{
 "use_case": "claims-conduct-pack",
 "title": "Claims-file conduct pack: a California auto denial with three planted problems",
 "about": "A synthetic California auto claim file (first notice, adjuster log, denial letter) and its policy. Planted: the claim was acknowledged 29 days after notice (the limit is 15), the denial letter says Exclusion 4 excludes loss at excessive speed when the policy excludes organized races and speed contests, and the letter has no Department of Insurance review notice. All three must be flagged, with the deadline computed and the policy line quoted, and the signed file review must verify.",
 "licence": "Synthetic: Harbor Oak Mutual, its policy forms and every person are invented (scripts/claims_cases.py). Part of decosa-api, AGPL-3.0-or-later.",
 "inputs": [
  {
   "file": "inputs/claim.json",
   "what": "The claim: id, line (auto), state (CA), party."
  },
  {
   "file": "inputs/documents.json",
   "what": "The claim file: first notice of loss, the adjuster activity log and the denial letter."
  },
  {
   "file": "inputs/policy.json",
   "what": "The policy wording (a fictional personal auto form)."
  }
 ],
 "steps": [
  {
   "id": "review",
   "method": "POST",
   "path": "/claims/check",
   "body": {
    "claim": {
     "$file": "inputs/claim.json"
    },
    "documents": {
     "$file": "inputs/documents.json"
    },
    "policy": {
     "$file": "inputs/policy.json"
    },
    "title": "Rehearsal: HOM-CA-2604117 (fictional)"
   }
  },
  {
   "id": "verify",
   "method": "POST",
   "path": "/record/verify",
   "auth": false,
   "body": {
    "record": {
     "$ref": "review.record"
    }
   }
  },
  {
   "id": "tampered",
   "method": "POST",
   "path": "/record/verify",
   "auth": false,
   "body": {
    "record": {
     "$ref": "review.record"
    }
   },
   "tamper": {
    "at": "record.statement.flags",
    "set": 0
   }
  }
 ],
 "checks": [
  {
   "says": "the late acknowledgement is flagged",
   "path": "review.checklist[id=ack][0].status",
   "equals": "flag"
  },
  {
   "says": "its deadline is 15 calendar days after the first notice",
   "path": "review.checklist[id=ack][0].computed.deadline",
   "equals": "2026-06-03"
  },
  {
   "says": "the denial reason that misstates Exclusion 4 is flagged",
   "path": "review.checklist[id=reason:1][0].status",
   "equals": "flag"
  },
  {
   "says": "the flag quotes the policy line it was checked against",
   "path": "review.checklist[id=reason:1][0].grounding.spans[0].quote",
   "contains": "organized race"
  },
  {
   "says": "the missing Department of Insurance review notice is flagged",
   "path": "review.checklist[id=review_notice][0].status",
   "equals": "flag"
  },
  {
   "says": "the signed file review verifies",
   "path": "verify.ok",
   "equals": true
  },
  {
   "says": "a file review with its flag count changed no longer verifies",
   "path": "tampered.ok",
   "equals": false
  },
  {
   "says": "every model call has a signed receipt",
   "receipts": "signed",
   "min": 3
  }
 ]
}