Claim CLM-2024-001009

Claim CLM-2024-001009
8/60

Key Facts

LOB:MOTOR
Loss Type:Rear-end Collision
Outcome:Repaired
Amount:GBP 19,354
Risk Score:31 (low)
Date of Loss:2024-11-09
Settlement:GBP 19,354

Timeline

2024-11-09Incident occurred
2024-11-10Claim reported
2024-11-15Assessment completed
2024-11-28Decision made
2024-12-02Claim closed

Analysis

NEEDS REVIEW
4 FAIL4 WARN16 PASS
FAILS2Promised Follow-Up Not Completed
FAILS2Payment Without Supporting Artifact
FAILS2Closed with Open Financial Items

Inspections

24 inspections
Summary
CommsPromised Follow-Up Not CompletedFAILS277%Commitment broken3
FinancePayment Without Supporting ArtifactFAILS277%No supporting doc3
FinanceClosed with Open Financial ItemsFAILS282%Unclean closure3
EvidenceDocument Quality Too LowFAILS395%Engineer report too blurry to read2
FileTimeline CoherenceWARNS282%Timeline gap needs clarification2
FileClaim Story ConfidenceWARNS372%Needs attention1
RepairInvoice vs Authorization MismatchWARNS285%Invoice 10% over estimate2
EvidenceTranscript Not AvailableWARNS377%Needs attention1
FileRequired Evidence PresencePASSS289%All required documents present1
FileDocument Extractability / OCR RiskPASSS385%Documents are text-extractable2
FileStructured vs Narrative MismatchPASSS277%Structured fields match narrative1
CommsFirst Contact DelayPASSS273%First contact within SLA1
CommsNo-Update GapPASSS279%Regular updates provided1
CommsFinal Decision Explanation MissingPASSS277%Closure letter present1
RepairRepair Cycle Time OutlierPASSS294%Repair cycle within expected range1
RepairRework Loop DetectedPASSS283%Single repair cycle2
RepairSupplier Delay Attribution MissingPASSS371%Ownership clear2
TL/ValMissing Valuation Evidence PackPASSS171%Valuation evidence pack complete1
FinanceReserve Category MismatchPASSS384%Reserve categories correct1
FinanceDuplicate or Near-Duplicate PaymentsPASSS176%No duplicate payments detected2
RecoverySubrogation Expected but Not Set UpPASSS185%Recovery reserve created1
RecoveryTP Insurer Details MissingPASSS272%TP insurer details captured2
RecoveryExcess Recovery MissingPASSS276%Amount monitored2
EvidenceCritical Document MissingPASSS290%All expected documents present2
Evidence

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