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An auto claims-severity AI silently over-flagged coastal-county BI claims to SIU. This is the $499 Snapshot that found it.

Mid-size South Carolina P&C carrier. ~12,000 auto BI claims over 90 days. Coastal counties (Beaufort, Charleston, Georgetown, Horry, Colleton, Jasper) SIU-flag rate rose from ~5% to ~19%. Silent to aggregate dashboards. Loud to a per-group sensor. Every reg citation, chart, and finding is a click away with a "how does this help me?" companion.

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The 4-number quick verdict

Determination

Category C

High-severity drift events

C3 SIU-flag rate

5% → 19%

Days to detect (silent)

45+

What does Category C actually mean? →

What happened in one paragraph

A mid-size South Carolina-domiciled P&C carrier's auto BI claims-severity classifier (mock model sc-claims-severity-v2.3.1) silently over-routed the C3 coastal-county group (Beaufort, Charleston, Georgetown, Horry, Colleton, Jasper) to the SIU-flag lane. Aggregate claim-cycle-time and closure-rate dashboards stayed within normal bands. The differential was visible only through per-county-group distributional-shape analysis by an independent verifier. Under the SC Unfair Claims Settlement Practices Act (SC Code §38-59-20), each over-flagged claim risks a "prompt investigation" violation; under FCRA §615, credit-based-insurance-scoring adverse-action notices tied to the same input chain are now in scope.

Read the full scenario walkthrough →

The three charts (each linked to its own deep-dive)

Chart 1 · Deep dive Rolling mean severity score by county group Where the silent C3 coastal-county divergence begins. What the eye sees vs what the claims dashboard reported. Chart 2 · Deep dive Baseline vs recent distribution C3 mass moved right (into SIU-flag lane). How to read the shape shift. Chart 3 · Deep dive Lane rate per county group C3 SIU-flag rate rose sharply while C1/C2/C4/C5 stayed stable. The exact pattern SC DOI examiners look for.

South Carolina regulations applied — each on its own page

Every cited framework has a dedicated subpage with the actual regulatory text, plain-English translation, what triggers the exposure in this sample, what the $499 Snapshot shows against it, and a "how does this help me?" benefit companion.

Regulation · SC SC Code §38-59-20 -- Unfair Claims Settlement Practices Act Prompt investigation + prompt settlement standard. AI-driven SIU over-flagging that delays legitimate claims is the exposure hook. Regulation · SC SC Code §38-73 -- Rate Regulation Rating factors must be actuarially justified + not unfairly discriminatory. ZIP-based inputs feeding claims routing implicate this. Regulation · SC SC Code §38-57-30 -- Unfair Trade Practices Act Misleading representations. AI-generated explanations that don't match actual model behavior = enforcement hook. Regulation · SC SC Code §38-99 -- Insurance Data Security Act Cybersecurity + data protection program for insurers. AI-touching-PII systems fall inside the required risk-management program. Regulation · SC SC DOI Bulletin Watch The class of AI-in-insurance guidance to expect from the SC DOI, given the NAIC Model Bulletin adoption pattern in peer states. Regulation · Federal FCRA §615 -- Adverse Action Notices Credit-based insurance scoring adverse-action-notice duty. Silent drift + inconsistent notices = enforcement hook. Regulation · Peer-state baseline NAIC AI Model Bulletin (2023) SC has not formally adopted as of most recent tracking. Referenced as the peer-state baseline SC DOI will measure against. Regulation (shared) NIST AI RMF 1.0 GOVERN / MAP / MEASURE / MANAGE. Voluntary but load-bearing baseline cited by state DOIs across the country.

Findings + methodology deep dives

Scenario The auto BI claims-triage AI, in full Model, county groups, drift mechanism, what the aggregate dashboard missed, what the sensor caught. Methodology How Category C is derived Category A / B / C decision logic. Why 11 high-severity events + C3 group-differential = C. Methodology Counterparty-question rehearsal The 5-decision reproducibility drill your GC / SC DOI liaison / defense counsel will thank you for. Methodology Independent-verifier declaration Why the control layer cannot sit inside the entity being regulated.

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Same structure as this sample. Your carrier's data, your AI system, SC DOI footprint, SC + federal regulatory citations. Below procurement threshold. Report PDF via email.

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