{"txn_id":"HL-CLM-1041","assessment_id":"ra_4f7dcf60ef7c464a","occurred_at":"2026-07-08T19:01:57+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_fba659ecfa"},"output":{"decision":"pay","score":0.205,"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 2026-07-08, 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 2026-07-08 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-07-08","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:25.176927+00:00","fingerprint":"81d522f1b919c5e3d25b898c"},"review":null,"ledger":{"seq":1041,"hash":"ed6db00d919a743645518589761b172634f44dfb1665d0198eb5e0d1627c1f6a","prev_hash":"4b377d68a55c91c7d24ebfade4a609d9b8b0a4144baa23f09a2ba0e11933f9e9","recorded_at":"2026-07-08T19:02:55+00:00"}}