Home/Evidence Verification Dataset for Medical Expense Claims Based on Insurance Policies and Contracts
Evidence Verification Dataset for Medical Expense Claims Based on Insurance Policies and Contracts
#evidence verification #policy-based reasoning #claim eligibility assessment #medical insurance claims verification #insurance policy compliance #healthcare expense reimbursement assessment
- 5000
- 0.5GB
- JSON
- CATL
MOBIUSI INC
Updated:2026-10-14
AI Analysis & Value Prop
Designed for medical expense claims, this dataset pairs insurance contracts, policy wording, endorsements, and other legal documents with claim requirements to verify whether the documents support specific expenses or coverage conditions. Annotations cover policy version alignment, applicable conditions, supporting evidence spans, and conflicts between documents. The data supports training and evaluating claims evidence verifiers, as well as assisting claims review and legal document analysis.
Dataset Insights
Sample Examples
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Technical Specifications
| Field | Type | Description |
|---|---|---|
| file_name | string | File name |
| support_level | string | The overall degree to which the source documents support the claim requirement being verified. |
| evidence_spans | array | Document clauses or source passages used in the judgment, with their relationship to the claim requirement. |
| version_alignment | string | Whether the cited policy wording version applies to the relevant policy and claim. |
| decision_rationale | string | A concise explanation of the overall judgment based on the evidence spans, version alignment, and applicable conditions. |
| document_conflicts | array | Relevant conflicts between contracts, policy wording, endorsements, or other documents. Use an empty array when no conflicts are identified. |
| condition_assessment | string | Whether the conditions specified in the documents are met, missing, or contradicted by the available information. |
| source_documents_text | string | Text of source documents such as insurance contracts, policy wording, and endorsements. Clearly separate multiple documents and retain their names, versions, and clause details. |
| claim_requirement_text | string | The medical expense item, coverage condition, or specific claim assertion that needs verification. |
| missing_or_unmet_conditions | array | Conditions required by the documents that the available claim information does not establish as met, or that are explicitly unmet. Use an empty array when there are none. |
Compliance Statement
| Authorization Type | Proprietary - Commercial AI Training License (No Redistribution) |
| Commercial Use | Requires exclusive subscription or authorization contract (monthly or per-invocation charging) |
| Privacy and Anonymization | No PII, no real company names, simulated scenarios follow industry standards |
| Compliance System | Compliant with China's Data Security Law / EU GDPR / supports enterprise data access logs |
Frequently Asked Questions
- What does the dataset contain?
- Each example includes source documents such as insurance contracts, policy wording, or endorsements, along with a medical expense item, coverage condition, or claim assertion to verify. Labels cover support level, version alignment, applicable conditions, evidence spans, and conflicts between documents.
- How does the dataset assess whether claim evidence is sufficient?
- It records an overall support level and identifies relevant clauses and their relationship to the claim requirement. It also captures missing or unmet conditions, version mismatches, and document conflicts so that judgments can be traced to their supporting evidence.
- What are the intended use cases?
- The data can be used to train or evaluate evidence verifiers for medical expense claims and to support claims review, insurance document retrieval and analysis, and evidence-support classification.
- How can I obtain the data and confirm its licensing terms?
- Contact the data provider or platform for available delivery options. Before use, review the license, document provenance, and applicable privacy and compliance requirements. The provider's published terms determine the permitted uses.
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Verified for Enterprise UseCite this Work
@dataset{Mobiusi2026,
title={Evidence Verification Dataset for Medical Expense Claims Based on Insurance Policies and Contracts},
author={MOBIUSI INC},
year={2026},
url={https://www.mobiusi.com/datasets/65dfba66fb6368d283b72924d528c01f},
urldate={2026-10-10},
keywords={medical claims dataset, insurance contract evidence, policy wording analysis, claims review training data, evidence sufficiency, endorsement version matching, legal document understanding, claims verifier training},
version={1.0}
}Using this in research? Please cite us.
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