Regulatory Assessment

HL-CLM-1108 PASS

TX · health · claims · decided 2026-07-11 03:07 UTC · Harborline Health Plan, Inc. (fictional)

On 2026-07-11, 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 2026-07-11 and recorded no findings.

PASS: 0 finding(s) under rules 2026.10+dbe5ddf6, corpus 2026-10-30-5f07c521. No regulatory finding; the case file is recorded.

Findings (0)

No finding under the rules in force on 2026-07-11 for this state, line and stage. The case file is recorded all the same.

Point in time

Law as of
2026-07-11
Rules version
2026.10+dbe5ddf6
Corpus snapshot
2026-10-30-5f07c521
Engine
regbench-engine/0.4.0 · deterministic-1
Fingerprint
28d57ca522bec1e13bbc5a44
Evaluated
2026-10-30 11:23:25 UTC
Exhibit C case file
yes

Ledger

Entry
#1108 · assessment · recorded 2026-07-11T03:10:34+00:00
Hash
b7dbdf2a20c6a8ca8802861ddaa65d19b418728d8a0c8839dab5d79a74f09bb9
Previous
81b3a60fedcda9fc07db34e2ccea598b349122abe255086324713a105d0d2e89
Stored copy intact
yes, hashes match

Verify the whole chain Case file JSON

Carrier review

No review item: the disposition was PASS.

Recorded facts

AI system
claims-adjud v5.1 · internal · high-risk class: claims
Governance attested
True
Testing report
test://harborline/claims-adjud/2026Q1
Model documentation
doc://harborline/claims-adjud/5.1
Feature classes
medical_records, claims_history
Protected factors used
none
External data (ECDIS)
False
Consumer report / credit
False / False
Data sources
none recorded
Decision
pay · score 0.097
Human review
none
Adverse to consumer
False
Notice
not recorded · reasons: False · specific: False · external data disclosed: False
Appeal channel
–
Consumer token
tok_e46fc96371