record_id
stringlengths 10
10
| domain
stringclasses 2
values | use_case
stringclasses 6
values | signal_type
stringclasses 6
values | risk_weight
stringclasses 3
values | evidence_text
stringlengths 76
159
| advisory_note
stringclasses 12
values | governance_tag
stringclasses 1
value | created_at
stringdate 2025-01-01 00:00:00
2026-01-04 00:00:00
|
|---|---|---|---|---|---|---|---|---|
REC-000300
|
justice
|
regulatory_assessment
|
policy_conflict
|
medium
|
Matter category MC-8904 may require preliminary review per procedural rule PR-8904.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-12-28T00:00:00Z
|
REC-000109
|
insurance
|
claims_review
|
missing_document
|
medium
|
Policy amendment form mentioned in correspondence from 2025-02-11 cannot be located in the file. Amendment relates to coverage modification request.
|
Document gap identified. Professional judgment required to determine if additional documentation should be requested.
|
advisory_only_human_review_required
|
2025-03-05T00:00:00Z
|
REC-000199
|
justice
|
regulatory_assessment
|
prior_reference
|
low
|
Case history shows prior matter PM-8428 from 2024-03-29 with similar factual elements.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-12-29T00:00:00Z
|
REC-000164
|
justice
|
evidence_review
|
prior_reference
|
medium
|
Earlier case EC-7150 involved same jurisdiction and similar legal questions.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-05-07T00:00:00Z
|
REC-000101
|
insurance
|
underwriting_support
|
frequency_anomaly
|
high
|
Provider code P-5096 appears in 5096 separate claims within 20-month timeframe.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-05-26T00:00:00Z
|
REC-000173
|
justice
|
case_preparation
|
policy_conflict
|
high
|
Alleged conduct may intersect with regulatory provision RP-6816 in code section 13.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-08-09T00:00:00Z
|
REC-000276
|
justice
|
case_preparation
|
timeline_anomaly
|
high
|
Regulatory notice dated 2024-02-14 precedes alleged violation date of 2024-10-30 by 259 days.
|
Temporal pattern identified that may warrant attention. Human reviewer should assess whether the timing raises questions.
|
advisory_only_human_review_required
|
2025-11-17T00:00:00Z
|
REC-000082
|
insurance
|
claims_review
|
policy_conflict
|
low
|
Claim amount of $23850 approaches or exceeds policy limit of $73045 specified in schedule.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2025-03-21T00:00:00Z
|
REC-000210
|
justice
|
case_preparation
|
policy_conflict
|
low
|
Alleged conduct may intersect with regulatory provision RP-5066 in code section 9.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2025-01-16T00:00:00Z
|
REC-000260
|
justice
|
case_preparation
|
frequency_anomaly
|
medium
|
Case file shows 8341 related filings within 18-month period with similar fact patterns.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-07-26T00:00:00Z
|
REC-000188
|
justice
|
regulatory_assessment
|
frequency_anomaly
|
medium
|
Regulatory code RC-6869 appears in 6869 separate cases within 9-month timeframe.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-06-15T00:00:00Z
|
REC-000025
|
insurance
|
fraud_triage
|
document_inconsistency
|
low
|
Incident date listed as 2024-01-26 in claim form conflicts with 2024-06-30 shown in police report PR-6442.
|
Discrepancy between documents identified. Human reviewer should examine the variance and determine its significance.
|
advisory_only_human_review_required
|
2025-07-15T00:00:00Z
|
REC-000039
|
insurance
|
claims_review
|
frequency_anomaly
|
low
|
Account shows 1659 claims submitted within 22-month period, with similar incident patterns.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-03-06T00:00:00Z
|
REC-000015
|
insurance
|
fraud_triage
|
timeline_anomaly
|
low
|
Claim submitted on 2024-07-13 for incident allegedly occurring on 2024-07-15, representing a 2-day reporting delay.
|
Temporal pattern identified that may warrant attention. Human reviewer should assess whether the timing raises questions.
|
advisory_only_human_review_required
|
2025-01-26T00:00:00Z
|
REC-000085
|
insurance
|
fraud_triage
|
prior_reference
|
low
|
Account history shows prior claim PC-8432 from 2024-08-08 with similar incident characteristics.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-01-27T00:00:00Z
|
REC-000060
|
insurance
|
underwriting_support
|
policy_conflict
|
medium
|
Claimed service type ST-9022 may fall outside coverage scope defined in policy section 18.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-08-22T00:00:00Z
|
REC-000265
|
justice
|
regulatory_assessment
|
policy_conflict
|
low
|
Alleged conduct may intersect with regulatory provision RP-6273 in code section 9.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-06-25T00:00:00Z
|
REC-000278
|
justice
|
case_preparation
|
timeline_anomaly
|
low
|
Filing submitted on 2024-02-25 for events allegedly occurring on 2024-03-16, representing a 20-day delay.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-06-11T00:00:00Z
|
REC-000115
|
insurance
|
claims_review
|
timeline_anomaly
|
medium
|
Policy effective date of 2024-08-07 precedes claim incident date of 2024-10-19 by only 73 days.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-02-14T00:00:00Z
|
REC-000233
|
justice
|
regulatory_assessment
|
prior_reference
|
medium
|
Earlier case EC-3356 involved same jurisdiction and similar legal questions.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-05-18T00:00:00Z
|
REC-000038
|
insurance
|
fraud_triage
|
frequency_anomaly
|
low
|
Provider code P-6363 appears in 6363 separate claims within 15-month timeframe.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-05-10T00:00:00Z
|
REC-000043
|
insurance
|
underwriting_support
|
prior_reference
|
high
|
Historical records indicate prior interaction with provider P-8385 in claim from 2024-03-29.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-09-11T00:00:00Z
|
REC-000155
|
justice
|
evidence_review
|
policy_conflict
|
low
|
Alleged conduct may intersect with regulatory provision RP-7841 in code section 19.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2025-09-13T00:00:00Z
|
REC-000279
|
justice
|
evidence_review
|
frequency_anomaly
|
high
|
Case file shows 2036 related filings within 12-month period with similar fact patterns.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-05-25T00:00:00Z
|
REC-000222
|
justice
|
regulatory_assessment
|
timeline_anomaly
|
low
|
Filing submitted on 2024-12-09 for events allegedly occurring on 2025-10-16, representing a 311-day delay.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-02-25T00:00:00Z
|
REC-000205
|
justice
|
regulatory_assessment
|
policy_conflict
|
medium
|
Alleged conduct may intersect with regulatory provision RP-7718 in code section 11.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2025-12-03T00:00:00Z
|
REC-000212
|
justice
|
case_preparation
|
prior_reference
|
high
|
Case history shows prior matter PM-1357 from 2024-03-17 with similar factual elements.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-03-04T00:00:00Z
|
REC-000184
|
justice
|
regulatory_assessment
|
policy_conflict
|
low
|
Matter category MC-1528 may require preliminary review per procedural rule PR-1528.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2025-04-18T00:00:00Z
|
REC-000161
|
justice
|
evidence_review
|
prior_reference
|
low
|
Case history shows prior matter PM-2562 from 2024-12-05 with similar factual elements.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-01-24T00:00:00Z
|
REC-000107
|
insurance
|
underwriting_support
|
missing_document
|
high
|
Policy amendment form mentioned in correspondence from 2024-01-17 cannot be located in the file. Amendment relates to coverage modification request.
|
Document gap identified. Professional judgment required to determine if additional documentation should be requested.
|
advisory_only_human_review_required
|
2025-03-10T00:00:00Z
|
REC-000296
|
justice
|
case_preparation
|
missing_document
|
low
|
Expert report mentioned in filing from 2024-02-09 cannot be located in the documentation package.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-12-14T00:00:00Z
|
REC-000022
|
insurance
|
fraud_triage
|
document_inconsistency
|
high
|
Property value stated as $39666 in appraisal differs from $39758 listed in policy schedule PS-9280.
|
Conflicting information noted across sources. Professional judgment required to reconcile or clarify the inconsistency.
|
advisory_only_human_review_required
|
2025-01-23T00:00:00Z
|
REC-000029
|
insurance
|
claims_review
|
prior_reference
|
medium
|
Historical records indicate prior interaction with provider P-5844 in claim from 2024-11-30.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-07-27T00:00:00Z
|
REC-000273
|
justice
|
case_preparation
|
prior_reference
|
medium
|
Earlier case EC-6207 involved same jurisdiction and similar legal questions.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-10-06T00:00:00Z
|
REC-000177
|
justice
|
evidence_review
|
timeline_anomaly
|
high
|
Regulatory notice dated 2024-08-25 precedes alleged violation date of 2025-02-18 by 177 days.
|
Temporal pattern identified that may warrant attention. Human reviewer should assess whether the timing raises questions.
|
advisory_only_human_review_required
|
2025-08-19T00:00:00Z
|
REC-000116
|
insurance
|
fraud_triage
|
timeline_anomaly
|
high
|
Policy effective date of 2024-03-07 precedes claim incident date of 2025-07-09 by only 489 days.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-09-18T00:00:00Z
|
REC-000014
|
insurance
|
fraud_triage
|
frequency_anomaly
|
low
|
Provider code P-8062 appears in 8062 separate claims within 4-month timeframe.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-07-26T00:00:00Z
|
REC-000136
|
insurance
|
underwriting_support
|
frequency_anomaly
|
high
|
Account shows 1969 claims submitted within 4-month period, with similar incident patterns.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-04-01T00:00:00Z
|
REC-000180
|
justice
|
evidence_review
|
timeline_anomaly
|
low
|
Filing submitted on 2024-04-29 for events allegedly occurring on 2024-07-06, representing a 68-day delay.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-04-06T00:00:00Z
|
REC-000137
|
insurance
|
claims_review
|
frequency_anomaly
|
medium
|
Account shows 2758 claims submitted within 19-month period, with similar incident patterns.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-09-16T00:00:00Z
|
REC-000221
|
justice
|
evidence_review
|
prior_reference
|
low
|
Earlier case EC-6213 involved same jurisdiction and similar legal questions.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-05-02T00:00:00Z
|
REC-000240
|
justice
|
regulatory_assessment
|
prior_reference
|
high
|
Earlier case EC-7131 involved same jurisdiction and similar legal questions.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-11-24T00:00:00Z
|
REC-000037
|
insurance
|
claims_review
|
timeline_anomaly
|
medium
|
Policy effective date of 2024-01-30 precedes claim incident date of 2024-12-10 by only 315 days.
|
Temporal pattern identified that may warrant attention. Human reviewer should assess whether the timing raises questions.
|
advisory_only_human_review_required
|
2025-02-12T00:00:00Z
|
REC-000183
|
justice
|
evidence_review
|
policy_conflict
|
medium
|
Alleged conduct may intersect with regulatory provision RP-9369 in code section 18.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2026-01-04T00:00:00Z
|
REC-000214
|
justice
|
regulatory_assessment
|
document_inconsistency
|
low
|
Event date listed as 2024-10-29 in complaint differs from 2025-02-25 shown in incident log IL-8848.
|
Discrepancy between documents identified. Human reviewer should examine the variance and determine its significance.
|
advisory_only_human_review_required
|
2025-11-19T00:00:00Z
|
REC-000166
|
justice
|
regulatory_assessment
|
missing_document
|
low
|
Chain of custody form referenced in evidence log EL-9395 dated 2024-07-10 is not present in case file.
|
Document gap identified. Professional judgment required to determine if additional documentation should be requested.
|
advisory_only_human_review_required
|
2025-07-17T00:00:00Z
|
REC-000086
|
insurance
|
claims_review
|
document_inconsistency
|
high
|
Incident date listed as 2024-03-24 in claim form conflicts with 2024-10-05 shown in police report PR-7947.
|
Discrepancy between documents identified. Human reviewer should examine the variance and determine its significance.
|
advisory_only_human_review_required
|
2025-06-26T00:00:00Z
|
REC-000165
|
justice
|
case_preparation
|
missing_document
|
low
|
Expert report mentioned in filing from 2024-06-06 cannot be located in the documentation package.
|
Document gap identified. Professional judgment required to determine if additional documentation should be requested.
|
advisory_only_human_review_required
|
2025-07-04T00:00:00Z
|
REC-000077
|
insurance
|
underwriting_support
|
document_inconsistency
|
high
|
Property value stated as $13724 in appraisal differs from $34433 listed in policy schedule PS-3076.
|
Conflicting information noted across sources. Professional judgment required to reconcile or clarify the inconsistency.
|
advisory_only_human_review_required
|
2025-09-20T00:00:00Z
|
REC-000158
|
justice
|
regulatory_assessment
|
timeline_anomaly
|
low
|
Regulatory notice dated 2024-01-07 precedes alleged violation date of 2024-01-17 by 10 days.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-01-09T00:00:00Z
|
REC-000108
|
insurance
|
claims_review
|
timeline_anomaly
|
high
|
Policy effective date of 2024-06-28 precedes claim incident date of 2025-04-20 by only 296 days.
|
Temporal pattern identified that may warrant attention. Human reviewer should assess whether the timing raises questions.
|
advisory_only_human_review_required
|
2025-01-23T00:00:00Z
|
REC-000215
|
justice
|
case_preparation
|
missing_document
|
medium
|
Expert report mentioned in filing from 2024-12-18 cannot be located in the documentation package.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-01-16T00:00:00Z
|
REC-000009
|
insurance
|
fraud_triage
|
timeline_anomaly
|
high
|
Policy effective date of 2024-04-24 precedes claim incident date of 2024-06-10 by only 47 days.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-11-24T00:00:00Z
|
REC-000032
|
insurance
|
underwriting_support
|
prior_reference
|
high
|
Account history shows prior claim PC-4997 from 2025-01-28 with similar incident characteristics.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-04-01T00:00:00Z
|
REC-000080
|
insurance
|
fraud_triage
|
policy_conflict
|
medium
|
Claimed service type ST-4522 may fall outside coverage scope defined in policy section 15.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-08-01T00:00:00Z
|
REC-000012
|
insurance
|
underwriting_support
|
frequency_anomaly
|
high
|
Provider code P-5061 appears in 5061 separate claims within 20-month timeframe.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-01-04T00:00:00Z
|
REC-000271
|
justice
|
regulatory_assessment
|
document_inconsistency
|
high
|
Jurisdiction stated as District-4170 in filing conflicts with District-5819 in service records.
|
Discrepancy between documents identified. Human reviewer should examine the variance and determine its significance.
|
advisory_only_human_review_required
|
2025-07-13T00:00:00Z
|
REC-000195
|
justice
|
evidence_review
|
prior_reference
|
medium
|
Case history shows prior matter PM-7418 from 2024-07-12 with similar factual elements.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-05-04T00:00:00Z
|
REC-000256
|
justice
|
regulatory_assessment
|
frequency_anomaly
|
high
|
Case file shows 3611 related filings within 21-month period with similar fact patterns.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-11-09T00:00:00Z
|
REC-000010
|
insurance
|
fraud_triage
|
policy_conflict
|
low
|
Claimed service type ST-1009 may fall outside coverage scope defined in policy section 8.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2025-05-04T00:00:00Z
|
REC-000078
|
insurance
|
fraud_triage
|
missing_document
|
medium
|
Medical report referenced in claim submission dated 2024-02-14 is not present in the documentation package. Claim references treatment at facility code F-5941.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-09-09T00:00:00Z
|
REC-000120
|
insurance
|
fraud_triage
|
timeline_anomaly
|
low
|
Policy effective date of 2024-04-05 precedes claim incident date of 2025-05-29 by only 419 days.
|
Temporal pattern identified that may warrant attention. Human reviewer should assess whether the timing raises questions.
|
advisory_only_human_review_required
|
2025-01-15T00:00:00Z
|
REC-000226
|
justice
|
regulatory_assessment
|
timeline_anomaly
|
low
|
Filing submitted on 2024-02-20 for events allegedly occurring on 2025-02-06, representing a 352-day delay.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-04-13T00:00:00Z
|
REC-000211
|
justice
|
regulatory_assessment
|
frequency_anomaly
|
high
|
Case file shows 2989 related filings within 7-month period with similar fact patterns.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-07-10T00:00:00Z
|
REC-000026
|
insurance
|
claims_review
|
frequency_anomaly
|
low
|
Account shows 4652 claims submitted within 11-month period, with similar incident patterns.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-06-29T00:00:00Z
|
REC-000099
|
insurance
|
fraud_triage
|
policy_conflict
|
high
|
Claimed service type ST-7172 may fall outside coverage scope defined in policy section 6.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-01-23T00:00:00Z
|
REC-000160
|
justice
|
regulatory_assessment
|
frequency_anomaly
|
medium
|
Case file shows 2320 related filings within 20-month period with similar fact patterns.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-11-23T00:00:00Z
|
REC-000220
|
justice
|
case_preparation
|
frequency_anomaly
|
high
|
Regulatory code RC-6846 appears in 6846 separate cases within 15-month timeframe.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-03-07T00:00:00Z
|
REC-000113
|
insurance
|
fraud_triage
|
frequency_anomaly
|
low
|
Account shows 6933 claims submitted within 24-month period, with similar incident patterns.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-07-10T00:00:00Z
|
REC-000134
|
insurance
|
claims_review
|
timeline_anomaly
|
medium
|
Policy effective date of 2024-07-25 precedes claim incident date of 2024-08-07 by only 13 days.
|
Temporal pattern identified that may warrant attention. Human reviewer should assess whether the timing raises questions.
|
advisory_only_human_review_required
|
2025-01-26T00:00:00Z
|
REC-000232
|
justice
|
regulatory_assessment
|
missing_document
|
high
|
Expert report mentioned in filing from 2024-04-25 cannot be located in the documentation package.
|
Document gap identified. Professional judgment required to determine if additional documentation should be requested.
|
advisory_only_human_review_required
|
2025-05-16T00:00:00Z
|
REC-000125
|
insurance
|
claims_review
|
policy_conflict
|
medium
|
Claimed service type ST-8710 may fall outside coverage scope defined in policy section 5.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-07-07T00:00:00Z
|
REC-000287
|
justice
|
evidence_review
|
missing_document
|
high
|
Expert report mentioned in filing from 2025-04-28 cannot be located in the documentation package.
|
Document gap identified. Professional judgment required to determine if additional documentation should be requested.
|
advisory_only_human_review_required
|
2025-09-14T00:00:00Z
|
REC-000224
|
justice
|
regulatory_assessment
|
missing_document
|
low
|
Expert report mentioned in filing from 2024-01-21 cannot be located in the documentation package.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-06-23T00:00:00Z
|
REC-000036
|
insurance
|
claims_review
|
frequency_anomaly
|
medium
|
Account shows 6763 claims submitted within 20-month period, with similar incident patterns.
|
Pattern frequency identified that differs from baseline. Human reviewer should assess whether this is significant.
|
advisory_only_human_review_required
|
2025-09-07T00:00:00Z
|
REC-000202
|
justice
|
regulatory_assessment
|
missing_document
|
high
|
Chain of custody form referenced in evidence log EL-1201 dated 2024-01-03 is not present in case file.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-10-11T00:00:00Z
|
REC-000084
|
insurance
|
fraud_triage
|
prior_reference
|
medium
|
Account history shows prior claim PC-6567 from 2024-07-03 with similar incident characteristics.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-03-14T00:00:00Z
|
REC-000048
|
insurance
|
claims_review
|
missing_document
|
high
|
Policy amendment form mentioned in correspondence from 2024-05-09 cannot be located in the file. Amendment relates to coverage modification request.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-01-27T00:00:00Z
|
REC-000054
|
insurance
|
claims_review
|
policy_conflict
|
low
|
Claim amount of $49190 approaches or exceeds policy limit of $87696 specified in schedule.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-10-23T00:00:00Z
|
REC-000112
|
insurance
|
claims_review
|
prior_reference
|
medium
|
Historical records indicate prior interaction with provider P-7655 in claim from 2024-02-28.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-11-08T00:00:00Z
|
REC-000121
|
insurance
|
claims_review
|
missing_document
|
high
|
Policy amendment form mentioned in correspondence from 2024-08-03 cannot be located in the file. Amendment relates to coverage modification request.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-12-17T00:00:00Z
|
REC-000159
|
justice
|
case_preparation
|
prior_reference
|
high
|
Earlier case EC-3439 involved same jurisdiction and similar legal questions.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-02-10T00:00:00Z
|
REC-000146
|
insurance
|
underwriting_support
|
missing_document
|
low
|
Policy amendment form mentioned in correspondence from 2024-01-04 cannot be located in the file. Amendment relates to coverage modification request.
|
Document gap identified. Professional judgment required to determine if additional documentation should be requested.
|
advisory_only_human_review_required
|
2025-04-28T00:00:00Z
|
REC-000095
|
insurance
|
fraud_triage
|
document_inconsistency
|
low
|
Incident date listed as 2025-03-24 in claim form conflicts with 2025-03-25 shown in police report PR-9564.
|
Discrepancy between documents identified. Human reviewer should examine the variance and determine its significance.
|
advisory_only_human_review_required
|
2025-11-20T00:00:00Z
|
REC-000044
|
insurance
|
underwriting_support
|
document_inconsistency
|
medium
|
Incident date listed as 2024-09-21 in claim form conflicts with 2024-10-13 shown in police report PR-5526.
|
Discrepancy between documents identified. Human reviewer should examine the variance and determine its significance.
|
advisory_only_human_review_required
|
2025-12-20T00:00:00Z
|
REC-000094
|
insurance
|
fraud_triage
|
policy_conflict
|
high
|
Claimed service type ST-6267 may fall outside coverage scope defined in policy section 11.
|
Potential policy consideration identified. Human reviewer should examine the relevant provisions and assess applicability.
|
advisory_only_human_review_required
|
2025-09-16T00:00:00Z
|
REC-000153
|
justice
|
evidence_review
|
timeline_anomaly
|
medium
|
Filing submitted on 2024-04-30 for events allegedly occurring on 2024-07-13, representing a 74-day delay.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-08-27T00:00:00Z
|
REC-000035
|
insurance
|
underwriting_support
|
timeline_anomaly
|
medium
|
Claim submitted on 2024-05-21 for incident allegedly occurring on 2024-06-03, representing a 13-day reporting delay.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-02-01T00:00:00Z
|
REC-000143
|
insurance
|
underwriting_support
|
policy_conflict
|
medium
|
Claimed service type ST-2489 may fall outside coverage scope defined in policy section 17.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-08-22T00:00:00Z
|
REC-000093
|
insurance
|
claims_review
|
timeline_anomaly
|
high
|
Claim submitted on 2024-02-08 for incident allegedly occurring on 2024-11-13, representing a 279-day reporting delay.
|
Timeline irregularity noted. Professional judgment required to evaluate the significance of the temporal sequence.
|
advisory_only_human_review_required
|
2025-08-25T00:00:00Z
|
REC-000191
|
justice
|
regulatory_assessment
|
prior_reference
|
medium
|
Case history shows prior matter PM-2559 from 2024-04-03 with similar factual elements.
|
Previous activity noted. Professional judgment required to evaluate the significance of the historical reference.
|
advisory_only_human_review_required
|
2025-01-05T00:00:00Z
|
REC-000169
|
justice
|
evidence_review
|
document_inconsistency
|
medium
|
Event date listed as 2024-12-06 in complaint differs from 2025-01-24 shown in incident log IL-6399.
|
Conflicting information noted across sources. Professional judgment required to reconcile or clarify the inconsistency.
|
advisory_only_human_review_required
|
2025-06-14T00:00:00Z
|
REC-000034
|
insurance
|
underwriting_support
|
document_inconsistency
|
high
|
Property value stated as $30537 in appraisal differs from $17839 listed in policy schedule PS-5543.
|
Conflicting information noted across sources. Professional judgment required to reconcile or clarify the inconsistency.
|
advisory_only_human_review_required
|
2025-05-01T00:00:00Z
|
REC-000079
|
insurance
|
fraud_triage
|
frequency_anomaly
|
low
|
Account shows 3067 claims submitted within 13-month period, with similar incident patterns.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-08-21T00:00:00Z
|
REC-000131
|
insurance
|
fraud_triage
|
policy_conflict
|
medium
|
Claimed service type ST-6325 may fall outside coverage scope defined in policy section 18.
|
Possible provision intersection noted. Professional judgment required to interpret the policy language and determine relevance.
|
advisory_only_human_review_required
|
2025-10-07T00:00:00Z
|
REC-000042
|
insurance
|
underwriting_support
|
frequency_anomaly
|
low
|
Provider code P-3506 appears in 3506 separate claims within 11-month timeframe.
|
Occurrence rate noted that may warrant attention. Professional judgment required to evaluate the pattern.
|
advisory_only_human_review_required
|
2025-08-27T00:00:00Z
|
REC-000013
|
insurance
|
claims_review
|
prior_reference
|
high
|
Account history shows prior claim PC-2160 from 2024-02-02 with similar incident characteristics.
|
Historical pattern identified. Human reviewer should assess whether prior matters provide relevant context.
|
advisory_only_human_review_required
|
2025-10-20T00:00:00Z
|
REC-000283
|
justice
|
case_preparation
|
missing_document
|
medium
|
Chain of custody form referenced in evidence log EL-6851 dated 2024-07-21 is not present in case file.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-04-10T00:00:00Z
|
REC-000281
|
justice
|
case_preparation
|
document_inconsistency
|
low
|
Event date listed as 2024-01-06 in complaint differs from 2025-02-07 shown in incident log IL-9800.
|
Conflicting information noted across sources. Professional judgment required to reconcile or clarify the inconsistency.
|
advisory_only_human_review_required
|
2025-11-27T00:00:00Z
|
REC-000288
|
justice
|
case_preparation
|
missing_document
|
medium
|
Expert report mentioned in filing from 2024-01-11 cannot be located in the documentation package.
|
This signal indicates incomplete documentation. Human review should assess whether the missing item is material to the evaluation.
|
advisory_only_human_review_required
|
2025-09-05T00:00:00Z
|
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