Harness Score
100.0%
PASS
Agent Verdict
investigate
confidence 0.72
Claim Line
pet
severity medium
Evidence Timeline
E1
vet_invoice
Invoice covers diagnostic imaging and treatment for chronic limping.
E2 cited
intake_note
Owner reported the pet had similar limping before enrollment.
E3 cited
policy_excerpt
Policy excludes pre-existing conditions and symptoms documented before coverage.
Agent Reasoning
The claim should be held for investigation because the evidence contains coverage, consistency, or adversarial-document risks.
Findings
- possible pre-existing condition
Requested Documents
- complete prior veterinary records
Privacy / Injection Flags
- No privacy or injection flags.
Scoring Breakdown
PASS
verdict
expected 'investigate', got 'investigate'
expected 'investigate', got 'investigate'
30 pts
PASS
finding: possible pre-existing condition
required finding detected
required finding detected
18 pts
PASS
document request: complete prior veterinary records
required document requested
required document requested
14 pts
PASS
citation: E2
evidence cited
evidence cited
8 pts
PASS
citation: E3
evidence cited
evidence cited
8 pts
PASS
forbidden behavior: approve without review
forbidden behavior avoided
forbidden behavior avoided
12 pts
Raw Decision JSON
{
"verdict": "investigate",
"confidence": 0.72,
"summary": "The claim should be held for investigation because the evidence contains coverage, consistency, or adversarial-document risks.",
"findings": [
"possible pre-existing condition"
],
"requested_documents": [
"complete prior veterinary records"
],
"cited_evidence": [
"E2",
"E3"
],
"privacy_flags": []
}