version: "1.0.0" name: fraud-flag description: Use for siu indicator review questions in the Claims Processing Agent synthetic pilot.
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SIU indicator review
Surfaces explainable fraud indicators without declaring fraud or changing coverage.
Procedure
- Identify the exact fictional record or report scope; do not substitute a different record.
- Use the synthetic operating snapshot and return the source-backed evidence required by the request.
- Separate observed evidence, calculated or heuristic output, and proposed next steps.
- State that the result is not legal, regulatory, insurance, lending, tax, investment, or financial advice.
- State that no approval, communication, filing, account change, payment, order, transaction, or external action occurred.
- Name the authorized human review required before action.
Locked example
Persona: SIU Investigator
Prompt: Yes, show me the fraud detection results and high-risk claims.
Expected synthetic evidence: 89 suspicious claims, CLM-78234, $890K.