fraud-escalation

name	fraud-escalation
description	Apply the value ceiling and serial-returner / flagged-account risk gates and route cases to a human supervisor. USE FOR deciding whether a return must be escalated to the returns supervisor. DO NOT USE FOR the base eligibility check (policy-eligibility).

Fraud & Escalation Gate

Implements BR-003 (escalate high-value or high-risk). Overrides an approve_candidate from policy-eligibility when a gate fires.

Operational contract

• Inputs: the case object + the eligibility verdict.
• Outputs: escalate | proceed + a risk rationale.
• Deps: customer_get_profile fields (lifetime_return_rate, account_status).
• Idempotency: pure function of inputs.
• Failure behavior: on ambiguity, escalate (fail safe toward the human).

Procedure

1. BR-003 gates — escalate if ANY:
   • refund_amount > 250 (auto-approve ceiling), OR
   • lifetime_return_rate ≥ 0.40 (serial-returner risk), OR
   • account_status == review_flagged, OR
   • days_since_delivery > 30 AND a plausible override reason needs human judgement.
2. If a gate fires → escalate_to_supervisor; summarize which gate(s) + the risk.
3. If no gate fires → proceed (carry the eligibility verdict forward).
4. Emit the escalation reason for the audit record (BR-005).

Output schema

{ "decision": "escalate | proceed",
  "gates_fired": ["value_ceiling", "serial_returner"],
  "escalation": { "reason": "Refund $1,180 > $250 ceiling", "queue": "returns-supervisors" } }