{"txn_id":"HL-CLM-1067","assessment_id":"ra_da92ecc4ef8f4f37","occurred_at":"2026-07-07T07:07:23+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_0654ee9a79"},"output":{"decision":"pay","score":0.13,"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 2026-07-07, 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 2026-07-07 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-07-07","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:25.239991+00:00","fingerprint":"104c7f4de3c3aada2f3f1205"},"review":null,"ledger":{"seq":1067,"hash":"b1d16ab9cf15f6411fcdba091d78570f2ed6fa663fc3c057ca049ac69261ca1b","prev_hash":"4b9912d1015ea58b1ae2165c8a305c48925cc6c80b2cf8b3066262fcd08f1eee","recorded_at":"2026-07-07T07:10:31+00:00"}}