Claim CLM-2024-001016

Claim CLM-2024-001016
17/60

Key Facts

LOB:HOME
Loss Type:Subsidence
Outcome:Repaired
Amount:GBP 17,441
Risk Score:16 (low)
Date of Loss:2024-10-26
Settlement:GBP 17,441

Timeline

2024-10-26Incident occurred
2024-10-27Claim reported
2024-11-01Assessment completed
2024-11-20Decision made
2024-11-22Claim closed

Analysis

NEEDS REVIEW
4 FAIL7 WARN18 PASS
FAILS2Required Evidence Present (by Peril/Archetype)
FAILS2Settlement Method Consistent with Indemnity
FAILS2Unoccupied Condition Breach Materiality

Inspections

32 inspections
Summary
FileRequired Evidence Present (by Peril/Archetype)FAILS278%Missing surveyor report3
CoverageSettlement Method Consistent with IndemnityFAILS281%Settlement method not documented3
CoverageUnoccupied Condition Breach MaterialityFAILS277%Occupancy not relevant3
RecoveryRecovery Reserve Exists but No Action EvidenceFAILS294%Stalled for 60 days3
FileDocument Quality / OCR RiskWARNS375%Needs attention1
FileContents Itemisation CompletenessWARNS274%Needs attention1
CoverageUnderground Services Responsibility CheckWARNS275%Needs attention2
CommsFirst Contact TimelinessWARNS294%Needs attention2
RepairRepair Route Scope/Completion EvidenceWARNS274%Scope documented but completion unclear2
CashCash Settlement Offered with Documented RationaleWARNS281%Cash rationale brief but present2
CashVulnerability ConsideredWARNS285%Vulnerability noted but support minimal1
InvestGradual Damage Decisions Supported by ProofINCS239%Insufficient evidence to determine1
RepairRepair Quality Risk (Rework Loop)INCS243%Insufficient evidence to determine1
RecoveryRecovery Received Without Matching ExpectationINCS241%Insufficient evidence to determine1
FileClaim Timeline CoherencePASSS272%Timeline events are coherent2
FileStructured vs Narrative Mismatch (Loss Type/Cause/Pathway)PASSS292%Loss type coding matches narrative2
CoverageExclusion Invoked Without Evidence PackPASSS170%Exclusion supported by evidence pack1
CoverageSubsidence/Ground Movement Classification SupportedPASSS193%Subsidence classification supported1
InvestInvestigation Thoroughness RecordedPASSS289%All steps recorded2
InvestSubsidence Expert Evidence + Monitoring PresentPASSS186%Subsidence evidence pack complete2
InvestMajor Water Damage: Source and Mitigation EvidencePASSS279%Mitigation actions documented1
CommsNo-Update Gaps (Silence Periods)PASSS270%Regular updates provided1
CommsDecline/Partial Settlement Explanation QualityPASSS293%Decision explanation clear1
RepairRepairs Must Be Effective and LastingPASSS191%Quality verified2
CashCash Settlement Oversight & Monitoring PresentPASSS284%Monitoring active2
AltAccAA Need Assessed and DocumentedPASSS287%Habitability checked1
AltAccAA Timeline Aligns with Repair TimelinePASSS290%No gaps1
FinanceReserve/Exposure Structure PresentPASSS288%All cost areas covered2
FinanceLarge Reserves/Payments Have Approval TrailPASSS271%Authority verified1
FinancePayment Without Supporting DocumentPASSS278%All payments have supporting docs2
FinanceDuplicate Payments / Near-DuplicatesPASSS181%No duplicate payments detected2
FinanceClosed Claim with Open Reserves / Open TasksPASSS295%Clean closure2
Evidence

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