{"txn_id":"HL-CLM-1031","assessment_id":"ra_c465c7cf9feb459f","occurred_at":"2026-09-24T16:34:09+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_ec1dc6b5e9"},"output":{"decision":"pay","score":0.261,"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 2026-09-24, 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 2026-09-24 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-09-24","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:25.159381+00:00","fingerprint":"3531680655d8cf3249748ac7"},"review":null,"ledger":{"seq":1031,"hash":"ede752b4ba28c16ecd4398a2c5cf4ff008dbdb344726729d1517b03c7f26621b","prev_hash":"1db0c8022c1fd10819ba8282936a787eb9cdf4dd206ce5cae3f076c6fa120361","recorded_at":"2026-09-24T16:35:32+00:00"}}