabanlı topluluk yaklaşımlarından oluşan sekiz model eğitilmiş; performansları 5-katlı çapraz doğrulama ve ayrılmış test kümesi üzerinde karşılaştırılmıştır. En iyi sonuç 0,9007 R² değeriyle Gradient Boosting modelinden elde edilmiş, bu model için RandomizedSearchCV ile hiperparametre optimizasyonu yapılmış ve özellikle MAPE değerinde iyileşme sağlanmıştır. 'bmi' ve 'charges' değişkenlerine %1–%99 aralığında uç kırpma uygulanarak yürütülen duyarlılık analizinde, uç kırpmanın özellikle ağaç tabanlı modellerde R² değerlerini artırdığı ve hata metriklerini iyileştirdiği görülmüştür. SHAP analizi, prim tutarları üzerinde en etkili değişkenin sigara kullanım durumu olduğunu ortaya koymuştur. Bulguların genellenebilirliği bağımsız bir veri setinde sınanmış ve ağaç tabanlı topluluk modellerinin üstünlüğü doğrulanmıştır. Sonuçlar, uç değer işleme ile birleştirilen ağaç tabanlı topluluk modellerinin sigorta prim tahmini için güvenilir bir temel sunduğunu göstermektedir.

Keywords

WINSORIZATION SENSITIVITY AND SHAP-BASED EXPLAINABILITY IN HEALTH INSURANCE PREMIUM PREDICTION

Abstract

Accurate prediction of health insurance premiums is critical both for preventing unnecessary costs for individuals and for ensuring sustainable profitability for insurers. In this study, annual health insurance premiums are predicted using machine learning-based regression methods on the openly accessible "Insurance Premium Prediction" dataset shared on Kaggle. Eight models comprising linear, instance-based, kernel-based, and tree-based ensemble approaches were trained and compared through 5-fold cross-validation on the training set and on a held-out test set. The best performance was achieved by Gradient Boosting with an R² of 0.9007; hyperparameter optimization using RandomizedSearchCV yielded a further improvement, particularly in MAPE. A sensitivity analysis applying winsorization at the 1st–99th percentile range to the 'bmi' and 'charges' variables showed that outlier clipping increased R² values and improved error metrics, especially for tree-based models. SHAP analysis identified smoking status as the most influential variable on premium amounts. The generalizability of the findings was tested on an independent dataset, where tree-based ensemble models again outperformed the alternatives. These results suggest that tree-based ensembles combined with outlier treatment provide a reliable basis for insurance premium estimation.

Keywords

References

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Details

Primary Language

Turkish

Subjects

Machine Learning (Other)

Journal Section

Research Article

Authors

Tuba Irmak ^*
0000-0003-4749-5226
Türkiye

Publication Date

September 3, 2026

Submission Date

February 9, 2026

Acceptance Date

July 28, 2026

Published in Issue

Year 2026 Volume: 29 Number: 3

IZ

https://izlik.org/JA45KL84FW

Cite

RIS / Bibtex

APA

Irmak, T. (2026). SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK. Kahramanmaraş Sütçü İmam Üniversitesi Mühendislik Bilimleri Dergisi, 29(3), 1042-1061. https://izlik.org/JA45KL84FW

AMA

1.Irmak T. SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK. KSU J. Eng. Sci. 2026;29(3):1042-1061. https://izlik.org/JA45KL84FW

Chicago

Irmak, Tuba. 2026. “SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK”. Kahramanmaraş Sütçü İmam Üniversitesi Mühendislik Bilimleri Dergisi 29 (3): 1042-61. https://izlik.org/JA45KL84FW.

EndNote

Irmak T (September 1, 2026) SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK. Kahramanmaraş Sütçü İmam Üniversitesi Mühendislik Bilimleri Dergisi 29 3 1042–1061.

IEEE

[1]T. Irmak, “SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK”, KSU J. Eng. Sci., vol. 29, no. 3, pp. 1042–1061, Sept. 2026, [Online]. Available: https://izlik.org/JA45KL84FW

ISNAD

Irmak, Tuba. “SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK”. Kahramanmaraş Sütçü İmam Üniversitesi Mühendislik Bilimleri Dergisi 29/3 (September 1, 2026): 1042-1061. https://izlik.org/JA45KL84FW.

JAMA

1.Irmak T. SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK. KSU J. Eng. Sci. 2026;29:1042–1061.

MLA

Irmak, Tuba. “SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK”. Kahramanmaraş Sütçü İmam Üniversitesi Mühendislik Bilimleri Dergisi, vol. 29, no. 3, Sept. 2026, pp. 1042-61, https://izlik.org/JA45KL84FW.

Vancouver

1.Tuba Irmak. SAĞLIK SİGORTASI PRİM TAHMİNİNDE UÇ KIRPMA DUYARLILIĞI VE SHAP TABANLI AÇIKLANABİLİRLİK. KSU J. Eng. Sci. [Internet]. 2026 Sep. 1;29(3):1042-61. Available from: https://izlik.org/JA45KL84FW