Step 10 of 12Assurance
10 · Oversight and assurance

Test oversight and assurance

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Design meaningful human oversight, then test whether a key control actually works. A documented control is not proof that it operates.

Meaningful human oversight

Before which consequential decision? What does the reviewer see beyond the AI output?

Who can override or pause? How are reasons recorded?

Training, time, workload, sampling of accepted outputs

Notice, explanation, review and redress

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CONTROL TEST

SIU review: every referred claim is reviewed and decided by an investigator within 10 working days.

The claim

The SIU Manager says 'we review every case promptly'.

Fictional sample of 10 closed SIU cases
CaseOutcomeWorking days heldCustomer updated?Reason for referral recorded?
S-01Genuine8NoScore only
S-02Fraud12n/aYes
S-03Genuine27NoScore only
S-04Genuine6YesYes
S-05Genuine34NoScore only
S-06Fraud9n/aYes
S-07Genuine19NoScore only
S-08Genuine11NoScore only
S-09Genuine5YesYes
S-10Genuine22NoScore only

Your test: How many cases met the 10-day target? What does 'Score only' tell you about the quality of human review?

Assurance result

Is the control designed well enough to address the risk? What is missing from its design?

Show your count from the sample and what it means

Condition, criteria, cause, effect; then the action, owner and date

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NEW DEVELOPMENT · CLAIMS DIRECTOR

Auto-decline proposal

The Board meets on Thursday. I want approval to auto-decline claims above 0.95 from next month. Investigators agree with the model at that score 'almost every time'.

What would you tell the Board, and what evidence would you need before any automated decline?

Your response to the new development

What would you say, recommend and record?

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