{"txn_id":"HL-CLM-1045","assessment_id":"ra_95dcdaaac3e74bd8","occurred_at":"2026-07-05T09:11:26+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_cd7fd62839"},"output":{"decision":"pay","score":0.159,"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 2026-07-05, 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 2026-07-05 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-07-05","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:25.183266+00:00","fingerprint":"d3df271ed1715bb419e16810"},"review":null,"ledger":{"seq":1045,"hash":"7adb0cb3dc45084191698d5b47ffb9f733e57d7cf2d108b98c8894a2eeb3157c","prev_hash":"4ec0bcb0ed1c88773111ee863d4febbe0fad00f45daef5e9564bbb1ff36ebe28","recorded_at":"2026-07-05T09:12:50+00:00"}}