Label claims-file steps the file attributes to a system
Key facts
- Human involvement
- YellowClose supervision
- How AI is used
- One row per step the file attributes to a model, a score, or an automated decline. Columns are the page, the step in the file's words, and a Section 4 letter only as a label. Do not find a violation.
- What the lawyer must review
- 15 U.S.C. § 1012 leaves insurance regulation to state law unless a federal act specifically relates to the business of insurance. NAIC model MO-900 is a June 1990 model. Section 4 conduct is an unfair practice only through Section 3, and only where enacted. The model states that it does not create a private cause of action. An Australian joint statement and an insurance artificial-intelligence bulletin were not opened and are not used. California Insurance Code § 790.03 is California only.
- Written for / version
- United States versionUS
Who does what
| Role | What they do |
|---|---|
| Assistance | Consider narrowly defined preparation support after confirming the tool’s capability and permitted scope. |
| Lawyer | Set the scope, supervise the work closely, verify every part relied on, resolve omissions and exceptions, and approve the exact output. |
Checklist
- Verify the applicable jurisdiction and the version of each relevant law, rule or instrument in force at the material time.
- Confirm the output against the client’s instructions and the complete relevant source material, including omissions or contradictions.
- Resolve exceptions and record the responsible lawyer’s approval of the exact output and intended use.