AI Agents

Context

Designed for insurance within the Underwriting assessment stack, this agent is used after disclosures and evidence have been structured and verified—so underwriters can assign a risk tier that reflects the combined picture of health/medical factors, financial/occupation context where relevant, and verified asset/usage for P&C lines.

What it does

The agent ingests the validated inputs (questionnaire outcomes, medical evidence checks, income/occupation verification where applicable, asset and usage profiles, and policy-specific criteria) and assigns a risk tier according to your underwriting rules. It returns the tier with a short rationale that cites which verified factors drove the outcome, and highlights any dependencies that require a manual look (edge conditions, missing items, or conflicting evidence). Each conclusion links back to the exact field or document passage used, so reviewers can confirm and, if needed, override with a clear audit trail.

Core AI functions

Normalization of verified inputs to the carrier’s tiering schema; rule evaluation against approved underwriting criteria; factor weighting where rules specify composite scores; exception handling for borderline or conflicting signals; and reason-code generation that explains the assigned tier with field-level lineage to disclosures and evidence.

Problem solved

Tiering is often inconsistent when based on manual judgment and scattered evidence. Rules are applied unevenly, edge cases are treated differently, and reviewers lack a concise explanation of why a particular tier was chosen.

Business impact

Consistent pricing and approvals: tiers reflect verified facts, not guesswork; decisions are faster and more defensible; and rework drops because the rationale is explicit and tied to evidence.

Integration and adjacent use cases

Integration complexity: medium. The agent reads structured outputs from upstream steps; Medical questionnaire analyzer, Health history & diagnostic validator, Income & occupation verifier (life), Asset & usage pattern extractor (P&C), and writes the tier, rationale, and flags into the underwriting workbench or policy admin; no core changes are required.

It is commonly combined with:

• Manual exception escalation wrapper to route borderline or policy-sensitive outcomes with a complete evidence pack, and with

• Downstream issuance checks (e.g., Policy terms cross-check agent) to ensure the selected terms align with the assigned tier.