Configurations

Modules, fraud codes and the thresholds the steps decide against
read only in this build
Modules
5 modules · one degraded, one not built
ModuleVersionNoteStatus
Document normaliser4.2.1Rasterises, deskews and merges into per-item PDFs. 11 documents, 16 pages here.Enabled
Anchor pricing store2026.07Partner schedules plus settled claims. 8 anchors of 15 were relevant on this claim.Enabled
FX resolver1.9.0Live feed timing out; ECB reference rates for 25 Jul were used.Degraded
Clinical guideline index2026.05Indication and length-of-stay references behind the adequacy score.Enabled
Disbursement adapterStep 9 has no implementation and no section in the schema.Not built
Fraud-code catalogue
4 of 26 raised on this run
CodeDescriptionWeightThis run
OVERPRICINGLine billed materially above the anchor band for the same treatment and geography.+20raised
LAST_MINUTE_PURCHASEPolicy bought immediately before cover starts, in the destination country.+15raised
DOC_INTEGRITYRepeated attachments, or an application section carrying no amount.+20raised
DUPLICATE_INVOICESame invoice number seen on a prior settled claim.+22not raised
IDENTITY_DRIFTNames or dates of birth differ across documents beyond tolerance.+18not raised
UNLICENSED_PROVIDERProvider absent from the national registry.+26not raised
LATE_ADDITIONHigh-value item appears only in a re-run, not in the first submission.+9not raised
ROUND_AMOUNTSEvery line ends in a round figure in the original currency.+5not raised
Thresholds
What a verdict is measured against
ThresholdValueNote
Policy match threshold0.85This run scored 0.96. Below the bar, intake halts rather than guessing a policy.
Document confidence floor0.90Documents under this are surfaced for an operator to open. Three on this claim.
Rebuild cutoff0.70A raw file under this is not normalised. One file — signature PNG at 0.62.
Overpricing level highscore ≥ 70This run scored 91. Routes to the fraud queue; never changes the amount.
Deep antifraud depthrisk ≥ 60This run scored 55, so standard modules only — no vendor forensics.
Deductible gate50 EURApplies when the policy was purchased while already in the destination country.

Fixture data — these values are read, never written, in this build.