No human review before a consumer outcome on Claims triage (MDL-001)
The model can reach a consumer without a person able to review or override it first. This is the question a carrier asks earliest about anything touching claims or underwriting, because it decides whether the carrier has a control point it can describe to its examiner, or has to defend an automated decision it did not make. An answer of no does not end a review, but it moves the conversation from your controls to their appetite, and that is a conversation held at a level you are not in the room for.
To fix: Put a person in the path, or document precisely where the boundary sits: which decisions are advisory, which are automatic, and what the reviewable population is. A reviewer can accept an automated path that is bounded and described. They cannot accept one that is neither.