{"txn_id":"SR-UW-0619","assessment_id":"ra_634b862d58104dff","occurred_at":"2026-10-15T18:04:54+00:00","state":"CT","line_of_business":"life","stage":"rating","program_area":"Ratemaking/Rate Classification/Schedule Rating/Premium Audits","ai_system":{"system_id":"rx-score","model_version":"3","vendor":"third_party","vendor_name":"RxData Labs (fictional)","high_risk_class":"underwriting"},"inputs":{"feature_classes":["rx_history","credit","consumer_report","application_data"],"protected_factors_used":[],"ecdis_present":false,"consumer_report_used":true,"credit_used":true,"data_source_refs":["vendor://rxdata/score","cra://demo-bureau/attributes"],"consumer_token":"tok_a539569742"},"output":{"decision":"decline","score":0.934,"reason_codes":["RX4","CR2"],"premium_delta_pct":null},"human_involvement":{"reviewed":false,"reviewer_role":"underwriter","overridden":false},"adverse_action":{"is_adverse":true,"notice_sent_at":"2026-10-16T18:04:54+00:00","reasons_provided":true,"specific_reasons":true,"ecdis_disclosed":true,"appeal_channel":null},"carrier_note":null,"assessment":{"disposition":"FLAG","summary":"FLAG: 4 finding(s) under rules 2026.10+dbe5ddf6, corpus 2026-10-30-5f07c521. Routed to the carrier's compliance reviewer with cited findings.","narrative":"On 2026-10-15, rx-score v3 (a third-party system from RxData Labs (fictional)) produced 'decline' in a CT life rating transaction. Inputs included rx history, credit, consumer report, application data. A consumer report was used. No human reviewed the output before it took effect. The outcome was adverse to the consumer; a notice was sent on 2026-10-16 with specific reasons. RegBench applied 7 rule(s) in force on 2026-10-15 and recorded 4 finding(s); the most serious is 'Adverse high-risk decision from a system with no adverse-outcome testing on record' (medium, L1).","findings":[{"rule_id":"naic.adverse-outcome-testing","layer":"L1","judgment_basis":"guidance","advisory":false,"severity":"medium","title":"Adverse high-risk decision from a system with no adverse-outcome testing on record","required_action":"Attach the system's latest testing report reference (errors, bias, unfair discrimination, drift).","exhibits":["C"],"citations":[{"provision_id":"naic-ai-bulletin-s3-1-ais-program","label":"NAIC Model Bulletin on the Use of AI Systems by Insurers (adopted 4 Dec 2023), Section 3, 1.0 General Guidelines — the written AIS Program","source_url":"https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf","verified":true},{"provision_id":"naic-ai-bulletin-s4-oversight","label":"NAIC Model Bulletin (2023), Section 4 — Regulatory Oversight and Examination Considerations","source_url":"https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf","verified":true}]},{"rule_id":"naic.ais-program.third-party-diligence","layer":"L1","judgment_basis":"guidance","advisory":false,"severity":"medium","title":"Third-party AI system without an attested due-diligence and contract record","required_action":"Attach the vendor due-diligence record and contract terms (audit rights, regulatory cooperation) to the system's inventory entry and attest governance coverage.","exhibits":["A","C"],"citations":[{"provision_id":"naic-ai-bulletin-s3-4-third-party","label":"NAIC Model Bulletin (2023), Section 3, 4.0 Third-Party AI Systems and Data","source_url":"https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf","verified":true},{"provision_id":"naic-ai-bulletin-s4-oversight","label":"NAIC Model Bulletin (2023), Section 4 — Regulatory Oversight and Examination Considerations","source_url":"https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf","verified":true}]},{"rule_id":"doctrine.unreviewed-adverse-high-risk","layer":"L6","judgment_basis":"doctrine","advisory":true,"severity":"medium","title":"Adverse outcome from a high-risk AI system with no human review","required_action":"Route to the carrier's reviewer; record the review and any override on the transaction.","exhibits":["B","C"],"citations":[{"provision_id":"naic-ai-bulletin-s3-1-ais-program","label":"NAIC Model Bulletin on the Use of AI Systems by Insurers (adopted 4 Dec 2023), Section 3, 1.0 General Guidelines — the written AIS Program","source_url":"https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf","verified":true}]},{"rule_id":"naic.ais-program.documentation","layer":"L1","judgment_basis":"guidance","advisory":false,"severity":"low","title":"High-risk AI system with no model documentation reference","required_action":"Link the system to its model documentation (purpose, inputs, validation, monitoring) in the inventory.","exhibits":["A","C"],"citations":[{"provision_id":"naic-ai-bulletin-s4-oversight","label":"NAIC Model Bulletin (2023), Section 4 — Regulatory Oversight and Examination Considerations","source_url":"https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf","verified":true},{"provision_id":"naic-ai-bulletin-s3-1-ais-program","label":"NAIC Model Bulletin on the Use of AI Systems by Insurers (adopted 4 Dec 2023), Section 3, 1.0 General Guidelines — the written AIS Program","source_url":"https://content.naic.org/sites/default/files/inline-files/2023-12-4%20Model%20Bulletin_Adopted_0.pdf","verified":true}]}],"point_in_time":{"as_of":"2026-10-15","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:24.120100+00:00","fingerprint":"d76c272f49069ce338d10014"},"review":{"status":"resolved","outcome":"escalated","hours_to_resolve":32.3,"reviewer_role":"compliance","resolved_at":"2026-10-17T02:24:25.245819+00:00"},"ledger":{"seq":619,"hash":"fae3609788947139afe1cc9ef17e5be1f29cdcbc4d2e09dd0ce72d213017cc45","prev_hash":"c3c0ee50043dc7a28063db5d21a8992704a9bb645dd0adfd8e53c7174e4952c8","recorded_at":"2026-10-15T18:05:50+00:00"}}