Claim CLM-2024-001020

Key Facts

LOB:MOTOR
Loss Type:Weather Damage
Outcome:Cash Settlement
Amount:GBP 9,383
Risk Score:16 (low)
Date of Loss:2024-10-28
Settlement:GBP 9,383

Timeline

2024-10-28Incident occurred
2024-10-29Claim reported
2024-11-03Assessment completed
2024-11-18Decision made
2024-11-21Claim closed

Analysis

NEEDS REVIEW
2 FAIL2 WARN18 PASS
FAILS2Deductions Without Justification
FAILS3Document Quality Too Low
WARNS2Promised Follow-Up Not Completed

Inspections

23 inspections
Summary
TL/ValDeductions Without JustificationFAILS279%1200 deduction without justification2
EvidenceDocument Quality Too LowFAILS384%Quality issue2
CommsPromised Follow-Up Not CompletedWARNS278%Follow-up delayed but completed1
RepairRepair Cycle Time OutlierWARNS283%Duration borderline2
FileRequired Evidence PresenceINCS240%Insufficient evidence to determine2
FileDocument Extractability / OCR RiskPASSS378%Documents are text-extractable2
FileTimeline CoherencePASSS290%No sequence anomalies2
FileStructured vs Narrative MismatchPASSS292%Structured fields match narrative1
FileClaim Story ConfidencePASSS388%Key facts documented1
LiabilityLiability Stance ContradictionPASSS288%Liability stance is consistent2
LiabilityTP Present but Liability Not SetPASSS391%TP liability tracked2
CommsFirst Contact DelayPASSS290%Timely customer engagement2
CommsNo-Update GapPASSS285%Regular updates provided1
CommsFinal Decision Explanation MissingPASSS279%Decision explanation sent1
RepairRework Loop DetectedPASSS276%Single repair cycle1
RepairInvoice vs Authorization MismatchPASSS279%Costs aligned1
RepairSupplier Delay Attribution MissingPASSS384%Delays documented and attributed2
FinancePayment Without Supporting ArtifactPASSS293%Artifacts linked2
FinanceReserve Category MismatchPASSS374%Reserve categories correct1
FinanceDuplicate or Near-Duplicate PaymentsPASSS177%No duplicate payments detected1
FinanceClosed with Open Financial ItemsPASSS273%No open items2
EvidenceCritical Document MissingPASSS295%All expected documents present2
EvidenceTranscript Not AvailablePASSS390%Transcript available1
Evidence

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