Claim CLM-2024-001011

Claim CLM-2024-001011
48/60

Key Facts

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Loss Type:Theft - Contents
Outcome:Repaired
Amount:GBP 29,258
Risk Score:0 (low)
Date of Loss:2024-10-29
Settlement:GBP 29,258

Timeline

2024-10-29Incident occurred
2024-10-30Claim reported
2024-11-03Assessment completed
2024-12-09Decision made
2024-12-11Claim closed

Analysis

NEEDS REVIEW
3 FAIL3 WARN16 PASS
FAILS1Third Party Involvement but No Recovery Reserve
FAILS2Required Evidence Present (by Peril/Archetype)
FAILS2AA Need Assessed and Documented

Inspections

29 inspections
Summary
FileRequired Evidence Present (by Peril/Archetype)FAILS290%Missing surveyor report3
AltAccAA Need Assessed and DocumentedFAILS277%Habitability not assessed3
RecoveryThird Party Involvement but No Recovery ReserveFAILS187%Neighbour liable but no recovery3
RepairRepair Route Scope/Completion EvidenceWARNS271%Verify1
FinanceReserve/Exposure Structure PresentWARNS286%Needs attention1
FinanceClosed Claim with Open Reserves / Open TasksWARNS284%Small reserve open at closure2
FileClaim Timeline CoherenceINCS235%Insufficient evidence to determine1
InvestSubsidence Expert Evidence + Monitoring PresentINCS137%Insufficient evidence to determine1
CommsNo-Update Gaps (Silence Periods)INCS231%Insufficient evidence to determine1
CommsDecline/Partial Settlement Explanation QualityINCS249%Insufficient evidence to determine1
CashCash Settlement Oversight & Monitoring PresentINCS231%Insufficient evidence to determine1
FinancePayment Without Supporting DocumentINCS247%Insufficient evidence to determine1
FinanceDuplicate Payments / Near-DuplicatesINCS146%Insufficient evidence to determine2
FileDocument Quality / OCR RiskPASSS386%Documents are text-extractable1
FileStructured vs Narrative Mismatch (Loss Type/Cause/Pathway)PASSS273%No field/notes conflict2
FileContents Itemisation CompletenessPASSS279%All items captured1
CoverageSettlement Method Consistent with IndemnityPASSS273%Settlement method documented with rationale1
CoverageExclusion Invoked Without Evidence PackPASSS183%Expert report confirms2
CoverageStorm Claim Definition/Conditions AppliedPASSS176%Weather evidence present1
InvestInvestigation Thoroughness RecordedPASSS287%Investigation thoroughly documented1
InvestGradual Damage Decisions Supported by ProofPASSS277%Gradual damage proof documented1
CommsFirst Contact TimelinessPASSS293%First contact within SLA2
RepairRepair Quality Risk (Rework Loop)PASSS283%Single repair cycle1
RepairOutsourced Handling Oversight PresentPASSS277%QA checks recorded2
CashCash Settlement Offered with Documented RationalePASSS278%Cash settlement rationale documented2
CashVulnerability ConsideredPASSS283%Tailored support offered1
FinanceLarge Reserves/Payments Have Approval TrailPASSS290%Large payments have approval trail1
RecoveryRecovery Reserve Exists but No Action EvidencePASSS290%Recovery actions documented1
RecoveryRecovery Received Without Matching ExpectationPASSS289%Expected vs received matched2
Evidence

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