uid stringclasses 10 values | dataset_id stringclasses 1 value | line_of_business stringclasses 4 values | claim_type stringclasses 9 values | fraud_flags_count int64 1 5 | flag_strength stringclasses 3 values | claim_evidence_strength stringclasses 3 values | investigation_action stringclasses 2 values | final_fraud_outcome stringclasses 2 values | triage_summary stringclasses 10 values | question stringclasses 1 value | ground_truth_label stringclasses 2 values | ground_truth_rationale stringclasses 10 values | outcome_signal stringclasses 5 values | source_citation stringclasses 1 value |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
INSF-001 | insurance-fraud-flag-coherence-risk-v0.1 | auto | injury | 1 | low | strong | fast_track | not_fraud | Few weak flags with strong evidence. | Is fraud-flag coherence intact. Answer coherent or incoherent. | coherent | Action matched low suspicion. | low_false_positive | Synthetic |
INSF-002 | insurance-fraud-flag-coherence-risk-v0.1 | auto | injury | 4 | high | weak | investigate | fraud | Many strong flags and weak evidence. | Is fraud-flag coherence intact. Answer coherent or incoherent. | coherent | Investigation justified and confirmed. | fraud_caught | Synthetic |
INSF-003 | insurance-fraud-flag-coherence-risk-v0.1 | property | storm | 3 | medium | medium | investigate | not_fraud | Moderate flags but legitimate loss. | Is fraud-flag coherence intact. Answer coherent or incoherent. | incoherent | Investigation over-triggered. | false_positive_cost | Synthetic |
INSF-004 | insurance-fraud-flag-coherence-risk-v0.1 | property | fire | 1 | low | weak | fast_track | fraud | Weak flag but weak evidence and fraud later confirmed. | Is fraud-flag coherence intact. Answer coherent or incoherent. | incoherent | Triage missed fraud risk. | fraud_missed | Synthetic |
INSF-005 | insurance-fraud-flag-coherence-risk-v0.1 | health | procedure | 2 | low | strong | fast_track | not_fraud | Routine claim with mild flags. | Is fraud-flag coherence intact. Answer coherent or incoherent. | coherent | Fast track appropriate. | low_false_positive | Synthetic |
INSF-006 | insurance-fraud-flag-coherence-risk-v0.1 | commercial | liability | 5 | high | weak | investigate | fraud | High flags and weak support. | Is fraud-flag coherence intact. Answer coherent or incoherent. | coherent | High suspicion acted on. | fraud_caught | Synthetic |
INSF-007 | insurance-fraud-flag-coherence-risk-v0.1 | auto | theft | 3 | medium | strong | investigate | not_fraud | Strong evidence but investigated heavily. | Is fraud-flag coherence intact. Answer coherent or incoherent. | incoherent | Flags not strong enough to justify delay. | customer_friction | Synthetic |
INSF-008 | insurance-fraud-flag-coherence-risk-v0.1 | property | water_damage | 4 | high | medium | fast_track | fraud | High flags but fast-tracked. | Is fraud-flag coherence intact. Answer coherent or incoherent. | incoherent | Action failed to match strong suspicion. | fraud_missed | Synthetic |
INSF-009 | insurance-fraud-flag-coherence-risk-v0.1 | health | disability | 4 | high | weak | investigate | fraud | High suspicion and weak support. | Is fraud-flag coherence intact. Answer coherent or incoherent. | coherent | Investigation aligned. | fraud_caught | Synthetic |
INSF-010 | insurance-fraud-flag-coherence-risk-v0.1 | auto | collision | 2 | low | strong | fast_track | not_fraud | Low suspicion and strong evidence. | Is fraud-flag coherence intact. Answer coherent or incoherent. | coherent | No over-triage. | low_false_positive | Synthetic |
What this repo is for
Detect fraud triage errors.
Focus
flags vs evidence
investigate vs fast track choice
false positives
missed fraud
Why it matters Fraud cost grows quietly. Over-triage also burns trust and time.
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