REVIEW

HV-1102: Accident benefits, two key dates

DEMO

Client DAAccident benefitsNorth YorkOwner SPopen, last reviewed 2026-09-02

REVIEW

Clock stripas of 2026-10-05

REVIEWEXCEPTIONBenefit menu keyed to the wrong dateSHADOW v1.0SABS-VER-01, Prior benefit set

The memo chose the benefit menu by the accident date (2026-08-14, after 1 July 2026). The rule chooses it by the policy date: the policy renewed 2026-03-01, before 1 July 2026, so the prior benefit set: medical, rehabilitation, attendant care, income replacement, non-earner, lost educational expenses, visitor expenses, damage to personal items, death and funeral, with caregiver and housekeeping for catastrophic impairment applies until 2027-03-01 unless a written agreement changed it. The memo records: "Told the client that income replacement is not available."

The client may have been told a benefit is unavailable when the policy still carries it.

POLICY RENEWAL DATE2026-03-01Inferred, needs counselNEXT RENEWAL2027-03-01Inferred, needs counselDECLARATIONS PAGENot on fileMissingWRITTEN AGREEMENT CHANGING COVERAGENot on fileMissingDATE THE MEMO USED TO CHOOSE THE BENEFIT MENUAccident dateFrom a documentWHAT THE CLIENT WAS TOLDIncome replacement not availableFrom a document

Upload the declarations page. Is there a written agreement changing coverage before renewal?to benefits clerk
Which date selects the benefit menu on this file: the accident date or the policy renewal date?to knowledge partner

FORKWhich date selects the benefit menu?Open in ExchangeA The accident date, the junior's memoB The policy renewal date, sabs-ver-01

REC-HV-1102-3842346…98a2ac2Inferred, needs counselVERIFIEDCOUNSEL-CONFIRMSroutes to reviewexamined 6 documents, all extracted

REVIEWEXCEPTIONNo response to the treatment plan: due 2026-09-16, now pastSHADOW v1.0SABS-38

Brightwater General (fictional) received the treatment plan on 2026-09-01. Its response was due 2026-09-16. No response is on file at 2026-10-05.

Brightwater General (fictional) cannot rely on the Minor Injury Guideline for this plan, and pays for the plan's goods and services from 2026-09-17, the 11th business day, until it gives proper notice.

TREATMENT PLAN RECEIVED BY THE INSURER2026-09-01From a documentINSURER'S RESPONSENot on fileMissing

Which document shows the insurer's response to the treatment plan, if any?to benefits clerk

REC-HV-1102-5f0ef73…4bdb2f5From a documentSECONDARYFIRMCOUNSEL-CONFIRMSroutes to reviewexamined 6 documents, all extracted

REVIEWCANNOT DETERMINETribunal clock cannot start: no written refusal on fileSHADOW v1.0LAT-56, LAT Rules, effective 17 November 2025

The two years run from the insurer's written refusal. None is on file.

WRITTEN REFUSAL FROM THE INSURERNot on fileMissing

Has the insurer issued a written refusal?to benefits clerk

REC-HV-1102-632bfe0…5eeb69fMissingSECONDARYCOUNSEL-CONFIRMSroutes to reviewexamined 6 documents, all extracted

Rules that pass on this file

PASSConflict search cleared by a partnerAUTHORITY v1.1RPC-3.4REC-HV-1102-1
PASSSigned standard form agreement on fileAUTHORITY v1.1CFA-01REC-HV-1102-2
PASSPayer order: the auto insurer pays first for medical and rehabilitationSHADOW v1.0SABS-VER-01REC-HV-1102-4
PASSEvery document-backed fact carries a matching quoteSHADOW v1.0FIRM-RECORD-01REC-HV-1102-7

Context boundaryOverture

THIS RUNTIME CAN SEE

This file's documents, notes and party names
The policy book and its seeded sources
The conflicts index: names, roles, matter ids and status only

IT CANNOT SEE

Any other matter's documents, notes or party names (WALL-01)
Any public model or public tool (FIRM-AI-1.2)

Permitted route: sh4pe local modelNot installed in this prototype. In production, inference that sees client content runs on firm hardware.