{
  "scenario_version": "nt-cover-scenario:v0",
  "scenario_id": "COVER-INS-005",
  "title": "Denial relied on to release a claim reserve, later defeated, followed by a settlement loss",
  "synthetic": true,
  "terms": {
    "terms_id": "TERMS-SYNTHETIC-001",
    "purpose": "close the claim file and release the claim reserve",
    "failing_effects": [
      "DEFEATED"
    ],
    "window_end": "2026-12-31T23:59:59Z",
    "loss_definition": {
      "min_loss_minor": 100000,
      "currency": "GBP",
      "requires_causal_link": true
    }
  },
  "readjudications": [
    {
      "proposal_id": "INS-005",
      "record_time": "2026-09-20T09:00:00Z"
    }
  ],
  "reliance": [
    {
      "reliance_id": "REL-001",
      "relied_on": {
        "proposal_id": "INS-005",
        "record_time": "2026-09-10T11:30:00Z"
      },
      "relied_by": "party:ref-7f3a",
      "purpose": "close the claim file and release the claim reserve",
      "relied_at": "2026-09-10T11:45:00Z"
    }
  ],
  "consequences": [
    {
      "consequence_id": "CON-001a",
      "reliance_id": "REL-001",
      "proposal_id": "INS-005",
      "observed_at": "2026-09-26T10:00:00Z",
      "description": "Claim reopened on appeal; the settlement amount has not been reported yet.",
      "path": "wrongful_denial_settlement",
      "independent": false,
      "loss_status": "pending",
      "supersedes": null,
      "loss_minor": null,
      "currency": "GBP",
      "causal_link": null
    },
    {
      "consequence_id": "CON-001",
      "reliance_id": "REL-001",
      "proposal_id": "INS-005",
      "observed_at": "2026-10-02T15:00:00Z",
      "description": "Claim reopened on appeal and settled; settlement and handling cost exceeded the released reserve.",
      "path": "wrongful_denial_settlement",
      "independent": false,
      "loss_status": "reported",
      "supersedes": "CON-001a",
      "loss_minor": 320000,
      "currency": "GBP",
      "causal_link": {
        "basis": "The reserve was released in reliance on the denial; the model withdrawal defeats the denial, so the reserve release was unwarranted.",
        "attested_by": "party:ref-c1d9"
      }
    },
    {
      "consequence_id": "CON-002",
      "reliance_id": null,
      "proposal_id": "INS-005",
      "observed_at": "2026-10-20T09:00:00Z",
      "description": "The financial ombudsman charged a complaint-handling fee after the claimant escalated. No declared path in the claims class carries a regulator's fee.",
      "path": null,
      "independent": true,
      "loss_status": "reported",
      "supersedes": null,
      "loss_minor": 75000,
      "currency": "GBP",
      "causal_link": null
    }
  ]
}