Genesis Claims Operations
Genesis Protect Acute does not present claim review as a black box.
Current claim review is operator-led with AI-assisted triage. Cases may be approved, denied, held, or re-reviewed under published terms.
Use this page for the Genesis Protect claim-review model: what evidence is expected, what is reviewed, what stays offchain, what gets anchored, and how holds or disputes work.
Genesis Protect Acute uses bounded operator-led review with AI support in Phase 0. The current public claim-review promise is staffed and operator-governed, not fully automated or fully decentralized.
What members submit
For the current Genesis Protect Acute scope, members can expect to provide:
- invoice or itemized bill
- discharge summary or doctor note
- proof of payment
- location and date proof
Evidence expectations can vary by published SKU or cohort terms. The public rule is simple: claims need enough evidence to connect the acute event, active cover window, location/date boundary, and claimed payout path.
Phase 0 review path
| Step | What happens | Public boundary |
|---|---|---|
| Submit | A member submits a claim for Travel 30 or Event 7. | Claim intake depends on active eligibility and product availability. |
| Package | Evidence is normalized against the published acute-claim schema. | Raw medical documents and personal details stay offchain. |
| Review | Operator-led review with AI support checks evidence, waiting periods, exclusions, and payout path. | This is not fully automated or fully decentralized claim review today. |
| Hold or decide | A case can be approved, denied, or held for more review. | Holds are legitimate when evidence or boundary checks are incomplete. |
| Anchor | Approved economic consequences can be anchored into protocol state. | The protocol sees claim state, evidence references, adjudication, reserve, and payout effects rather than raw documents. |
| Resolve | Denied, held, or appealed cases remain part of the review trail. | Once economically material, the case keeps a legible protocol-facing trail. |
What stays offchain
- Raw medical documents
- Personally identifying medical details
- Review workflow notes
- Internal escalation context
- Full AI or human reasoning traces
What gets anchored into protocol state
- Claim-case state
- Evidence references or commitments
- Claim attestation and adjudication consequences
- Obligation reserve and payout state
OmegaX does not need raw evidence onchain to make the economic path legible.
Holds, disputes, and appeals
Not every claim finalizes immediately. Genesis Protect Acute can hold or challenge a claim when:
- required evidence is missing
- the event appears outside the waiting period or exclusion boundary
- the case is low-confidence and needs more review
- the evidence package conflicts with the claimed payout path
| State | Meaning |
|---|---|
| Submitted | The claim is ready for operator review. |
| Held | Evidence, confidence, or boundary issues need more review. |
| Disputed | The case needs a clearer operator decision. |
| Appealed or re-reviewed | New evidence or corrections materially change the case. |
| Resolved | The claim is approved, denied, or closed without payout. |
The important public point is that dispute handling exists, but it remains a bounded operator-governed process during the current launch window rather than a fully decentralized public review market.
Current claim-review boundary
| Category | Public description |
|---|---|
| Current | Operator-backed oracle review for bounded Genesis Protect availability. |
| Not current | Fully automated approval, fully decentralized claim review, or a public review market. |
| Review boundary | AI can support triage, but final claim outcomes remain operator-governed under published terms. |
What each reader can expect
- Members can expect a real evidence review path, not instant blind automation.
- Sponsors can expect claims to stay bounded by published terms, staffed review, and explicit evidence requirements.
- LPs can expect claim review, reserve booking, and payout state to remain legible enough to audit.
- Builders can see how a bounded product maps offchain evidence review into protocol claim and settlement state.