Study kit proposed

Can a claims professional reconstruct the decision?

Insurers cite opacity as a reason to exclude AI. This study tests the narrowest claim that answers it: that claims professionals reconstruct an automated denial faster and more accurately from a receipt than from ordinary logs. It has not been run. If receipts do not help, that result is published and the claim is withdrawn.

Design

Reconstruction questions

  1. What action was taken or proposed, on what object?
  2. Under whose authority, and does that authority trace to someone other than the system itself?
  3. Which evidence was relied on, and was it about this claim?
  4. Was the evidence current when the decision took effect?
  5. Did review complete before the decision was committed?
  6. Which claimant routes (review, correction, appeal) remained available afterwards?
  7. Did the decision take effect before it was warranted?
  8. What would have had to change for the decision to be warranted?

Materials

Protocol · Preregistration fields (draft, not frozen) · Scoring sheet · Answer key

CaseLog conditionReceipt condition
INS-001
Denial after completed human review, appeal routes kept
INS-001-log.txt
INS-002
Denial committed in minutes, before review, appeal route closed
INS-002-log.txt
INS-003
Denial already sent, authority self-asserted
INS-003-log.txt

Receipt packets are computed in your browser with a fixed record time, so every participant receives identical bytes. The answer key is generated from the gate's checks, so it cannot drift from what a receipt shows; its SHA-256 is recorded in the preregistration. It has not yet been reviewed independently, which the protocol requires before any run.