arXiv:2607.07858cs.AIcs.LG2026-07

用多智能体AI提升商业保险自动核保的准确性与合规性

Agentic AI and Retrieval-Augmented Models in Straight-Through Underwriting

论文配图:Agentic AI and Retrieval-Augmented Models in Straight-Through Underwriting
图 1 · 摘自论文原文
  • 构建多智能体框架,分步执行检索、验真和规则校验
  • 在缺信息和多步骤场景下准确率提升显著,避免错误直通决策
  • 适合需要透明、可审计的保险自动化系统设计者

人工智能正重塑精算实践,尤其在需处理非结构化文档、异构数据源和受监管决策流程的领域。精算师面临从传统规则自动化到大语言模型(LLM)、检索增强生成(RAG)及能规划、检索、调用工具、反思的多智能体‘代理式’系统的复杂设计空间。本文探讨这些新兴架构如何支持精算核心需求:透明度、可审计性和人机协同治理,聚焦直通式决策流程。为使理念具体化,我们构建并分析了一个用于小型商业业主政策(BOPs)直通核保的代理式AI框架。在合成但真实的实验环境中,对比三种核保流程:(i) 单一LLM基线,(ii) 简单RAG系统,(iii) 结合定向检索、第三方数据验证和显式多步规则评估的多智能体‘代理式RAG’管道。结果表明,代理系统整体表现最优,尤其在多步骤和缺失信息场景中优势明显,结构化检索与反思机制有效防止了无依据的直通决策。

原文摘要 · Abstract (English)

Artificial intelligence (AI) is beginning to reshape actuarial practice, particularly in domains that require reasoning over unstructured documents, heterogeneous data sources, and regulated decision workflows. Actuaries now face a design space that ranges from traditional rule-based automation to large language models (LLMs), retrieval-augmented generation (RAG), and multi-agent ``agentic'' systems that plan, retrieve, call tools, and reflect. This paper examines how these emerging architectures can support actuarial priorities such as transparency, auditability, and human-in-the-loop governance, with a focus on straight-through decision processes. To make these ideas concrete, we develop and analyze an agentic AI framework for straight-through underwriting of small commercial Business Owner Policies (BOPs). We construct a synthetic but realistic experimental environment and compare three underwriting pipelines: (i) a single-LLM baseline, (ii) a naive RAG system, and (iii) a multi-agent ``Agentic RAG'' pipeline that combines targeted retrieval, third-party data checks, and explicit multi-step rule evaluation. The agentic system performs best overall, with the largest gains in multi-step and missing-information scenarios, where structured retrieval and reflection help the model avoid unsupported straight-through decisions.

AI核保多智能体RAG保险科技

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