HV-1120
Accident benefitsREVIEW
Clock strip
Exceptions
| Severity | Rule | Exception | Routes to |
|---|---|---|---|
| REVIEW | SABS-38-LATE | Late denial treated as effective | benefits clerk |
7 rules pass: RPC-3.4, CFA-01, SABS-VER-01, SABS-VER-01, SABS-38, LAT-56, FIRM-RECORD-01
- PASS, DEGRADEDConflict search cleared by a partnerRPC-3.4REC-HV-1120-1
- PASS, DEGRADEDSigned standard form agreement on fileCFA-01REC-HV-1120-2
- PASS, DEGRADEDBenefit menu selected from the policy date: prior benefit setSABS-VER-01REC-HV-1120-3
- PASS, DEGRADEDPayer order: prior rules applySABS-VER-01REC-HV-1120-4
- PASS, DEGRADEDInsurer's response to the treatment plan is on fileSABS-38REC-HV-1120-5
- PASS, DEGRADEDTribunal application deadline 2028-04-07LAT-56REC-HV-1120-6
- PASS, DEGRADEDEvery document-backed fact carries a matching quoteFIRM-RECORD-01REC-HV-1120-7
REVIEWEXCEPTIONSHADOW v1.0
A late denial is treated as effective for the gap
Verdict degraded: documents on this file not yet extracted: 1.
StoredDerivedBasis
Treatment plan received by the insurernone2026-03-18From a documentDOC-1120-03, p. 1“Received: 2026-03-18 11:05.”
Insurer's denialnone2026-04-07From a documentDOC-1120-04, p. 1“Letter from Brightwater General (fictional), dated 2026-04-07.”
File treated the denial as effectivenoneyesFrom a documentDOC-1120-05, p. 1“The denial is treated as effective from the date of the letter.”
- This denial arrived late. Has the file treated it as effective for the gap, and what is the s. 38(11) exposure from day 11?to benefits clerkF-HV-1120-SABS-38-LATE
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.