Claim CLM-2024-001003

Key Facts

LOB:MOTOR
Loss Type:Collision - Own Fault
Outcome:Total Loss
Amount:GBP 37,218
Risk Score:49 (medium)
Date of Loss:2024-12-03
Settlement:GBP 37,218

Timeline

2024-12-03Incident occurred
2024-12-04Claim reported
2024-12-10Assessment completed
2024-12-11Decision made
2024-12-14Claim closed

Analysis

NEEDS REVIEW
7 FAIL4 WARN13 PASS
FAILS1Duplicate or Near-Duplicate Payments
FAILS2Required Evidence Presence
FAILS2Structured vs Narrative Mismatch

Inspections

24 inspections
Summary
FileRequired Evidence PresenceFAILS271%Estimate absent3
FileDocument Extractability / OCR RiskFAILS391%OCR failed on key document2
FileStructured vs Narrative MismatchFAILS286%Loss type code conflicts with notes3
CommsFinal Decision Explanation MissingFAILS294%No closure letter sent3
RepairInvoice vs Authorization MismatchFAILS291%Cost overrun2
FinanceDuplicate or Near-Duplicate PaymentsFAILS192%Same 1200 paid twice to garage3
EvidenceCritical Document MissingFAILS276%Police report missing for theft claim2
RepairRepair Cycle Time OutlierWARNS284%Duration borderline1
FinanceReserve Category MismatchWARNS375%Verify intent1
FinanceClosed with Open Financial ItemsWARNS286%Small reserve open at closure1
EvidenceDocument Quality Too LowWARNS388%Needs attention2
FileTimeline CoherencePASSS282%Timeline events are coherent2
FileClaim Story ConfidencePASSS372%Claim story is complete2
LiabilityDispute Without Evidence PackPASSS292%Evidence pack present2
LiabilitySplit Liability Settlement InconsistencyPASSS293%Settlement matches2
CommsFirst Contact DelayPASSS274%First contact within SLA1
CommsNo-Update GapPASSS284%No communication gaps1
CommsPromised Follow-Up Not CompletedPASSS282%Follow-ups completed as promised1
RepairRework Loop DetectedPASSS282%Single repair cycle2
RepairSupplier Delay Attribution MissingPASSS395%Ownership clear1
TL/ValDeductions Without JustificationPASSS294%Deductions properly justified1
TL/ValSalvage Handling MissingPASSS285%Recovery tracked1
FinancePayment Without Supporting ArtifactPASSS270%Payments have supporting docs2
EvidenceTranscript Not AvailablePASSS383%Communication documented1
Evidence

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