Claim CLM-2024-001005

Claim CLM-2024-001005
10/60

Key Facts

LOB:MOTOR
Loss Type:Collision - Own Fault
Outcome:Cash Settlement
Amount:GBP 20,250
Risk Score:25 (low)
Date of Loss:2024-11-19
Settlement:GBP 20,250

Timeline

2024-11-19Incident occurred
2024-11-20Claim reported
2024-11-26Assessment completed
2024-11-30Decision made
2024-12-04Claim closed

Analysis

NEEDS REVIEW
1 FAIL0 WARN19 PASS
FAILS2Required Evidence Presence

Inspections

22 inspections
Summary
FileRequired Evidence PresenceFAILS273%Estimate absent3
FileDocument Extractability / OCR RiskINCS350%Insufficient evidence to determine1
CommsNo-Update GapINCS234%Insufficient evidence to determine1
FileTimeline CoherencePASSS295%Timeline events are coherent1
FileStructured vs Narrative MismatchPASSS275%Structured fields match narrative2
FileClaim Story ConfidencePASSS380%Key facts documented2
LiabilitySplit Liability Settlement InconsistencyPASSS286%Split liability correctly reflected1
CommsFirst Contact DelayPASSS288%First contact within SLA2
CommsPromised Follow-Up Not CompletedPASSS279%Commitments honored1
CommsFinal Decision Explanation MissingPASSS272%Closure letter present1
RepairRepair Cycle Time OutlierPASSS283%Duration acceptable1
RepairRework Loop DetectedPASSS276%Single repair cycle1
RepairInvoice vs Authorization MismatchPASSS293%Costs aligned2
RepairSupplier Delay Attribution MissingPASSS377%Delays documented and attributed1
FinancePayment Without Supporting ArtifactPASSS274%Artifacts linked1
FinanceReserve Category MismatchPASSS370%Exposure aligned2
FinanceDuplicate or Near-Duplicate PaymentsPASSS191%No duplicate payments detected1
FinanceClosed with Open Financial ItemsPASSS274%No open items2
RecoverySubrogation Expected but Not Set UpPASSS171%Recovery reserve created2
EvidenceCritical Document MissingPASSS286%All expected documents present1
EvidenceDocument Quality Too LowPASSS391%OCR confidence high2
EvidenceTranscript Not AvailablePASSS387%Communication documented2
Evidence

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