Insurance

Large Language Models (LLMs) are revolutionizing digital communication by powering conversational agents deployed across domains such as customer service, digital sales, and insurance. These agents, built on LLMs, can understand user input, retrieve relevant information, and generate coherent responses. However, while they excel at factual communication, they often lack the ability to engage in truly persuasive, context-sensitive dialogue, especially in domains like insurance, where trust and clarity are critical. Building on this need within the insurance domain, our work focuses on improving the persuasiveness of digital agents, aka LLMs. To support this, we introduce InsureDial, a Persuasive Insurance Dialogue dataset, designed to capture the nuances of persuasive communication specific to motor insurance interactions. We introduce PersuaRL, a reinforcement learning-based framework that equips LLM-driven dialogue agents with the ability to adaptively explore, select, and coordinate strategies across multiple expert modules, guided by the evolving dialogue context, to achieve more effective persuasion. We conduct extensive automatic human and qualitative evaluations on two benchmark persuasion dialogue datasets, including our InsureDial. Our evaluations consistently demonstrate that PersuaRL outperforms baseline, generating contextually appropriate and highly persuasive responses.

Agentic AI introduces new insurance challenges because autonomous AI systems can make decisions, invoke tools, modify external environments, and interact with third-party services. This paper develops an AI-native mathematical framework for underwriting, pricing, and contract design for agentic AI deployments. A deployment is represented by a risk state that captures autonomy level, operational authority, permission exposure, governance maturity, and dependency concentration. The framework maps the risk state to event probabilities, loss severities, governance costs, premiums, deductibles, coverage allocation, and policy covenants, and formulates an optimization problem for insurance contract design under participation, profitability, and incentive compatibility constraints. The paper establishes structural properties of insurability, including characterization of an insurability region, monotone deterioration of feasibility with increasing exposure, and governance certification thresholds. Insurance is further interpreted as both an operational cost and a regulatory mechanism for AI deployment. A healthcare case study illustrates contract optimization, sensitivity analysis, and automated claims processing for agentic AI systems.

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.

In skill-constrained production-inventory systems, the qualified human capacity available tomorrow depends on training decisions made today: production requires certified workers, certifications decay unless maintained, and training consumes the same scarce worker hours that production needs now. We study a closed-loop skill-constrained model predictive controller that, at every shift, solves a finite-horizon mixed-integer program over production, inventory, backlog, and training, with binary predicted certification, hard production eligibility, and an interpretable terminal value that prices certified-capacity gaps at the horizon boundary; only the first-period action is applied before replanning. On synthetic, seed-controlled SkillChain-Gym scenarios - announced and surprise new-skill shocks, demand shocks, absenteeism, forecast- and availability-quality modes, capacity-boundary and training-rate sweeps, and negative controls - we evaluate the controller against production-only and maintenance-only ablations, static cross-training insurance plans, and a strong reactive heuristic, under an ex-ante locked configuration and paired statistics. The result is regime dependence, not superiority: no policy class dominates. Predictive control helps when skill or labor bottlenecks are forecastable early enough for training to complete; lean static insurance remains hard to beat under surprise shocks, near the demand-capacity boundary, and wherever pre-shock slack makes insurance cheap. Attribution ablations separate certification maintenance, re-acquisition of lapsed certifications, and greenfield skill acquisition. Forecastability, not adaptivity per se, decides when predictive control pays.

Money laundering through insurance claims poses a threat to insurers both through fraudulent payouts and reputational and regulatory risk. Despite this, little research has examined how such laundering can be prevented. This paper examines whether machine learning can help insurers flag suspicious claims before payout, shifting the focus from passive reporting to active prevention. Using production data from a major Norwegian insurer, we train gradient-boosted decision tree models to detect claims later reported to authorities for suspected money laundering. Because fraud and laundering may share behavioural patterns, we also examine whether insurance fraud labels can serve as an auxiliary training signal. We compare different learning setups using the Budget-Weighted Capture Rate, a metric introduced in this paper to measure how many laundering cases are captured when only a small share of claims can be manually reviewed. The results show that incorporating fraud-related investigation labels substantially improves laundering detection. The best-performing model captures nearly two-thirds of laundering cases within the top-ranked 2 to 6 percent of claims selected for investigation. To our knowledge, this is the first empirical study of machine learning for money laundering detection in insurance claims.

AI agents can now take irreversible actions in operational systems, but agent-caused losses are still not clearly assigned, priced, or transferred. Providers often disclaim consequential damages, users are left with uncompensated losses, and default human review limits the efficiency gains of automation. We ask when autonomous AI deployment can become economically acceptable despite failure risk. Our answer is to quantify risk at the customer-task-trace episode level and transfer it through insurance. Automation is acceptable when its expected benefit exceeds the premium, control cost, and remaining risk. This requires a defined role with bounded permissions and comparable traces. We introduce trace-economic underwriting, which maps tool-use traces to customer exposure and claimable loss, then uses this representation for pricing, control, and risk transfer. It uses deterministic economic labels rather than an LLM judge. In our trace-to-loss testbed, trace-economic pricing reduces pricing MAE from $17.7K to$569 and removes regressive cross-subsidy. A 300-trace expert audit accepts 295 labels unchanged. On 1,000 real SWE-smith traces, trace-conditioned controls reduce CVaR95 by 72%. Theorem~1 gives a finite-sample scope condition. We release code, labels, and audit sheets.

Paper A defines a time-consistent actuarial runtime that prices each side-effect-bearing action against a contractually fixed safe default and gates execution against a reserve budget. It treats the operator as passive. This paper makes the operator strategic. We characterise a five-attack space for autonomous AI-agent insurance contracts and prove when the actuarial runtime is gaming-resistant. Two attack surfaces -- post-toll safe-default selection and within-boundary action splitting -- are closed by Paper A's minimal-authority and no-splitting clauses. The remaining three require new contract clauses. First, common-control aggregation prevents cross-boundary re-routing from reducing toll below the boundary potential applied to total exposure. Second, interface failures such as invalid JSON are contract-relevant events, not safety wins: treating them as zero-toll safe defaults can reward unreliable models, while escalation fees reverse the incentive. We validate this interface-compliance theorem on committed cross-model traces from the companion empirical paper. Third, a model-identity menu with a componentwise-minimum penalty schedule makes truthful reporting of the deployed model weakly dominant. We then compose these clauses with Paper A's runtime guarantees to obtain joint incentive compatibility over the five-attack space. Finally, a two-parameter premium family discharges operator individual rationality and weak budget balance at the truthful equilibrium. The result is an incentive-compatibility layer for actuarial control of autonomous-agent side effects.

Fairness in insurance pricing remains a long-standing and deeply debated puzzle. On one hand, insurers, driven by profitability considerations, set premiums that differentiate across individual risks to achieve actuarial fairness. On the other hand, insurance serves a critical societal function by pooling risks across a population, motivating cross-subsidization among groups to promote solidarity fairness. The tension between these two competing notions of fairness makes insurance pricing inherently complex, particularly in modern settings where granular data allow for increasingly fine risk differentiation and regulators face growing pressure to protect vulnerable groups. To address this challenge, we propose an $α$-\textbf{F}air \textbf{I}ndividual \textbf{S}olvent \textbf{P}remium ($α$-FISP) framework for insurance pricing that explicitly captures the trade-off between actuarial and solidarity fairness while guaranteeing solvency, a fundamental requirement in insurance operations. We formulate the pricing problem as a constrained optimization task, where actuarially fair premiums are adjusted subject to budget constraints on cross-subsidization within each risk class. This formulation naturally yields a family of solutions parameterized by $α$, tracing a continuum between purely actuarial and purely solidarity-based pricing and enabling decision-makers to select an operating point along this fairness spectrum. We derive theoretical guarantees for the proposed framework. Numerical experiments show that $α$-FISP is computationally tractable and aligns well with the U.S. regulatory regimes featuring heterogeneous state-level fairness requirements.

We develop a statistical learning theory for gradient boosting applied to the estimation of covariate-dependent Generalized Pareto (GP) distributions in the context of Peaks-over-Threshold modeling. After an orthogonal reparametrization of the GP likelihood that diagonalizes its Fisher information matrix, we cast the estimation problem within the Empirical Risk Minimization (ERM) framework and derive non-asymptotic error bounds for the boosting estimator. Our analysis accounts for three distinct sources of error in the process: statistical fluctuations, the approximation bias inherent to the asymptotic nature of the GP model-controlled under second-order regular variation-and the approximation error associated with the finite number of boosting iterates, making explicit the resulting bias-variance trade-off. We illustrate the practical benefits of the reparametrization through simulations, showing that it significantly reduces gradient correlation during training and improves convergence stability. The methodology is applied to a medical malpractice insurance dataset from the Texas Department of Insurance, comprising over 18 000 closed claims. The gradient boosting approach yields a good fit for the tail of settlement cost distributions and reveals that the number of days to settlement is the dominant predictor of tail heaviness, consistent with earlier findings in the reserving literature.

Accurate estimation of long-term care transition probabilities is central to disability insurance pricing, reserving, and solvency assessment. Classical actuarial multi-state models commonly rely on Markov, semi-Markov, or proportional-hazard specifications, which provide a direct connection to cohort projection but may be restrictive for irregular longitudinal health data with nonlinear aging patterns and heterogeneous covariate histories. This paper develops a well-calibrated estimator of multi-state transition probabilities for irregular longitudinal health data. The model learns from individual health history, incorporates the time elapsed between observations, and conditions transition probabilities on demographic and socioeconomic attributes. It produces a valid probability distribution over the next observed health state, with four possible states: healthy, mild disability, severe disability, and death. Individual probabilities are aggregated by age group and origin state to form transition matrices compatible with actuarial cohort projection. Using longitudinal data from the Health and Retirement Study, we compare the proposed estimator with logistic regression, gradient-boosted trees, a recurrent neural network, and a last-state persistence benchmark. The evaluation considers probabilistic accuracy, endpoint discrimination and calibration for severe disability and death, risk concentration, and transition matrix error after aggregation. The proposed estimator improves severe disability discrimination relative to logistic regression and gradient-boosted tree benchmarks, maintains strong calibration, and yields the lowest transition matrix error among the evaluated models in the held-out test analysis. Results show that a structured machine learning estimator can support long-term care transition modeling when judged by calibration and projection fidelity, beyond discrimination.

Accurate loss reserving is foundational to insurer solvency, yet accelerating climate driven catastrophes systematically violate the stability assumptions on which traditional actuarial methods depend. This white paper presents a research program testing whether Long Short Term Memory (LSTM) neural networks can detect and adapt to these structural breaks faster and more accurately than Chain Ladder, Bornhuetter Ferguson, and Cape Cod methods. Using 15 plus years of regulatory development triangle data from Florida and Louisiana, enriched with NOAA hurricane intensity indices and sea surface temperatures, we hypothesize a targeted improvement of 15, 20% in reserve accuracy for catastrophe exposed years, a threshold grounded both in the prior neural network reserving literature and in the formal convergence results developed here. Beyond empirical validation, we develop a theoretical framework grounding LSTM structural break detection in probabilistic terms, providing formal performance guarantees that compensate for the limited number of catastrophe events in the test period. We document the research design, methodology, expected contributions, and a candid assessment of limitations.

Agentic artificial intelligence (AI) systems are transforming the risk landscape by extending beyond information generation to autonomous planning, tool invocation, decision execution, and persistent modification of digital and physical environments. These capabilities introduce novel exposures that do not fit neatly within traditional insurance categories such as cyber, professional liability, product liability, or directors and officers coverage. This paper examines the emerging insurance market for agentic AI and develops a framework for understanding its underwriting, pricing, reinsurance, and product-design implications. We characterize agentic AI as a continuum of autonomy and delegated authority, emphasizing the distinction between informational outputs and systems capable of independently generating insured events through external actions. We analyze major risk pathways, including hallucinations, prompt-injection attacks, autonomous decision errors, model drift, dependency failures, and cyber-physical harms, and evaluate how existing insurance products are adapting to address these exposures. The paper further proposes an actuarial framework based on exposure assessment, scenario analysis, dependency mapping, and accumulation-risk management, drawing parallels to the evolution of cyber insurance. Finally, we present a coordinated insurance architecture that integrates cyber, technology errors and omissions, product liability, performance-warranty, and affirmative AI-liability coverages through explicit allocation mechanisms and dedicated AI aggregates. The analysis suggests that the future of agentic-AI insurance lies not in a single monoline product but in a layered ecosystem of complementary coverages supported by improved governance, transparency, telemetry, and regulatory clarity.

AI losses that arise through an insured organization's generative or agentic AI system require state reconstruction, not merely event reconstruction, because the relevant state changes as the system reasons, retrieves, calls tools, and acts. The relevant question is not only what loss occurred, but what the system was allowed to do, what it actually did, and whether that reconstructed loss can support insurance claim recovery. This paper addresses losses in which the insured's AI system is in the causal chain, including externally triggered failures such as prompt injection, retrieval-augmented generation (RAG) poisoning, malicious tool output, credential misuse, and data poisoning. Specifically, this paper introduces CER, a use-case-level diagnostic for AI residual risk transfer. C (control boundary) asks whether the system had an enforceable operating envelope. E (evidence reconstruction) asks whether the system state and causal chain can be reconstructed from retained artifacts. R (insurance response) asks whether the reconstructed loss is insured: whether insurance coverage is available in the market and placed for the insured, together with the proof needed to support insurance claim recovery. The paper makes three contributions: it defines the AI-specific reconstruction problem, operationalizes that problem through CER, and specifies claim-grade evidence for AI reconstruction. Public examples include the reported PocketOS and Replit agentic database-deletion incidents and Moffatt v. Air Canada as an adjudicated output/reliance case. Keywords: AI systems; CER framework; residual risk transfer; agentic AI; generative AI; AI insurance; evidence reconstruction.

We propose a foundational runtime actuarial layer for autonomous AI agents in which every side-effect-bearing action carries a time-consistent, counterfactual risk toll computed against a contractually fixed safe default, inside an explicit underwriting boundary. The framework treats per-action insurance as the primary unit of analysis and replaces post-hoc annual liability cover with a pre-action transaction layer. The paper establishes four structural results: (i) a well-defined counterfactual toll under a chosen safe-default mapping and continuation policy, with explicit non-uniqueness; (ii) a no-splitting property within an underwriting boundary that telescopes path-decomposed actions into a boundary potential, with a corollary tying gaming-resistance to boundary design; (iii) an irreversible-authority premium, split into a strictly positive action-level component and an if-and-only-if characterisation of the set-level robust capital increase; and (iv) a conservative runtime gating theorem that translates high-probability toll envelopes into an executed-action budget guarantee. The result is the mathematical base layer for a broader program: an empirical companion instantiates the runtime through an Actuarial Action Interface and authority-frontier experiments; a mechanism-design companion studies strategic operator incentives and cross-boundary aggregation; and a dynamic-underwriting companion studies experience rating and audit-replay calibration. The present paper states the primitive contract, the toll identity, the within-boundary no-arbitrage result, and the budget guarantee on which those later layers depend.

Autonomous AI agents increasingly issue side-effect-bearing actions: database mutations, refunds, payments, external commitments. We propose the Actuarial Action Interface (AAI), a deterministic runtime contract that prices each such action against a contractually fixed safe default under a time-consistent risk mapping, and gates execution against a per-boundary reserve capital budget. We then develop the Authority Frontier, an evaluation primitive measuring how much autonomous authority the runtime releases at each level of reserve capital. The framework provides (i) a deterministic quote-bind-commit protocol with toll-bounded capability tokens; (ii) a universal seven-class action taxonomy mapping heterogeneous tool calls to comparable authority units; (iii) replay determinism and pathwise reserve coverage under alpha-spending; (iv) cross-domain normalization via full reserve demand C_full and capital metrics Capital@k. We instantiate AAI across four agentic environments (database mutation, customer-service refund, and the public tau-bench retail and airline tool-use traces) and report a live Postgres panel in which three Azure-hosted models propose actions through the same contract. The frontier exhibits a common low-reserve refusal and intermediate-release pattern across domains, with saturation only where the budget grid reaches full reserve demand; required reserve capital varies by 22x (Capital@50 from 289 to 6457). The framework does not force domains into the same shape; it surfaces each domain's actuarial geometry. In the live panel the contract prevents realized loss across all three models at low budget while differing in underwriting persistence under denial: model identity is an actuarial underwriting variable. The contribution is a benchmark-ready evaluation framework for runtime actuarial control of autonomous-agent side effects.

Modelling claim frequency and severity for non-life insurance pricing predominantly relies on generalised linear models, with gradient-boosted machines as the leading machine learning alternative. Tabular foundation models (TFMs) present a fundamentally different inference paradigm. By pre-training on large collections of synthetic datasets, TFMs enable inference on new data through in-context learning, without any dataset-specific fitting or hyperparameter tuning. This paper presents a first empirical evaluation of TabPFN for motor insurance pricing, benchmarking it against GLM and XGBoost on two publicly available MTPL datasets. Our results show that TabPFN does not consistently outperform established baselines, exhibits substantially longer inference times, and is sensitive to the size of the in-context training set. While tabular foundation models represent a promising direction, particularly in data-scarce settings, their current performance does not offer a viable replacement for established actuarial methods.

Corporate credit underwriting requires analysts to extract actionable evidence from long, heterogeneous financial documents spanning hundreds of pages and multiple languages. Standard Retrieval-Augmented Generation (RAG) pipelines optimize for semantic similarity, which frequently surfaces passages that are topically related but lack decision utility, a problem we term the similarity-utility gap. We propose a two-phase non-parametric retrieval architecture that separates high-recall candidate retrieval from high-precision utility ranking. The first phase combines lexical and dense multilingual retrieval to construct a broad candidate pool. The second phase applies an adaptive retrieval controller that filters candidates using query intent and document structure signals, followed by an LLM-as-a-Judge utility scoring mechanism that ranks passages by analytical usefulness rather than semantic proximity. A context-aware extraction module preserves structural fidelity across narrative text and complex financial tables. The system is deployed entirely on-premise to satisfy enterprise data governance requirements. Evaluated on a multilingual corpus of proprietary financial documents with analyst-curated relevance labels, the system significantly outperforms naive retrieval baselines. In production deployment across more than 800 credit analysts, document review time was reduced from several hours to approximately three minutes, demonstrating the practical value of utility-aware RAG architectures for document-intensive decision-support workflows.

Capped-usage SaaS products -- LLM subscriptions such as Claude Code and ChatGPT, cloud platforms such as Vercel and Cloudflare Workers, corporate benefit platforms, identity-verification services with liability transfer -- share a structural signature with insurance products: a fixed premium decoupled from realized consumption, stochastic per-user demand with heavy-tailed severity, a non-fungible cap that resets on a fixed schedule, and a portfolio-level exposure that requires reserve adequacy under tail risk. We argue that this is not an analogy. It is the same operational problem actuarial science has been tooled for decades to address, restated with new dependent variables (tokens, bandwidth bytes, function-invocations, gym check-ins) in place of medical claims. This paper proposes a modeling framework for capped-usage SaaS pricing built from frequency-severity decomposition, premium calculation principles, and Monte Carlo reserve adequacy. We map the framework to publicly observable subscription tiers in two domains (LLM services and cloud platforms), ground it in canonical health-insurance economics (Arrow 1963; Pauly 1968; Manning et al. 1987; Brot-Goldberg et al. 2017), and demonstrate divergence from traditional unit economics through a worked example. The contribution is operational rather than theoretical: not a new theorem, but vocabulary and tools currently absent from cs.LG/stat.ML practice.

Instruction-tuned language models exhibit behavioural fairness in high-stakes decisions while retaining biased associations in their internal representations. However, whether these suppressed representations can affect model outputs - and whether such causal potency is symmetric across demographic groups - remains unknown. We investigate the use of open-weight models for mortgage underwriting using matched applications that differ only in racially-associated names and reveal a critical disconnect: models show no output-level bias, yet retain and amplify demographic representations across model layers. Through activation steering and novel cross-layer interventions, we demonstrate that this suppressed information is decision-relevant: when reinjected at critical layers, it produces near-complete decision reversals. Critically, this latent bias is asymmetric - steering interventions affect decisions in one demographic direction, while producing minimal effects in reverse - and susceptible to adversarial prompt engineering and parameter-efficient fine-tuning. These findings demonstrate that behavioural audits focused on outputs are insufficient: fair outputs can mask exploitable internal biases. They also motivate dual-layer testing frameworks combining output evaluation with representational analysis for AI governance in high-stakes decisions.

The rapid diffusion of agentic AI has created a new coverage problem for commercial insurance: some AI-mediated losses are now affirmatively insured, some create silent-AI exposure under legacy cyber, technology errors-and-omissions (E&O), directors-and-officers (D&O), employment practices liability (EPLI), crime, and media policies, and others are being actively excluded. This paper maps that emerging boundary by coding 55 AI threat classes against 26 insurance products, endorsements, and exclusion regimes using public carrier materials and OWASP/MITRE threat catalogs. We identify a four-tier insurability frontier: affirmatively insured perils, silent-AI exposures, actively excluded perils, and perils outside conventional private insurance structures. Our coding measures publicly claimed positioning rather than executed contract wording; the headline statistics describe what carriers publicly state about coverage, not what would be paid in any specific claim. Three patterns emerge. First, affirmative AI coverage is beginning to differentiate by primary risk emphasis: public materials often position Munich Re around model performance and drift, Armilla and parts of the Lloyd's market around hallucination and broader AI liability, Tokio Marine Kiln and CFC around IP and technology E&O concerns, Apollo ibott around emerging autonomous system liability, and Coalition around deepfake and AI-enabled cyber response. Second, legacy lines retain silent-AI exposure where AI is an instrumentality rather than the legal cause of loss. Third, foundation model concentration is the clearest genuinely novel insurability frontier because upstream model failure can correlate losses across many cedents at once; the relevant market design question is which insurability constraint each candidate structure relaxes, not merely which systemic risk template exists.

Automatically generating formal ontologies from unstructured natural language remains a central challenge in knowledge engineering. While large language models (LLMs) show promise, it remains unclear which architectural design choices drive generation quality and why current approaches fail. We present a controlled experimental study using domain-specific insurance contracts to investigate these questions. We first establish a single-agent LLM baseline, identifying key failure modes such as poor Ontology Design Pattern compliance, structural redundancy, and ineffective iterative repair. We then introduce a multi-agent architecture that decomposes ontology construction into four artifact-driven roles: Domain Expert, Manager, Coder, and Quality Assurer. We evaluate performance across architectural quality (via a panel of heterogeneous LLM judges) and functional usability (via competency question driven SPARQL evaluation with complementary retrieval augmented generation based assessment). Results show that the multi-agent approach significantly improves structural quality and modestly enhances queryability, with gains driven primarily by front-loaded planning. These findings highlight planning-first, artifact-driven generation as a promising and more auditable path toward scalable automated ontology engineering.

According to the United Nations Office for Disaster Risk Reduction (2025), the average annual cost of natural catastrophes increased from 70--80 billion USD between 1970 and 2000 to 180--200 billion USD between 2001 and 2020. Reports from organizations such as the IFOA and the WWF highlight the need for the insurance sector to adapt to this rapidly evolving context by developing medium- to long-term strategies that go beyond the one-year horizon of prudential regulations such as Solvency II. This paper introduces an artificial intelligence framework based on Conditional Generative Adversarial Networks (Conditional GANs) to generate future spatio-temporal trajectories of climatic indices. The approach focuses on the Soil Wetness Index (SWI), a key indicator used in France to assess drought severity. Drought accounts for approximately 30% of the indemnities paid under the French natural catastrophe insurance scheme. The proposed model, SwiGAN, simulates plausible drought propagation patterns up to 2050 for a region of France particularly exposed to this hazard. By generating realistic sequences of SWI maps, SwiGAN provides insights into drought dynamics under climate change scenarios and supports the design of adaptive risk management and insurance strategies. The methodology is also generalizable to other climate-related perils and actuarial applications such as economic scenario generation.

Commercial insurance underwriting is a labor-intensive process that requires manual review of extensive documentation to assess risk and determine policy pricing. While AI offers substantial efficiency improvements, existing solutions lack comprehensive reasoning and internal mechanisms to ensure reliability in regulated, high-stakes environments. Full automation remains impractical and inadvisable when human judgment and accountability are critical. This study presents a decision-negative, human-in-the-loop agentic system that incorporates an adversarial self-critique mechanism as a bounded safety architecture for regulated underwriting workflows. In this system, a critic agent challenges the primary agent's conclusions prior to submitting recommendations to human reviewers. This internal system of checks and balances addresses a critical gap in AI safety for regulated workflows. Additionally, the research develops a formal taxonomy of failure modes to characterize potential errors by decision-negative agents. This taxonomy provides a structured framework for risk identification and management in high-stakes applications. Experimental evaluation using 500 expert-validated underwriting cases demonstrates that the adversarial critique mechanism reduces AI hallucination rates from 11.3% to 3.8% and increases decision accuracy from 92% to 96%. At the same time, the framework enforces strict human authority over all binding decisions by design. These findings indicate that adversarial self-critique supports safer AI deployment in regulated domains and offers a model for responsible integration where human oversight is indispensable.

With the rapid development of machine learning and deep learning techniques, actuaries and the broader insurance industry face a persistent trade-off between predictive accuracy and interpretability. This paper provides a comprehensive applied assessment of Explainable Boosting Machines (EBM) in a car insurance framework, focusing on claim frequency and severity modeling. EBM combines the additive structure of generalized additive models (GAM) with a cyclic gradient boosting algorithm, resulting in a glass-box model whose predictions are interpretable by design. Using real-world data, we empirically illustrate its practical relevance and compare EBM with modern benchmark models used in non-life insurance pricing. The evaluation considers (i) out-of-sample predictive accuracy, including Murphy diagrams and Bregman dominance tests, and (ii) calibration assessment using T-reliability diagrams and Murphy's score decomposition. Finally, we highlight the link between EBM predictions and Shapley values, showing how predictions can be transparently decomposed into exact main and pairwise interaction effects, providing actionable insights beyond predictive performance.