Regulatory Assessment
HL-CLM-1079 PASS
NY · health · claims · decided 2026-08-13 01:38 UTC · Harborline Health Plan, Inc. (fictional)
On 2026-08-13, claims-adjud v5.1 (an internally developed system) produced 'pay' in a NY 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 1 rule(s) in force on 2026-08-13 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 2026-08-13 for this state, line and stage. The case file is recorded all the same.
Point in time
- Law as of
- 2026-08-13
- Rules version
- 2026.10+dbe5ddf6
- Corpus snapshot
- 2026-10-30-5f07c521
- Engine
- regbench-engine/0.4.0 · deterministic-1
- Fingerprint
- d04b2934ca44329523a9b2bd
- Evaluated
- 2026-10-30 11:23:25 UTC
- Exhibit C case file
- yes
Ledger
- Entry
- #1079 · assessment · recorded 2026-08-13T01:39:18+00:00
- Hash
- ebd7676a6c2f0d49f133fbab407f7827e658f7b90b7b7d480567237a9b64fdf5
- Previous
- b8c1a41e73cd9578af04e2f7f723dce8e6940f2c0bac419044634ef018a28cb1
- Stored copy intact
- yes, hashes match
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 0.054
- Human review
- none
- Adverse to consumer
- False
- Notice
- not recorded · reasons: False · specific: False · external data disclosed: False
- Appeal channel
- –
- Consumer token
- tok_dc53e1822d