{"txn_id":"HL-CLM-1013","assessment_id":"ra_62ec70a9fb394e99","occurred_at":"2026-10-26T12:19:00+00:00","state":"TX","line_of_business":"health","stage":"claims","program_area":"Claims/Adjudication","ai_system":{"system_id":"claims-adjud","model_version":"5.1","vendor":"internal","vendor_name":null,"high_risk_class":"claims"},"inputs":{"feature_classes":["medical_records","claims_history"],"protected_factors_used":[],"ecdis_present":false,"consumer_report_used":false,"credit_used":false,"data_source_refs":[],"consumer_token":"tok_402742a9cf"},"output":{"decision":"pay","score":0.016,"reason_codes":[],"premium_delta_pct":null},"human_involvement":{"reviewed":false,"reviewer_role":null,"overridden":false},"adverse_action":{"is_adverse":false,"notice_sent_at":null,"reasons_provided":false,"specific_reasons":false,"ecdis_disclosed":false,"appeal_channel":null},"carrier_note":null,"assessment":{"disposition":"PASS","summary":"PASS: 0 finding(s) under rules 2026.10+dbe5ddf6, corpus 2026-10-30-5f07c521. No regulatory finding; the case file is recorded.","narrative":"On 2026-10-26, claims-adjud v5.1 (an internally developed system) produced 'pay' in a TX health claims transaction. Inputs included medical records, claims history. No human reviewed the output before it took effect. The outcome was not adverse to the consumer. RegBench applied 7 rule(s) in force on 2026-10-26 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-10-26","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:25.121280+00:00","fingerprint":"8ab8ba77f875ed6c7d5786d7"},"review":null,"ledger":{"seq":1013,"hash":"ced4553cb57b19f192db94a02be9a3f7ba8bc2b264859c1240140f57391580a6","prev_hash":"acf1b302da92e24b4e48677cb55041c78e41b2a18218ed2ec9ffc11d7ce23301","recorded_at":"2026-10-26T12:20:50+00:00"}}