{"txn_id":"HL-CLM-1033","assessment_id":"ra_bfee78b8e4be4f8b","occurred_at":"2026-10-27T00:36:07+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_1423a14e19"},"output":{"decision":"pay","score":0.154,"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 2026-10-27, 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 2026-10-27 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-10-27","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:25.162560+00:00","fingerprint":"9dcb79c5a395088e4599406e"},"review":null,"ledger":{"seq":1033,"hash":"0c3dcbbbd23dfb3e828a5ae4bba2a5056129bdcbb442f8c7fe3c597bb6bbb861","prev_hash":"e7a04f3a2f05e6d98a4e6f00d2a4f7883509a54b3da59f6b90c391fb5423ef11","recorded_at":"2026-10-27T00:40:01+00:00"}}