Insurance Claim Routing Demo

Insurance Claim Routing Demo

Build an AI function that routes insurance claims using pseudo-labeled training data.

Overview

Seed input-only data → pseudo-label with a strong teacher → build a cheap student function → evaluate. Estimated time: ~10 minutes.

Workflow

Step 1: Introduction

Explain to user:

Welcome to the Pseudo-Labeling & Teacher-Student Distillation Demo!

At the end of this demo, you will witness the Cortex AI Function Studio's ability to:
- Generate pseudo-labels using a strong teacher model (no labeled data needed!)
- Build a cheap student model that reproduces teacher-quality decisions
- Evaluate how closely the student matches the teacher using the exact_match metric

This demo starts with unlabeled claim intake records. We will use a strong
teacher model to create routing labels, then build a cheaper student model
and measure how closely it reproduces those decisions.

Claim routes:
- fast_track_auto
- property_damage
- injury_review
- fraud_review
- documentation_needed
- manual_specialist_review

Objects created: all prefixed with DEMO_ for easy cleanup.

Step 2: Setup - Choose Location

If {database} and {schema} are already known from the prerequisite flow, accept them silently and skip the prompt.

Otherwise, ask user:

Where would you like to create the demo objects?

Database: [e.g., TEMP]
Schema: [e.g., PUBLIC]

Store the database and schema for use throughout the demo.

Step 3: Create Input-Only Sample Data

Explain to user:

I'll load 80 realistic insurance claim intake records from a pre-generated set:
auto collisions, property damage, theft, injury, fraud, and documentation cases.

Columns:
- CLAIM_SUMMARY  (pre-generated, unique per row)
- INCIDENT_CHANNEL
- CUSTOMER_SEGMENT

I'll create:
- {database}.{schema}.DEMO_CLAIMS_UNLABELED

Run the data generation script:

PYTHONPATH=<SKILL_DIRECTORY>/src uv run --project <SKILL_DIRECTORY> python <SKILL_DIRECTORY>/src/generate_claims_data.py load \
  --connection <CONNECTION_NAME> \
  --database {database} \
  --schema {schema}

Note: Replace <SKILL_DIRECTORY> with the absolute path to the cortex-ai-function-studio skill directory, and <CONNECTION_NAME> with the active Snowflake connection.

Verify creation and confirm summaries are diverse:

SELECT COUNT(*) FROM {database}.{schema}.DEMO_CLAIMS_UNLABELED;

SELECT LEFT(CLAIM_SUMMARY, 150) AS SUMMARY_PREVIEW, INCIDENT_CHANNEL, CUSTOMER_SEGMENT
FROM {database}.{schema}.DEMO_CLAIMS_UNLABELED
LIMIT 5;

Step 4: Pseudo-Label with Teacher Model

Present the pseudo-label configuration:

Now we'll use a strong teacher model to label each claim intake row.

Default teacher model: claude-opus-4-6 (or the strongest available Claude Opus variant)
Fallback: use the strongest available Claude-family model in the account

Source table: {database}.{schema}.DEMO_CLAIMS_UNLABELED
Input columns: CLAIM_SUMMARY, INCIDENT_CHANNEL, CUSTOMER_SEGMENT
Output fields:
  - claim_route (string) — routing category
Destination table: {database}.{schema}.DEMO_CLAIMS_DATA

If the default teacher model is unavailable, load references/model_selection.md and choose the strongest Claude-family option.

MANDATORY: Do not synthesize labels ad hoc in this demo. Load synthetic-data/SKILL.md and follow the Pseudo-Label Input-Only Tables workflow.

Pass this context into that workflow:

• source_table: {database}.{schema}.DEMO_CLAIMS_UNLABELED
• input_columns: ['CLAIM_SUMMARY', 'INCIDENT_CHANNEL', 'CUSTOMER_SEGMENT']
• output_table: {database}.{schema}.DEMO_CLAIMS_DATA
• model: {teacher_model}
• task_description: Classify each claim intake row into exactly one routing category: fast_track_auto, property_damage, injury_review, fraud_review, documentation_needed, or manual_specialist_review.
• output_schema: {"properties": {"claim_route": {"type": "string", "description": "One of: fast_track_auto, property_damage, injury_review, fraud_review, documentation_needed, manual_specialist_review"}}}
• preview_rows: 0

The label-synthesis workflow must:

• skip the preview step and label all rows in one pass
• continue with EXPECTED as the default label column

Show the label distribution after labeling completes:

SELECT EXPECTED:claim_route::STRING AS CLAIM_ROUTE, COUNT(*) AS ROW_COUNT
FROM {database}.{schema}.DEMO_CLAIMS_DATA
GROUP BY 1
ORDER BY ROW_COUNT DESC;

The pseudo-label workflow stores labels as a VARIANT column (EXPECTED). Since our output has a single field, convert it to a plain string column for evaluation:

ALTER TABLE {database}.{schema}.DEMO_CLAIMS_DATA ADD COLUMN EXPECTED_OUTPUT VARCHAR;
UPDATE {database}.{schema}.DEMO_CLAIMS_DATA SET EXPECTED_OUTPUT = EXPECTED:claim_route::STRING;
ALTER TABLE {database}.{schema}.DEMO_CLAIMS_DATA DROP COLUMN EXPECTED;

Step 5: Create the Student AI Function

Present the function configuration:

Now we'll create a cheaper student model for claim routing.

Default student model: llama3.1-8b

Function name: DEMO_ROUTE_CLAIM
Inputs: CLAIM_SUMMARY, INCIDENT_CHANNEL, CUSTOMER_SEGMENT
Outputs:
  - claim_route (string) — routing category
System prompt:
"You are an insurance claim routing system. Given a claim summary, incident
channel, and customer segment, classify the claim into exactly one route:
fast_track_auto, property_damage, injury_review, fraud_review,
documentation_needed, or manual_specialist_review."

User prompt template:
"Claim summary: {CLAIM_SUMMARY}\nIncident channel: {INCIDENT_CHANNEL}\nCustomer segment: {CUSTOMER_SEGMENT}"

⚠️ STOP: Wait for user confirmation before creating the function.

Load create/SKILL.md and follow it from Step 7 onward, passing:

• database, schema
• function_name: DEMO_ROUTE_CLAIM
• function_intention: Route insurance claims to the correct processing track.
• model: chosen student model
• inputs: [{"name": "CLAIM_SUMMARY", "sql_type": "VARCHAR"}, {"name": "INCIDENT_CHANNEL", "sql_type": "VARCHAR"}, {"name": "CUSTOMER_SEGMENT", "sql_type": "VARCHAR"}]
• outputs: [{"name": "claim_route", "json_type": "string", "description": "One of: fast_track_auto, property_damage, injury_review, fraud_review, documentation_needed, manual_specialist_review"}]
• system_prompt: confirmed prompt
• user_prompt_template: Claim summary: {CLAIM_SUMMARY}\nIncident channel: {INCIDENT_CHANNEL}\nCustomer segment: {CUSTOMER_SEGMENT}

Return here after the smoke test succeeds.

Step 6: Evaluate the Student AI Function

Present the evaluation configuration:

Let's evaluate how well the student model routes claims.

Since the function returns a single claim_route string, the built-in
exact_match metric works perfectly — it compares the predicted route
directly against the teacher-labeled EXPECTED_OUTPUT.

Default metric: exact_match
Experiment: auto-generated per evaluation (run_id)

⚠️ STOP: Wait for user confirmation before running evaluation.

Load evaluate/SKILL.md and follow it from Step 4 onward (Run Evaluation), passing:

• function_name: {database}.{schema}.DEMO_ROUTE_CLAIM
• function_model: chosen student model
• test_table: {database}.{schema}.DEMO_CLAIMS_DATA
• input_columns: ['CLAIM_SUMMARY', 'INCIDENT_CHANNEL', 'CUSTOMER_SEGMENT']
• label_column: EXPECTED_OUTPUT
• metric_name: exact_match

The evaluation auto-creates an experiment named after its run_id. Capture experiment_name from the JSON output for the queries below.

Skip Step 6 (next steps) in the evaluate workflow — return here after results are presented.

Once evaluation is done, review the results. Show the scores to the user. Offer to see what cases did not match:

Would you like to see which claims the function routed incorrectly?

If yes, query the per-row eval artifact (requires ENABLE_EXPERIMENT_SNOWURL_READ_PATH_RESOLUTION). First create the JSON file format (required — inline (TYPE => JSON) isn't supported on SnowURL):

CREATE OR REPLACE TEMPORARY FILE FORMAT eval_detail_json_fmt
  TYPE = JSON
  STRIP_OUTER_ARRAY = TRUE;

SELECT
    LEFT($1:input_text::STRING, 150) AS SUMMARY_PREVIEW,
    $1:expected::STRING  AS EXPECTED_ROUTE,
    $1:predicted::STRING AS PREDICTED_ROUTE,
    $1:metric_score::FLOAT AS SCORE,
    $1:metric_feedback::STRING AS FEEDBACK
FROM 'snow://experiment/{experiment_name}/versions/EVAL/eval_detail.json'
(FILE_FORMAT => eval_detail_json_fmt)
WHERE $1:metric_score::FLOAT < 1.0
ORDER BY SCORE
LIMIT 20;

Discuss common failure patterns. Explain that labels are teacher-generated (pseudo-labels), not human ground truth.

After reviewing results, continue to Step 7.

Step 7: Cleanup

Ask user:

The Insurance Claim Routing demo is complete!

Would you like to clean up the demo objects?

This will drop:
- {database}.{schema}.DEMO_CLAIMS_UNLABELED
- {database}.{schema}.DEMO_CLAIMS_DATA
- {database}.{schema}.DEMO_ROUTE_CLAIM
- The per-evaluation experiment ({experiment_name})

⚠️ STOP: Wait for user confirmation before cleanup.

If yes, execute:

DROP TABLE IF EXISTS {database}.{schema}.DEMO_CLAIMS_UNLABELED;
DROP TABLE IF EXISTS {database}.{schema}.DEMO_CLAIMS_DATA;
DROP FUNCTION IF EXISTS {database}.{schema}.DEMO_ROUTE_CLAIM(VARCHAR, VARCHAR, VARCHAR);
DROP EXPERIMENT IF EXISTS {database}.{schema}.{experiment_name};

Step 8: Next Steps

Summarize the workflow: unlabeled data → teacher pseudo-labels → cheap student function → evaluation.

Explain to user:

You completed the pseudo-labeling and teacher-student distillation workflow:

1. Loaded unlabeled insurance claim intake records
2. Used a strong teacher model (Claude Opus) to generate routing labels
3. Built a cheaper student model to reproduce teacher routing decisions
4. Evaluated the student against teacher labels using exact_match

Key takeaways:

  Pseudo-labeling: When you don't have labeled data, a strong teacher model
  can generate high-quality training labels from your unlabeled data. This
  is dramatically faster than manual annotation.

  Teacher-student distillation: Once you have labels, you can train a cheap
  student model that approaches teacher quality at a fraction of the cost.

Want to build richer evaluation metrics? Try the "Custom Evaluation Metrics" demo.
Want to optimize the student's prompt? Try the "Prompt Optimization" demo.

Key Cautions

• Pseudo-labels are teacher-generated, not human ground truth
• Insurance routing is regulated — keep human review for high-stakes decisions (fraud_review, injury_review)
• Some model names may not be available in every account or region

Stopping Points

• ✋ Step 1: After introduction
• ✋ Step 2: After choosing database and schema
• ✋ Step 4: Before pseudo-labeling
• ✋ Step 5: Before creating the student function
• ✋ Step 6: Before evaluation
• ✋ Step 7: Before cleanup