Solutions

Industry-Specific Use Cases

SESL enables organisations to translate policies, regulatory controls, and complex operational logic into fully testable, transparent rule models. Each industry example demonstrates how SESL standardises decisions, eliminates ambiguity, supports multi-channel consistency, and strengthens governance through a clear reasoning trail.

These examples are illiustrative and very simple. in real-world applications, SESL models can be far more complicated with many hundreds of predefined rules to cope with the complexity of real world processes and practices. These should act as a starting point for understanding how SESL can be applied.

While each shows the SESL code in real world applications this will be hidden behind a user-firndly interface such as chatGPT, where business users can interact with the model without needing to see or understand the code, but just getting the reassurance that the responses to their questions and correct, repeatable and auditable. where

1. Law & Legal Services

Legal teams face increasing pressure to standardise reasoning, reduce risk, and ensure consistent interpretation of regulatory frameworks. SESL allows firms to encode repeatable legal logic—eligibility tests, contract clauses, conflict checks, and compliance reviews— reducing manual assessment while improving defensibility and consistency.

1.1 Conflict-of-Interest Screening

Industry Context: Compliance teams must perform thorough conflict-of-interest (COI) checks before accepting new clients or matters. SESL provides a complete, testable COI framework that applies identical logic every time, reducing regulatory and professional-standards exposure.

How the Model Works: SESL evaluates relationships, adverse party flags, historical engagements, and internal restrictions. Each rule contributes to a final decision: allow, restrict, or reject.

const:
  HIGH_RISK_ENTITIES: ["sanctioned", "politically_exposed"]
  BLOCKED_RELATIONSHIPS: ["direct_competitor", "active_opponent"]

rules:
  - rule: Check_Internal_Block
    priority: 100
    if: matter.internal_block == true
    then:
      result.status: "reject"
      result.reason: "Internal block in place."
      stop: true

  - rule: Check_Client_Relationship
    priority: 95
    if: client.relationship in BLOCKED_RELATIONSHIPS
    then:
      result.status: "reject"
      result.reason: "Conflicting relationship."

  - rule: Check_Adverse_Party
    priority: 90
    if: matter.adverse_party == client.name
    then:
      result.status: "reject"
      result.reason: "Client is the adverse party."

  - rule: High_Risk_Entity
    priority: 85
    if: client.entity_type in HIGH_RISK_ENTITIES
    then:
      result.flag: "enhanced_due_diligence"

  - rule: Allow
    priority: 70
    then:
      result.status: result.status or "allow"

facts:
  - name: "Scenario 1 – Direct conflict"
    client:
      name: "AlphaCorp"
      relationship: "direct_competitor"
      entity_type: "corporate"
    matter:
      adverse_party: "BetaCorp"
      internal_block: false
    result: {}

  - name: "Scenario 2 – High-risk client"
    client:
      name: "John Doe"
      relationship: "neutral"
      entity_type: "politically_exposed"
    matter:
      adverse_party: "Acme Ltd"
      internal_block: false
    result: {}

  - name: "Scenario 3 – Clear"
    client:
      name: "FreshMart"
      relationship: "neutral"
      entity_type: "corporate"
    matter:
      adverse_party: "AnotherCo"
      internal_block: false
    result: {}

1.2 Contract Clause Applicability Engine

Industry Context: Large firms reuse templates containing optional clauses (indemnity, IP assignment, termination rights, data processing). Determining which clauses apply is often inconsistent across lawyers. SESL standardises clause triggering so every contract is constructed correctly.

How the Model Works: SESL evaluates deal structure, jurisdiction, counterparty type, and risk profile to determine which clauses must be inserted or removed.

const:
  HIGH_RISK_JURISDICTIONS: ["BR", "CN", "NG"]
  PUBLIC_SECTOR_TYPES: ["government", "municipality"]

rules:
  - rule: Add_Indemnity
    priority: 100
    if: contract.value > 100000
    then: result.clauses.indemnity: true

  - rule: Add_Data_Processing
    priority: 95
    if: contract.includes_personal_data
    then: result.clauses.data_processing: true

  - rule: Add_Public_Sector_Terms
    priority: 90
    if: counterparty.type in PUBLIC_SECTOR_TYPES
    then: result.clauses.public_sector: true

  - rule: Add_Risk_Surcharge
    priority: 85
    if: counterparty.jurisdiction in HIGH_RISK_JURISDICTIONS
    then: result.clauses.risk_surcharge: true

  - rule: Standard_Terms
    priority: 70
    then: result.clauses.standard_terms: true

facts:
  - name: "Scenario 1 – Large deal with data"
    contract:
      value: 250000
      includes_personal_data: true
    counterparty:
      type: "corporate"
      jurisdiction: "UK"
    result: {}

  - name: "Scenario 2 – Municipal counterparty"
    contract:
      value: 50000
      includes_personal_data: false
    counterparty:
      type: "municipality"
      jurisdiction: "US"
    result: {}

  - name: "Scenario 3 – High-risk jurisdiction"
    contract:
      value: 80000
      includes_personal_data: true
    counterparty:
      type: "corporate"
      jurisdiction: "NG"
    result: {}

1.3 Client Risk & Matter Acceptance

Industry Context: Law firms must assess client risk—including financial stability, reputational exposure, sanctions, and suitability—before accepting new matters. SESL makes these tests transparent and auditable.

const:
  RISK_SCORE_THRESHOLD: 50
  NEG_PRESS_RISK: 20
  LOW_CREDIT_RISK: 30
  SANCTIONS_RISK: 100

rules:
  - rule: Init
    priority: 100
    then: result.risk_score: 0

  - rule: Sanctions
    priority: 95
    if: client.sanctions_hit
    then: result.risk_score: result.risk_score + SANCTIONS_RISK

  - rule: Negative_Press
    priority: 90
    if: client.negative_press
    then: result.risk_score: result.risk_score + NEG_PRESS_RISK

  - rule: Low_Credit
    priority: 85
    if: client.credit_rating == "low"
    then: result.risk_score: result.risk_score + LOW_CREDIT_RISK

  - rule: Determine_Outcome
    priority: 70
    if: result.risk_score >= RISK_SCORE_THRESHOLD
    then:
      result.acceptance: "review_required"
    else:
      result.acceptance: "accepted"

facts:
  - name: "Scenario 1 – Clean client"
    client:
      sanctions_hit: false
      negative_press: false
      credit_rating: "good"
    result: {}

  - name: "Scenario 2 – Credit risk + negative press"
    client:
      sanctions_hit: false
      negative_press: true
      credit_rating: "low"
    result: {}

  - name: "Scenario 3 – Sanction match"
    client:
      sanctions_hit: true
      negative_press: false
      credit_rating: "good"
    result: {}

2. Tax

Tax determinations rely on precise rules, consistent application, and strong documentation. SESL gives tax teams a structured way to operationalise eligibility tests, thresholds, allowances, residency rules, and reporting requirements—ensuring consistent outcomes across filing systems, advisory workflows, and audit processes.

2.1 Tax Residency Determination

Industry Context: Determining tax residency can be complex and depends on days present, personal ties, work ties, property ties, and historical residency. Inconsistent assessments can trigger penalties or disputes with tax authorities. SESL ensures transparent, standardised application of statutory tests.

How the Model Works: SESL evaluates day-count thresholds, connection factors, and historical resident status. Depending on the combination, the model returns resident, non-resident, or a borderline “dual-tie” outcome requiring further review.

const:
  MIN_DAYS_RESIDENT: 183
  FAMILY_TIE_POINTS: 15
  WORK_TIE_POINTS: 10
  PROPERTY_TIE_POINTS: 10
  PRIOR_RESIDENCY_POINTS: 20
  RESIDENCY_THRESHOLD: 25

rules:
  - rule: Auto_Resident
    priority: 100
    if: person.days_in_country >= MIN_DAYS_RESIDENT
    then:
      result.status: "resident"
      result.reason: "Meets day-count rule."
      stop: true

  - rule: Score_Init
    priority: 95
    then: result.score: 0

  - rule: Family_Tie
    priority: 90
    if: person.has_family_tie
    then: result.score: result.score + FAMILY_TIE_POINTS

  - rule: Work_Tie
    priority: 85
    if: person.has_work_tie
    then: result.score: result.score + WORK_TIE_POINTS

  - rule: Property_Tie
    priority: 80
    if: person.owns_property
    then: result.score: result.score + PROPERTY_TIE_POINTS

  - rule: Prior_Residency
    priority: 75
    if: person.was_resident_last_year
    then: result.score: result.score + PRIOR_RESIDENCY_POINTS

  - rule: Determine_Status
    priority: 70
    if: result.score >= RESIDENCY_THRESHOLD
    then:
      result.status: "resident"
    else:
      result.status: "non_resident"

2.2 VAT / Sales Tax Threshold Determination

Industry Context: Revenue authorities and enterprise finance teams must consistently determine whether a business exceeds VAT or sales-tax registration thresholds. Manual checks lead to inconsistent filings, compliance breaches, and penalties. SESL enables a transparent, traceable model that evaluates turnover, sales mix, and supply location.

How the Model Works: SESL checks rolling 12-month taxable turnover, type of goods/services, exempt categories, and cross-border considerations. The model returns: mandatory registration, eligible but optional, or not required.

const:
  VAT_THRESHOLD: 85000
  ZERO_RATED: ["food_basic", "children_clothes"]
  EXEMPT: ["education", "healthcare"]

rules:
  - rule: Init
    priority: 100
    then: result.taxable_turnover: 0

  - rule: Calculate_Taxable
    priority: 95
    for: sale in business.sales
    if: sale.category not in EXEMPT
    then: result.taxable_turnover: result.taxable_turnover + sale.amount

  - rule: Mandatory_Register
    priority: 90
    if: result.taxable_turnover >= VAT_THRESHOLD
    then:
      result.status: "mandatory_registration"
      result.reason: "Threshold exceeded."
      stop: true

  - rule: Optional_Register
    priority: 80
    if: result.taxable_turnover > 0
    then:
      result.status: "optional_registration"

  - rule: Not_Required
    priority: 70
    then:
      result.status: "not_required"

facts:
  - name: "Scenario 1 – Mandatory registration"
    business:
      sales:
        - { category: "general_goods", amount: 60000 }
        - { category: "services", amount: 30000 }
    result: {}

  - name: "Scenario 2 – Optional registration (below threshold)"
    business:
      sales:
        - { category: "general_goods", amount: 20000 }
        - { category: "education", amount: 40000 }
    result: {}

  - name: "Scenario 3 – Not required (entirely exempt)"
    business:
      sales:
        - { category: "education", amount: 90000 }
    result: {}

2.3 Corporate Tax Deduction Eligibility (Capex/Opex)

Industry Context: Multinational corporations frequently misclassify expenses—leading to audit findings, back-dated adjustments, and penalties. SESL creates deterministic classification logic aligned with tax authority guidance, internal controls, and audit requirements.

How the Model Works: SESL evaluates expense nature, expected useful life, asset type, and accounting policy. Output categories include: OPEX (deductible), CAPEX (capitalised), or non-deductible.

const:
  MIN_CAPEX_LIFESPAN: 2
  NON_DEDUCTIBLE_TYPES: ["fines", "penalties"]

rules:
  - rule: Check_Non_Deductible
    priority: 100
    if: expense.type in NON_DEDUCTIBLE_TYPES
    then:
      result.classification: "non_deductible"
      result.reason: "Expense type disallowed."
      stop: true

  - rule: Capex_Long_Life
    priority: 95
    if: expense.useful_life_years >= MIN_CAPEX_LIFESPAN
    then:
      result.classification: "capex"
      result.reason: "Long-life asset creation."
      stop: true

  - rule: Opex
    priority: 80
    then:
      result.classification: "opex"
      result.reason: "Operational expense."

facts:
  - name: "Scenario 1 – Capital expenditure"
    expense:
      type: "equipment"
      useful_life_years: 5
    result: {}

  - name: "Scenario 2 – Operational expense"
    expense:
      type: "marketing"
      useful_life_years: 0
    result: {}

  - name: "Scenario 3 – Non-deductible"
    expense:
      type: "fines"
      useful_life_years: 0
    result: {}

2.4 Cross-Border Withholding Tax (WHT) Rate Calculator

Industry Context: Cross-border payments expose organisations to complex treaty rules, documentation requirements, and compliance risks. Incorrect withholding rates are a major cause of tax disputes and delayed payments. SESL enables defensible, real-time WHT determinations across finance systems.

How the Model Works: SESL evaluates treaty eligibility, residency status, payment type, and documentation validity to calculate the correct withholding percentage.

const:
  DEFAULT_WHT: 30
  TREATY_RATES:
    interest: 10
    royalties: 12
    dividends: 5

rules:
  - rule: Invalid_Documentation
    priority: 100
    if: not payment.has_valid_certificate
    then:
      result.rate: DEFAULT_WHT
      result.reason: "No valid treaty documentation."
      stop: true

  - rule: Treaty_Rate
    priority: 90
    if:
      all:
        - payment.treaty_eligible
        - payment.type in TREATY_RATES
    then:
      result.rate: TREATY_RATES[payment.type]
      result.reason: "Treaty rate applied."
      stop: true

  - rule: Default_Rate
    priority: 70
    then:
      result.rate: DEFAULT_WHT
      result.reason: "Default WHT applied."

facts:
  - name: "Scenario 1 – Treaty rate (dividends)"
    payment:
      type: "dividends"
      treaty_eligible: true
      has_valid_certificate: true
    result: {}

  - name: "Scenario 2 – Invalid documentation"
    payment:
      type: "interest"
      treaty_eligible: true
      has_valid_certificate: false
    result: {}

  - name: "Scenario 3 – Non-treaty country"
    payment:
      type: "royalties"
      treaty_eligible: false
      has_valid_certificate: true
    result: {}

3. Government & Public Services

Public agencies face increasing pressure to demonstrate fairness, auditability, and consistency in operational decisions. SESL ensures policy logic is explicit, testable, and consistently applied across caseworkers, legacy systems, and digital channels.

3.1 Housing Benefit Eligibility

Industry Context: Housing-benefit calculation is highly regulated and politically sensitive. SESL ensures rules are transparent, deterministic, and auditable.

How the Model Works: Rules evaluate age, documentation, income bands, and thresholds to determine full eligibility, partial eligibility, or rejection.

const:
  MIN_AGE: 18
  MAX_INCOME_FULL: 18000
  MAX_INCOME_PARTIAL: 30000
  PARTIAL_RATE: 0.25
  BASE_CONTRIBUTION: 100
  REQUIRED_DOCS: ["proof_of_id", "income_statement"]

rules:
  - rule: Age_Check
    priority: 100
    if: applicant.age < MIN_AGE
    then:
      result.eligible: false
      result.reason: "Below minimum age."
      stop: true

  - rule: Documentation_Check
    priority: 95
    if: not all(item in applicant.documents for item in REQUIRED_DOCS)
    then:
      result.eligible: false
      result.reason: "Missing mandatory documentation."
      stop: true

  - rule: Full_Benefit
    priority: 90
    if: applicant.income <= MAX_INCOME_FULL
    then:
      result.band: "full"
      result.contribution: 0
      result.eligible: true

  - rule: Partial_Benefit
    priority: 85
    if:
      applicant.income > MAX_INCOME_FULL and
      applicant.income <= MAX_INCOME_PARTIAL
    then:
      result.band: "partial"
      result.contribution: BASE_CONTRIBUTION * PARTIAL_RATE
      result.eligible: true

  - rule: No_Benefit
    priority: 80
    if: applicant.income > MAX_INCOME_PARTIAL
    then:
      result.eligible: false
      result.reason: "Income above threshold."

3.2 Passport Renewal Screening

Industry Context: Passport operations manage high seasonal volumes while enforcing strict identity and document standards. SESL ensures consistent decision-making in all channels.

const:
  MIN_ADULT_AGE: 16
  MAX_PASSPORT_AGE: 10
  REQUIRED_DOCS: ["photo", "old_passport"]

rules:
  - rule: Age_Routing
    priority: 100
    if: applicant.age < MIN_ADULT_AGE
    then:
      result.eligible: false
      result.pathway: "child_passport"
      stop: true

  - rule: Nationality_Check
    priority: 98
    if: applicant.is_british != true
    then:
      result.eligible: false
      result.reason: "Non-British nationals require a different process."
      stop: true

  - rule: Doc_Validation
    priority: 95
    if: not all(item in applicant.documents for item in REQUIRED_DOCS)
    then:
      result.eligible: false
      result.reason: "Missing required documents."
      stop: true

  - rule: Renewal_Eligible
    priority: 90
    if: applicant.has_previous_passport and passport.years_since_issue <= MAX_PASSPORT_AGE
    then:
      result.eligible: true
      result.pathway: "renewal"

  - rule: Replacement_Path
    priority: 85
    if: applicant.has_previous_passport and passport.lost == true
    then:
      result.eligible: true
      result.pathway: "lost_replacement"

3.3 SME Grant Scoring

Industry Context: Government grant programmes require fairness and auditability. SESL expresses scoring logic as transparent rule models.

const:
  MIN_SCORE: 70
  WEIGHT_INNOVATION: 0.5
  WEIGHT_IMPACT: 0.3
  WEIGHT_DELIVERY: 0.2
  PRIORITY_REGION_BONUS: 5

rules:
  - rule: Score_Innovation
    priority: 95
    let: score: proposal.innovation * WEIGHT_INNOVATION
    then: result.score_innovation: score

  - rule: Score_Impact
    priority: 94
    let: score: proposal.impact * WEIGHT_IMPACT
    then: result.score_impact: score

  - rule: Score_Delivery
    priority: 93
    let: score: proposal.delivery * WEIGHT_DELIVERY
    then: result.score_delivery: score

  - rule: Bonus_Region
    priority: 90
    if: proposal.region_priority
    then: result.bonus: PRIORITY_REGION_BONUS

  - rule: Total_Score
    priority: 80
    let: total: result.score_innovation + result.score_impact + result.score_delivery + (result.bonus or 0)
    then: result.total_score: total

  - rule: Funding_Decision
    priority: 70
    if: result.total_score >= MIN_SCORE
    then: result.awarded: true
    else: result.awarded: false

4. Banking & Financial Services

Banks operate under intense regulatory scrutiny. SESL provides a transparent logic layer aligned with risk committees, auditors, and regulators.

4.1 Credit Card Pre-Eligibility

const:
  MIN_AGE: 18
  MIN_INCOME: 15000
  MAX_DTI: 0.45

rules:
  - rule: Age_Check
    priority: 100
    if: applicant.age < MIN_AGE
    then:
      result.status: "decline"
      result.reason: "Under minimum age."
      stop: true

  - rule: Income_Check
    priority: 95
    if: applicant.income < MIN_INCOME
    then:
      result.status: "decline"
      result.reason: "Income below threshold."
      stop: true

  - rule: Debt_to_Income
    priority: 90
    let: dti: applicant.debt / applicant.income
    if: dti > MAX_DTI
    then:
      result.status: "decline"
      result.reason: "High debt-to-income ratio."
      stop: true

  - rule: Risk_Flags
    priority: 85
    if: applicant.has_internal_risk_flag
    then:
      result.status: "review"
      result.reason: "Internal risk flag raised."
      stop: true

  - rule: Accept
    priority: 80
    then:
      result.status: "pre_approved"
      result.reason: "Meets all criteria."

4.2 AML Risk Scoring

const:
  PEP_POINTS: 60
  HR_COUNTRY_POINTS: 40
  SANCTION_POINTS: 100
  UNUSUAL_ACTIVITY_POINTS: 30
  RISK_HIGH: 80
  RISK_MEDIUM: 40

rules:
  - rule: Base
    priority: 100
    then: result.risk: 0

  - rule: PEP
    priority: 95
    if: customer.is_pep
    then: result.risk: result.risk + PEP_POINTS

  - rule: High_Risk_Country
    priority: 90
    if: customer.country in ["IR", "KP", "SY", "RU"]
    then: result.risk: result.risk + HR_COUNTRY_POINTS

  - rule: Sanction_Match
    priority: 85
    if: customer.sanctions_hit
    then: result.risk: result.risk + SANCTION_POINTS

  - rule: Unusual_Activity
    priority: 80
    if: customer.unusual_activity
    then: result.risk: result.risk + UNUSUAL_ACTIVITY_POINTS

  - rule: Categorise
    priority: 70
    if: result.risk >= RISK_HIGH
    then: result.category: "high"
    else if: result.risk >= RISK_MEDIUM
    then: result.category: "medium"
    else: result.category: "low"

4.3 Payment Sanctions Screening

const:
  BLOCKED_COUNTRIES: ["IR", "KP", "SY"]
  FLAGGED_COUNTRIES: ["RU", "CU"]
  HIGH_VALUE_THRESHOLD: 100000

rules:
  - rule: Blocked_Country
    priority: 100
    if: payment.country in BLOCKED_COUNTRIES
    then:
      result.status: "block"
      result.reason: "Sanctioned country."
      stop: true

  - rule: Flag_High_Risk_Country
    priority: 95
    if: payment.country in FLAGGED_COUNTRIES
    then: result.flag: "high_risk_country"

  - rule: High_Value_Flag
    priority: 90
    if: payment.amount > HIGH_VALUE_THRESHOLD
    then: result.flag: "high_value"

  - rule: Receiver_Flag
    priority: 85
    if: payment.receiver_risk_flag
    then: result.flag: "receiver_risk"

  - rule: Approve
    priority: 70
    then: result.status: "allow"

5. Healthcare

SESL ensures safe and consistent triage, stewardship, and scheduling logic across clinical teams, digital triage, and call centres.

5.1 Primary Care Triage

rules:
  - rule: Red_Flag_Chest
    priority: 100
    if: symptoms.chest_pain
    then:
      result.priority: "emergency"
      stop: true

  - rule: Red_Flag_Stroke
    priority: 95
    if: symptoms.facial_droop or symptoms.arm_weakness
    then:
      result.priority: "emergency"
      stop: true

  - rule: Fever_Urgent
    priority: 90
    if: symptoms.fever and patient.age < 3
    then:
      result.priority: "urgent"

  - rule: Chronic_Condition_Check
    priority: 85
    if: patient.has_chronic_condition and symptoms.breathing_difficulty
    then:
      result.priority: "urgent"

  - rule: Routine
    priority: 70
    then:
      result.priority: "routine"

5.2 Antibiotic Stewardship

const:
  FIRST_LINE_DAYS: 2

rules:
  - rule: Viral_Reject
    priority: 100
    if: assessment.bacterial == false
    then:
      result.recommend: "no_antibiotics"
      stop: true

  - rule: Allergy_Check
    priority: 95
    if: patient.allergy_penicillin
    then:
      result.recommend: "alternative_antibiotic"
      stop: true

  - rule: First_Line_Start
    priority: 90
    if: assessment.bacterial == true
    then:
      result.recommend: "start_first_line"

  - rule: First_Line_Failed
    priority: 85
    if: symptoms.days > FIRST_LINE_DAYS and symptoms.no_improvement
    then:
      result.recommend: "escalate_second_line"

5.3 Follow-Up Scheduling

const:
  HIGH_RISK_DAYS: 7
  MEDIUM_RISK_DAYS: 14
  LOW_RISK_DAYS: 30

rules:
  - rule: High_Risk
    priority: 100
    if: patient.risk == "high"
    then: result.follow_up_days: HIGH_RISK_DAYS

  - rule: Medium_Risk
    priority: 90
    if: patient.risk == "medium"
    then: result.follow_up_days: MEDIUM_RISK_DAYS

  - rule: Low_Risk
    priority: 80
    if: patient.risk == "low"
    then: result.follow_up_days: LOW_RISK_DAYS

6. Insurance

Insurers must operationalise underwriting, pricing, and claims rules with precision. SESL improves governance, reduces variation, and creates traceable decisions.

6.1 Auto Insurance Underwriting

const:
  MIN_DRIVER_AGE: 21
  HIGH_RISK_POSTCODES: ["AB1", "DD9"]
  MAX_RECENT_CLAIMS: 2

rules:
  - rule: Age
    priority: 100
    if: driver.age < MIN_DRIVER_AGE
    then: result.decision: "decline"

  - rule: Claims
    priority: 95
    if: driver.recent_claims > MAX_RECENT_CLAIMS
    then: result.decision: "decline"

  - rule: High_Risk_Postcode
    priority: 90
    if: driver.postcode in HIGH_RISK_POSTCODES
    then: result.decision: "review"

  - rule: Accept
    priority: 80
    then: result.decision: "accept"

6.2 Health Policy Pricing

const:
  BASE_PREMIUM: 100
  AGE_50_LOAD: 1.4
  SMOKER_LOAD: 1.3
  REGION_LOADS:
    north: 1.1
    south: 1.0
    central: 1.05

rules:
  - rule: Init
    priority: 100
    then: result.loading: 1.0

  - rule: Age
    priority: 95
    if: member.age > 50
    then: result.loading: result.loading * AGE_50_LOAD

  - rule: Smoker
    priority: 90
    if: member.smoker
    then: result.loading: result.loading * SMOKER_LOAD

  - rule: Region
    priority: 85
    then: result.loading: result.loading * REGION_LOADS[member.region]

6.3 Claims Fraud Scoring

const:
  VALUE_POINTS: 40
  DOC_MISMATCH_POINTS: 30
  PRIOR_FRAUD_POINTS: 50

rules:
  - rule: Init
    priority: 100
    then: result.fraud_score: 0

  - rule: High_Value
    priority: 95
    if: claim.amount > 10000
    then: result.fraud_score: result.fraud_score + VALUE_POINTS

  - rule: Doc_Mismatch
    priority: 90
    if: claim.doc_mismatch
    then: result.fraud_score: result.fraud_score + DOC_MISMATCH_POINTS

  - rule: Prior_Fraud
    priority: 85
    if: claimant.prior_fraud
    then: result.fraud_score: result.fraud_score + PRIOR_FRAUD_POINTS

7. Retail & E-Commerce

Retailers must optimise promotions, segmentation, logistics, and returns across channels. SESL unifies business logic across stores, apps, and warehouses.

7.1 RFM Segmentation

rules:
  - rule: Champion
    priority: 100
    if: customer.recency < 30 and customer.frequency > 10 and customer.monetary > 500
    then: result.segment: "champion"

  - rule: Loyal
    priority: 90
    if: customer.frequency > 5
    then: result.segment: "loyal"

  - rule: At_Risk
    priority: 80
    if: customer.recency > 90
    then: result.segment: "at_risk"

  - rule: Lapsed
    priority: 70
    if: customer.recency > 180
    then: result.segment: "lapsed"

7.2 Promotion Eligibility

const:
  MIN_CART: 50
  VIP_SEGMENTS: ["champion", "loyal"]

rules:
  - rule: Min_Cart
    priority: 100
    if: cart.total < MIN_CART
    then:
      result.discount: 0
      result.reason: "Below threshold."
      stop: true

  - rule: VIP_Bonus
    priority: 90
    if: customer.segment in VIP_SEGMENTS
    then:
      result.discount: 15
      stop: true

  - rule: Standard
    priority: 80
    then: result.discount: 10

7.3 Returns Policy

const:
  RETURN_DAYS: 30
  EXCLUDED_CATEGORIES: ["perishables", "custom_items"]

rules:
  - rule: Days_Check
    priority: 100
    if: order.days > RETURN_DAYS
    then:
      result.eligible: false
      result.reason: "Exceeded return window."
      stop: true

  - rule: Excluded_Cat
    priority: 95
    if: order.category in EXCLUDED_CATEGORIES
    then:
      result.eligible: false
      result.reason: "Category excluded."
      stop: true

  - rule: Condition_Check
    priority: 90
    if: item.condition != "good"
    then:
      result.eligible: false
      result.reason: "Item condition unacceptable."
      stop: true

  - rule: Accept
    priority: 80
    then: result.eligible: true

8. Pensions

Pension schemes operate with strict rules for eligibility, contributions, transfers, and retirement pathways. SESL provides transparent, auditable logic for administrators and trustees.

8.1 Retirement Eligibility Assessment

const:
  NORMAL_RETIREMENT_AGE: 65
  MIN_SERVICE_YEARS: 5
  EARLY_RETIREMENT_AGE: 55
  EARLY_PENALTY_RATE: 0.05

rules:
  - rule: Check_Service
    priority: 100
    if: member.service_years < MIN_SERVICE_YEARS
    then:
      result.eligible: false
      result.reason: "Insufficient service years."
      stop: true

  - rule: Too_Young
    priority: 95
    if: member.age < EARLY_RETIREMENT_AGE
    then:
      result.eligible: false
      result.reason: "Below early retirement age."
      stop: true

  - rule: Normal_Retirement
    priority: 90
    if: member.age >= NORMAL_RETIREMENT_AGE
    then:
      result.eligible: true
      result.pathway: "normal"
      result.penalty: 0

  - rule: Early_Retirement
    priority: 85
    if: member.age >= EARLY_RETIREMENT_AGE and member.age < NORMAL_RETIREMENT_AGE
    then:
      let:
        years_early: NORMAL_RETIREMENT_AGE - member.age
      result.eligible: true
      result.pathway: "early"
      result.penalty: years_early * EARLY_PENALTY_RATE