AI-Powered Death Claims Processing System
Deploys **11 specialized AI agents** orchestrated in a multi-phase pipeline. Uses Isolation Forest for fraud detection (94.
Problem Statement
The challenge addressed
Solution Architecture
AI orchestration approach
Claim Input Form
Multi-Agent Processing Dashboard
Processing Results & Compliance
AI Decision Summary
AI Agents
Specialized autonomous agents working in coordination
Claims Orchestrator Agent
Coordinating multiple specialized agents and synthesizing their findings into coherent claim decisions requires complex workflow management and decision aggregation.
Core Logic
Central coordination hub that manages the multi-phase processing pipeline. Aggregates findings from all agents, applies **Logistic Regression model** (94.7% accuracy) for final risk scoring, and generates recommendations: auto-approve, approve_with_review, escalate, or require_human_review. Implements message-passing architecture for inter-agent communication.
Document Intelligence Agent
Manual document review is slow, error-prone, and cannot scale. Death certificates, wills, and policy documents require expert analysis for authenticity verification.
Core Logic
Combines **OCR + NLP** for intelligent document analysis. Extracts structured data from death certificates, beneficiary IDs, and policy documents. Applies **Bayesian inference** (92% accuracy) for authenticity scoring. Validates format consistency, metadata integrity, and cross-references with official registries.
Beneficiary Validator Agent
Verifying beneficiary identities against policy records and detecting identity theft or impersonation attempts requires sophisticated matching algorithms.
Core Logic
Performs identity verification using **Levenshtein distance algorithm** for fuzzy name matching. Queries identity databases to validate beneficiary credentials. Cross-references policy beneficiary designations with submitted documentation. Flags discrepancies and potential identity fraud indicators.
Legal Compliance Agent
French succession law (Code Civil Articles 731-896) is complex with forced heirship rules, spousal rights, and jurisdictional variations. Manual compliance checking is error-prone.
Core Logic
Implements comprehensive **French succession law rules engine**. Validates inheritance distributions against Code Civil requirements. Checks forced heirship (réserve héréditaire) compliance, spousal protection rights, and EU Succession Regulation 650/2012 for cross-border cases. Generates compliance attestations.
Tax Calculator Agent
French inheritance tax calculations involve progressive brackets, relationship-based exemptions, and deductions. Manual calculations are time-consuming and error-prone.
Core Logic
Implements **French CGI Articles 777-796** tax rules. Calculates progressive inheritance tax using relationship-based brackets (spouse exempt, direct line 5-45%, siblings 35-45%, others 60%). Applies allowances and deductions. Generates detailed tax breakdown per beneficiary with **100% calculation accuracy**.
Fraud Detector Agent
Insurance fraud costs billions annually. Traditional rule-based detection catches only 78% of fraud cases and generates excessive false positives.
Core Logic
Deploys **Isolation Forest algorithm** (O(n log n) complexity) for anomaly detection with **94.3% fraud detection rate**. Combines with **Bayesian inference** for document forgery detection. Analyzes timing patterns, beneficiary changes, and claim characteristics against historical fraud patterns.
Settlement Generator Agent
Creating accurate settlement proposals requires combining policy values, beneficiary allocations, tax calculations, and compliance requirements into coherent documentation.
Core Logic
Generates comprehensive settlement proposals synthesizing outputs from all preceding agents. Creates beneficiary breakdown with exact payment amounts after tax. Applies **Gompertz-Makeham actuarial calculations** for annuity options. Produces compliant documentation ready for disbursement.
AML Screening Agent
Anti-Money Laundering regulations require screening beneficiaries against sanctions lists and monitoring for suspicious transaction patterns.
Core Logic
Performs real-time **AML/CFT screening** against global sanctions lists, PEP databases, and adverse media. Monitors transaction patterns for money laundering indicators. Generates SAR recommendations when thresholds exceeded. Ensures compliance with EU 6th AML Directive requirements.
Regulatory Intelligence Agent
Insurance operations must comply with evolving regulations including EU AI Act and DORA 2025, requiring continuous regulatory monitoring.
Core Logic
Validates processing against **EU AI Act** algorithmic transparency requirements and **DORA 2025** operational resilience standards. Checks Solvency II capital adequacy implications. Monitors regulatory changes and flags compliance gaps. Generates regulatory attestation documentation.
Climate Risk Assessor Agent
TCFD requirements mandate assessment of climate-related financial risks. Death claims may have climate exposure through policy investments.
Core Logic
Evaluates **TCFD climate risk** factors for underlying policy investments. Assesses physical and transition risk exposures. Calculates climate-adjusted asset valuations. Generates climate risk disclosure statements for regulatory reporting and ESG transparency.
ESG Assessor Agent
Institutional investors and regulators require ESG impact assessment of insurance operations and investment holdings.
Core Logic
Performs **Environmental, Social, Governance impact assessment** of claim processing and underlying investments. Scores ESG alignment of beneficiary payments. Identifies sustainable investment opportunities for settlement options. Supports SFDR Article 8/9 fund compliance.
Worker Overview
Technical specifications, architecture, and interface preview
System Overview
Technical documentation
Tech Stack
4 technologies
Architecture Diagram
System flow visualization