自動化核保管線

osop_version: "1.0"
id: "underwriting-pipeline"
name:"自動化核保管線"
description:"申請案件流經風險評分、精算建模與定價，邊界案例由人工審查。"

nodes:
  - id: "intake"
    type: "agent"
    subtype: "worker"
    name: "申請接收代理人"
    description: "解析申請表、驗證欄位並以第三方資料進行資料增強。"

  - id: "risk_score"
    type: "agent"
    subtype: "llm"
    name: "風險評分代理人"
    description: "根據申請人資料、理賠紀錄與信用資料計算風險評分。"

  - id: "actuarial_model"
    type: "agent"
    subtype: "llm"
    name: "精算模型代理人"
    description: "套用損失率模型與死亡率或發病率表格，計算預期損失。"

  - id: "policy_pricing"
    type: "agent"
    subtype: "llm"
    name: "保單定價代理人"
    description: "根據風險評分、預期損失與競爭定位設定保費。"

  - id: "human_review"
    type: "human"
    subtype: "review"
    name: "核保人員審查"
    description: "資深核保人員審查風險評分介於邊界的案件。"
    security:
      approval_gate: true

edges:
  - from: "intake"
    to: "risk_score"
    mode: "sequential"
  - from: "risk_score"
    to: "actuarial_model"
    mode: "sequential"
  - from: "actuarial_model"
    to: "policy_pricing"
    mode: "sequential"
  - from: "policy_pricing"
    to: "human_review"
    mode: "conditional"
    when: "risk_score.category == 'borderline'"
  - from: "risk_score"
    to: "human_review"
    mode: "conditional"
    when: "risk_score.flags.length > 0"
    label: "Flagged applications skip to human"