The invention discloses a causal federation element
reinforcement learning intelligent decision-making method and
system for people-benefiting insurance claim settlement, and relates to the field of insurance intelligent claim settlement, and the method comprises the steps: building and adaptively generating a regional causal
knowledge graph based on a multi-dimensional policy text; a causal federation element
reinforcement learning framework is adopted, through element strategy network initialization, and federation learning is utilized to carry out fine adjustment on small samples in an
encryption mode on the premise that data does not go out of
a domain, so that local intention recognition model
adaptation is realized; according to the claim consultation text of the user, performing intention recognition in combination with neural symbol double-track reasoning and
knowledge graph causal chain matching; and training the
decision tree, and generating a visual report through anti-factual reasoning to assist in
decision making. According to the method, the user intention recognition accuracy and the rule
interpretability are enhanced, the response
adaptation efficiency of policy dynamic updating is improved, privacy is guaranteed on the premise that data are not out of
a domain,
small sample learning is achieved, then the people-benefiting insurance claim settlement
processing efficiency and the customer satisfaction degree are optimized, and the operation cost is reduced.