File size: 12,938 Bytes
fc407ce
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
"""
Make Advisory Predictions with Explainability
=============================================

GOVERNANCE CONSTRAINTS:
- Advisory system only (NO autonomous decisions)
- Human-in-the-loop is MANDATORY
- All outputs are NON-BINDING suggestions
- Full explainability required (confidence, feature importance, rule signals)

Purpose: Generate advisory predictions with complete transparency
"""

import numpy as np
import joblib
import json
import yaml
from datetime import datetime

# FROZEN DECISION BOUNDARIES - DO NOT MODIFY (from decision_spec.yaml)
DECISION_BOUNDARIES = {
    'damage_thresholds': {
        'low': 5000,
        'medium': 15000,
        'high': 50000
    },
    'risk_weights': {
        'low': 1.0,
        'medium': 1.5,
        'high': 2.0
    },
    'injury_multiplier': 1.8,
    'severity_thresholds': {
        'low': 5,
        'medium': 15
    }
}

def load_model_artifacts():
    """
    Load trained model and encoders.
    """
    model = joblib.load('model.pkl')
    encoders = joblib.load('encoders.pkl')
    
    with open('model_metadata.json', 'r') as f:
        metadata = json.load(f)
    
    return model, encoders, metadata

def generate_rule_signals(claim_type, damage_amount, injury_involved, risk_factor):
    """
    Generate human-readable rule signals based on frozen decision boundaries.
    
    This provides transparent explanation of which rules are triggered.
    """
    signals = []
    
    # Damage threshold signals
    if damage_amount < DECISION_BOUNDARIES['damage_thresholds']['low']:
        signals.append(f"✓ Low damage (<${DECISION_BOUNDARIES['damage_thresholds']['low']:,}): ${damage_amount:,.2f}")
    elif damage_amount < DECISION_BOUNDARIES['damage_thresholds']['medium']:
        signals.append(f"⚠ Medium damage (${DECISION_BOUNDARIES['damage_thresholds']['low']:,}-${DECISION_BOUNDARIES['damage_thresholds']['medium']:,}): ${damage_amount:,.2f}")
    elif damage_amount < DECISION_BOUNDARIES['damage_thresholds']['high']:
        signals.append(f"⚠⚠ High damage (${DECISION_BOUNDARIES['damage_thresholds']['medium']:,}-${DECISION_BOUNDARIES['damage_thresholds']['high']:,}): ${damage_amount:,.2f}")
    else:
        signals.append(f"⚠⚠⚠ Very high damage (≥${DECISION_BOUNDARIES['damage_thresholds']['high']:,}): ${damage_amount:,.2f}")
    
    # Injury signal
    if injury_involved:
        signals.append(f"⚠ Injury involved (multiplier: {DECISION_BOUNDARIES['injury_multiplier']}x)")
    else:
        signals.append(f"✓ No injury involved")
    
    # Risk factor signal
    risk_weight = DECISION_BOUNDARIES['risk_weights'][risk_factor.lower()]
    if risk_factor.lower() == 'high':
        signals.append(f"⚠⚠ High risk factor (weight: {risk_weight}x)")
    elif risk_factor.lower() == 'medium':
        signals.append(f"⚠ Medium risk factor (weight: {risk_weight}x)")
    else:
        signals.append(f"✓ Low risk factor (weight: {risk_weight}x)")
    
    # Claim type signal
    if claim_type == "Liability":
        signals.append(f"⚠ Liability claim (additional multiplier applied)")
    else:
        signals.append(f"Claim type: {claim_type}")
    
    return signals

def calculate_uncertainty(prediction_proba):
    """
    Calculate prediction uncertainty using entropy.
    
    Returns:
        dict with uncertainty level and metrics
    """
    # Calculate entropy
    epsilon = 1e-10
    entropy = -np.sum(prediction_proba * np.log(prediction_proba + epsilon))
    max_entropy = np.log(len(prediction_proba))
    normalized_entropy = entropy / max_entropy
    
    # Determine uncertainty level
    if normalized_entropy < 0.3:
        level = "Low"
        interpretation = "Model is confident in this prediction"
    elif normalized_entropy < 0.6:
        level = "Medium"
        interpretation = "Model has moderate uncertainty - extra human scrutiny recommended"
    else:
        level = "High"
        interpretation = "Model is uncertain - REQUIRES careful human review"
    
    return {
        'level': level,
        'entropy': float(entropy),
        'normalized_entropy': float(normalized_entropy),
        'interpretation': interpretation,
        'confidence_distribution': {
            'Low': float(prediction_proba[0]),
            'Medium': float(prediction_proba[1]) if len(prediction_proba) > 1 else 0.0,
            'High': float(prediction_proba[2]) if len(prediction_proba) > 2 else 0.0
        }
    }

def get_feature_importance_for_prediction(model, feature_values):
    """
    Get feature importance specific to this prediction.
    
    Uses the model's global feature importance as a proxy.
    For tree-based models, this represents which features were most influential.
    """
    feature_names = ['claim_type', 'damage_amount', 'injury_involved', 'risk_factor']
    global_importance = model.feature_importances_
    
    # Create importance dictionary
    importance_dict = {}
    for name, importance, value in zip(feature_names, global_importance, feature_values):
        importance_dict[name] = {
            'importance_score': float(importance),
            'value': value,
            'relative_percentage': float(importance / np.sum(global_importance) * 100)
        }
    
    # Sort by importance
    sorted_features = sorted(importance_dict.items(), key=lambda x: x[1]['importance_score'], reverse=True)
    
    return dict(sorted_features)

def predict_claim(claim_type, damage_amount, injury_involved, risk_factor):
    """
    Make advisory prediction for insurance claim.
    
    Args:
        claim_type: str - "Auto", "Property", "Health", or "Liability"
        damage_amount: float - Damage amount in USD
        injury_involved: bool - Whether injury is involved
        risk_factor: str - "low", "medium", or "high"
    
    Returns:
        dict with complete advisory prediction and explainability
    """
    # Load model artifacts
    model, encoders, metadata = load_model_artifacts()
    
    # Validate inputs
    valid_claim_types = ['Auto', 'Property', 'Health', 'Liability']
    valid_risk_factors = ['low', 'medium', 'high']
    
    if claim_type not in valid_claim_types:
        raise ValueError(f"Invalid claim_type. Must be one of: {valid_claim_types}")
    
    if risk_factor not in valid_risk_factors:
        raise ValueError(f"Invalid risk_factor. Must be one of: {valid_risk_factors}")
    
    if damage_amount < 0:
        raise ValueError("damage_amount must be non-negative")
    
    # Encode inputs
    claim_type_encoded = encoders['claim_type'].transform([claim_type])[0]
    risk_factor_encoded = encoders['risk_factor'].transform([risk_factor])[0]
    injury_involved_encoded = int(injury_involved)
    
    # Create feature vector
    features = np.array([[
        claim_type_encoded,
        damage_amount,
        injury_involved_encoded,
        risk_factor_encoded
    ]])
    
    # Make prediction
    prediction = model.predict(features)[0]
    prediction_proba = model.predict_proba(features)[0]
    
    # Get severity label
    severity = encoders['target'].inverse_transform([prediction])[0]
    confidence = float(np.max(prediction_proba))
    
    # Generate explainability artifacts
    rule_signals = generate_rule_signals(claim_type, damage_amount, injury_involved, risk_factor)
    uncertainty = calculate_uncertainty(prediction_proba)
    feature_importance = get_feature_importance_for_prediction(
        model, 
        [claim_type, damage_amount, injury_involved, risk_factor]
    )
    
    # Compile advisory output
    advisory_output = {
        # GOVERNANCE: All outputs clearly marked as ADVISORY
        'governance_status': '⚠ ADVISORY ONLY - HUMAN CONFIRMATION REQUIRED',
        'decision_authority': 'HUMAN (not machine)',
        'binding': False,
        'requires_human_review': True,
        
        # Model suggestion (NON-BINDING)
        'model_suggestion': f"{severity} Severity (Advisory)",
        'severity_level': severity,
        'confidence_score': confidence,
        
        # Input summary
        'input_summary': {
            'claim_type': claim_type,
            'damage_amount': f"${damage_amount:,.2f}",
            'injury_involved': 'Yes' if injury_involved else 'No',
            'risk_factor': risk_factor
        },
        
        # Explainability
        'rule_signals': rule_signals,
        'feature_importance': feature_importance,
        'uncertainty_assessment': uncertainty,
        
        # Prediction metadata
        'prediction_metadata': {
            'model_type': metadata['model_type'],
            'model_architecture': metadata['model_architecture'],
            'prediction_timestamp': datetime.now().isoformat(),
            'dataset_source': metadata['dataset']
        },
        
        # Governance reminders
        'governance_reminders': [
            '⚠ This is an ADVISORY suggestion only',
            '⚠ Human decision-maker has FULL AUTHORITY to accept or override',
            '⚠ Human must independently evaluate the claim',
            '⚠ Human must document rationale for final decision',
            '⚠ All decisions must be logged in audit trail'
        ],
        
        # Decision boundaries reference
        'decision_boundaries_reference': DECISION_BOUNDARIES
    }
    
    return advisory_output

def format_advisory_output(output):
    """
    Format advisory output for human-readable display.
    """
    print("\n" + "="*70)
    print("INSURANCE CLAIM ADVISORY PREDICTION")
    print("="*70)
    print(f"\n{output['governance_status']}")
    print(f"Decision Authority: {output['decision_authority']}")
    print(f"Binding: {output['binding']}")
    
    print(f"\n{'='*70}")
    print("INPUT SUMMARY")
    print(f"{'='*70}")
    for key, value in output['input_summary'].items():
        print(f"  {key.replace('_', ' ').title()}: {value}")
    
    print(f"\n{'='*70}")
    print("MODEL ADVISORY SUGGESTION (Non-Binding)")
    print(f"{'='*70}")
    print(f"  Suggested Severity: {output['model_suggestion']}")
    print(f"  Model Confidence: {output['confidence_score']:.4f} ({output['confidence_score']*100:.2f}%)")
    
    print(f"\n{'='*70}")
    print("RULE SIGNALS (Transparent Decision Factors)")
    print(f"{'='*70}")
    for signal in output['rule_signals']:
        print(f"  {signal}")
    
    print(f"\n{'='*70}")
    print("FEATURE IMPORTANCE (What Influenced This Suggestion)")
    print(f"{'='*70}")
    for feature, details in output['feature_importance'].items():
        print(f"  {feature}: {details['relative_percentage']:.1f}% importance")
    
    print(f"\n{'='*70}")
    print("UNCERTAINTY ASSESSMENT")
    print(f"{'='*70}")
    uncertainty = output['uncertainty_assessment']
    print(f"  Uncertainty Level: {uncertainty['level']}")
    print(f"  Normalized Entropy: {uncertainty['normalized_entropy']:.4f}")
    print(f"  Interpretation: {uncertainty['interpretation']}")
    
    print(f"\n  Confidence Distribution:")
    for severity, prob in uncertainty['confidence_distribution'].items():
        print(f"    {severity}: {prob:.4f} ({prob*100:.2f}%)")
    
    print(f"\n{'='*70}")
    print("GOVERNANCE REMINDERS")
    print(f"{'='*70}")
    for reminder in output['governance_reminders']:
        print(f"  {reminder}")
    
    print(f"\n{'='*70}\n")

def main():
    """
    Example usage with sample claims.
    """
    print("\n" + "="*70)
    print("ADVISORY PREDICTION SYSTEM - DEMONSTRATION")
    print("="*70)
    print("Model Type: Classical ML (XGBoost)")
    print("Governance: Human-in-the-Loop Required")
    print("="*70 + "\n")
    
    # Example 1: Low severity claim
    print("\n" + "="*70)
    print("EXAMPLE 1: Low Damage Auto Claim")
    print("="*70)
    output1 = predict_claim(
        claim_type="Auto",
        damage_amount=2500.0,
        injury_involved=False,
        risk_factor="low"
    )
    format_advisory_output(output1)
    
    # Example 2: High severity claim
    print("\n" + "="*70)
    print("EXAMPLE 2: High Damage Liability Claim with Injury")
    print("="*70)
    output2 = predict_claim(
        claim_type="Liability",
        damage_amount=75000.0,
        injury_involved=True,
        risk_factor="high"
    )
    format_advisory_output(output2)
    
    # Example 3: Medium severity claim
    print("\n" + "="*70)
    print("EXAMPLE 3: Medium Damage Property Claim")
    print("="*70)
    output3 = predict_claim(
        claim_type="Property",
        damage_amount=12000.0,
        injury_involved=False,
        risk_factor="medium"
    )
    format_advisory_output(output3)
    
    print("\n" + "="*70)
    print("DEMONSTRATION COMPLETE")
    print("="*70)
    print("\nTo use this module in your code:")
    print("  from predict import predict_claim")
    print("  result = predict_claim('Auto', 5000.0, False, 'low')")
    print("="*70 + "\n")

if __name__ == "__main__":
    main()