[
  {
    "id": "hospital_contracting",
    "status": "needs_policy_verification",
    "reason": "Hospital reimbursement can depend on insurer contracts and policy type.",
    "ai_behavior": "Never guarantee exact reimbursement outcome.",
    "examples": [
      "non-contracted hospital",
      "authorization requirement",
      "partial reimbursement"
    ]
  },
  {
    "id": "medicine_reimbursement",
    "status": "needs_policy_verification",
    "reason": "Medicine reimbursement may depend on GVS status, preference policy and insurer conditions.",
    "ai_behavior": "Route to insurer, apotheker or Medicijnkosten.nl for final verification.",
    "examples": [
      "preference policy",
      "brand substitution",
      "bijbetaling"
    ]
  }
]