Rationale:

it does not understand this should be a simple, routine injury

Rationale:

it is not understanding that this is a minor injury

Rationale:

- Minor severity instead of moderate since no surgery involved and just an ankle sprain. - Claimant's occupation is clearly a student but industry risk category is healthcare outpatient - Adjuster notes mentioned clear liability, but litigation risk rationale mentioned disputed liability leading to misclassification - Since litigation risk was misclassified, it leads to settlement likelihood and management complexity to be misclassified as well.

Rationale:

LLM classified claimant industry risk category as healthcare outpatient instead of education.

Rationale:

Everything looks clinically accurate.

Rationale:

LLM classified claimant industry risk category as healthcare outpatient instead of education.

Rationale:

it was able to appropriately use the RICE definition

Rationale:

the claim was talking about a high ankle sprain which was relevant to the unstructured data

Rationale:

it kind of is making up the price i think

Rationale:

- Ultimate cost category is not $118k

Rationale:

made up the costs again

Rationale:

it got some of the cost categories wrong which tells me it is not understanding these context

Rationale:

i think it's messing up some of the prices or maybe I am not understanding them

Rationale:

it mentioned there was none for safety which i don't know is true since there was a safety harness, it just was not properly secured, so I don't know if there is a better term for this.

Rationale:

it understands everything, but like for this example, he fell when playing soccer, so I don't think there is any safety that should be involved and the LLM said unknown, and I wonder if there is a better category for this since there really isn't any safety stuff that can be included in this, it was just an accident, like he fell

Rationale:

the LLM may be hallucinating on the cost,

Rationale:

it did not include the safety harness in safety evaluation, which I think may change the category from none to something else. It's not that she wasn't using safety precautions, she just accidently fell.

Rationale:

it did not mention anything about how she feels like every day is reminder of what could have been with her wrist mobility. I don't know if we see this as important, but could it be a reason that she chooses to sue?? also, they left out the safety harness in the safety evaluation, so I don't know if that may be considered for something.

Rationale:

- Injury severity should be minor - Medical complexity should be simple - Medical complexity should be fast resolution - Risk level should be low - Experience modifier impact should be neutral

Rationale:

The development and cost seem correct. I would rate severity as mild and complexity as routine.

Rationale:

- Injury severity should be minor - Medical complexity should be simple - Medical complexity should be fast resolution - Risk level should be low - Experience modifier impact should be neutral

Rationale:

This overall seemed reasonable but the assessment of PT and ortho as more than simple care shows lack of understanding of common treatments for almost any condition with pain or discomfort.

Rationale:

a lot of the moderate category should be simple and low, so it is not understanding that this is a low and easy injury compared to others so I don't think it understands that

Rationale:

It caught most details. The connection of SIU -> potential fraud indicator was not picked up.

Rationale:

The information all seemed aligned with existing code sets.

Rationale:

a lot of the moderate category should be simple and low, so it is not understanding that this is a low and easy injury compared to others so I don't think it understands that

Rationale:

I noted no hallucinations.

Rationale:

The SIU was a missing element in the scoring.

Rationale:

it did not leave out anything important, just made up some stuff

Rationale:

- Expected development pattern should be fast resolution because claimant recovered <6 months, clear liability, and returned to full duty. LLM mentioned "expected to return to full duty soon" - For industry risk category, claimant occupation is marketing specialist not healthcare outpatient

Rationale:

it left out some important points that i think would change some categories to score less harsh, like it should be a simple accident because it was a sprain with PT only, and I don't know if the model picked up on that.

Rationale:

it left out that the surface was dangerous for the safety variable, and it had the type of accident set to moderate when this should really be simple.

Rationale:

it got the cost wrong a couple of times, so it's not interpreting something correctly because this is a pattern now

Rationale:

- Per settlement adjuster notes, total settlement recommendation is approximately $32,600 instead of $118k so ultimate cost category should be 25-50k.

Rationale:

this one has a couple hallucinations, cost and safety procedures

Rationale:

LLM mentioned ultimate cost prediction of $118,000 but no where to be found in settlement adjuster notes. Per settlement adjuster notes, the recommended settlement authority is up to $25,000.

Rationale:

the 118k is made up unless I am missing it.

Rationale:

- LLM rated medical complexity as "conservative" even though that isn't one of the choices; should be simple - Industry risk should have been other and not healthcare outpatient - Experience modifier impact should be favorable

Rationale:

Based on the context, this is an accurate assessment.

Rationale:

- LLM rated medical complexity as "conservative" even though that isn't one of the choices; should be simple - Industry risk should have been other and not healthcare outpatient - Experience modifier impact should be favorable

Rationale:

LLM did not use medical provider letter

Rationale:

Based on what is provided, there does not appear to be any hallucinated data.

Rationale:

The context of an infant falling and the parent providing information seems to be almost entirely missed in the LLM output.

Rationale:

LLM discussed clinical note instead of medical provider letter for injury severity

Rationale:

The LLM left out some inconsistencies across the documents.

Rationale:

The LLM seems to have assessed the information correctly based on the code sets provided.

Rationale:

LLM discussed clinical note instead of medical provider letter for injury severity

Rationale:

This is overall a relevant assessment. There are some inconsistencies that seem to be missed.

Rationale:

- LLM did not include wage loss and settlement analysis in the ultimate cost category