Claim CLM-2024-001001

Claim CLM-2024-001001
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Key Facts

LOB:MOTOR
Loss Type:Vandalism
Outcome:Settled
Amount:GBP 48,727
Risk Score:57 (medium)
Date of Loss:2024-10-25
Settlement:GBP 48,727

Timeline

2024-10-25Incident occurred
2024-10-26Claim reported
2024-11-01Assessment completed
2024-11-21Decision made
2024-11-25Claim closed

Analysis

NEEDS REVIEW
9 FAIL3 WARN13 PASS
FAILS1Subrogation Expected but Not Set Up
FAILS2Split Liability Settlement Inconsistency
FAILS2No-Update Gap

Inspections

25 inspections
Summary
FileDocument Extractability / OCR RiskFAILS376%Scanned PDF unreadable2
LiabilitySplit Liability Settlement InconsistencyFAILS293%50/50 split but full payment made3
CommsNo-Update GapFAILS287%Customer left waiting3
CommsPromised Follow-Up Not CompletedFAILS294%Promised callback not made3
CommsFinal Decision Explanation MissingFAILS293%Decision unexplained2
RepairSupplier Delay Attribution MissingFAILS376%Cause unknown2
RecoverySubrogation Expected but Not Set UpFAILS188%Recovery missed2
EvidenceDocument Quality Too LowFAILS389%Quality issue3
EvidenceTranscript Not AvailableFAILS394%No transcript of FNOL call3
LiabilityDispute Without Evidence PackWARNS285%Needs attention2
RepairRework Loop DetectedWARNS295%Needs attention2
RepairInvoice vs Authorization MismatchWARNS272%Invoice 10% over estimate2
FileRequired Evidence PresencePASSS283%All required documents present2
FileTimeline CoherencePASSS277%Timeline events are coherent2
FileStructured vs Narrative MismatchPASSS271%Structured fields match narrative1
FileClaim Story ConfidencePASSS370%Key facts documented2
LiabilityLiability Stance ContradictionPASSS281%Liability stance is consistent2
CommsFirst Contact DelayPASSS280%Timely customer engagement1
RepairRepair Cycle Time OutlierPASSS286%Repair cycle within expected range2
TL/ValMissing Valuation Evidence PackPASSS172%Valuation evidence pack complete2
FinancePayment Without Supporting ArtifactPASSS278%Payments have supporting docs2
FinanceReserve Category MismatchPASSS384%Reserve categories correct2
FinanceDuplicate or Near-Duplicate PaymentsPASSS180%Ledger clean1
FinanceClosed with Open Financial ItemsPASSS287%Clean financial closure2
EvidenceCritical Document MissingPASSS280%File complete1
Evidence

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