EKA—Enterprise Knowledge Assistant: Collaborative Multi-Agent AI for Large Claims Handling

Large insurance claims handling is a complex, knowledge-intensive process that requires the analysis of heterogeneous information sources and the reuse of past experience distributed across multiple organizational data sources. Consequently, a significant portion of decision-making knowledge is embedded in historical claims records and internal documents, making systematic access and reuse challenging. This paper presents Enterprise Knowledge Assistant (EKA), a collaborative multi-agent AI system designed to act as a sparring partner for large claims handlers. EKA integrates claims structured and unstructured data with an archive of more than five thousand historical cases related to claims management, enabling retrieval, interpretation, and synthesis of relevant past cases and decision patterns. The system is organized as a set of specialized AI agents, each responsible for distinct tasks including claim context analysis, knowledge extraction, document synthesis, and interaction with human users. Through agent collaboration, EKA provides decision support by analyzing comparable historical cases, uncovering hidden correlations, and extracting insurance wisdom, while keeping the human expert firmly in control. The paper describes the system architecture and reports an industrial case study evaluating EKA in a real insurance environment. Results indicate improved knowledge reuse and reduced analysis effort in large claims handling.

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Publication Details

Journal
Applied System Innovation
Published
2026-03-17
DOI
https://doi.org/10.3390/asi9030062
Primary Topic
Multi-Agent Systems and Negotiation
Type
article
Field-Weighted Citation Impact
0.00
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article

EKA—Enterprise Knowledge Assistant: Collaborative Multi-Agent AI for Large Claims Handling

Alberto Loffredo, Yifeng Lu, Yunting Liu, Joerg Ahrens et al.
Applied System Innovation
Multi-Agent Systems and Negotiation
article

EKA—Enterprise Knowledge Assistant: Collaborative Multi-Agent AI for Large Claims Handling

Alberto Loffredo, Yifeng Lu, Yunting Liu, Joerg Ahrens, Dong Chen, Yifei Fu, Zhengdao Chen
article en

Abstract

Large insurance claims handling is a complex, knowledge-intensive process that requires the analysis of heterogeneous information sources and the reuse of past experience distributed across multiple organizational data sources. Consequently, a significant portion of decision-making knowledge is embedded in historical claims records and internal documents, making systematic access and reuse challenging. This paper presents Enterprise Knowledge Assistant (EKA), a collaborative multi-agent AI system designed to act as a sparring partner for large claims handlers. EKA integrates claims structured and unstructured data with an archive of more than five thousand historical cases related to claims management, enabling retrieval, interpretation, and synthesis of relevant past cases and decision patterns. The system is organized as a set of specialized AI agents, each responsible for distinct tasks including claim context analysis, knowledge extraction, document synthesis, and interaction with human users. Through agent collaboration, EKA provides decision support by analyzing comparable historical cases, uncovering hidden correlations, and extracting insurance wisdom, while keeping the human expert firmly in control. The paper describes the system architecture and reports an industrial case study evaluating EKA in a real insurance environment. Results indicate improved knowledge reuse and reduced analysis effort in large claims handling.

Applied System InnovationVol. 9(3)
Office of Education (US), Claims (India) (IN), Data Management Services (United States) (US), Acciona (Spain) (ES)
Openalex Percentile: Top 22%
Multi-Agent Systems and Negotiation
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