Claim CLM-2024-001024

Claim CLM-2024-001024
33/60

Key Facts

LOB:MOTOR
Loss Type:Hit and Run
Outcome:Settled
Amount:GBP 2,825
Risk Score:4 (low)
Date of Loss:2024-11-23
Settlement:GBP 2,825

Timeline

2024-11-23Incident occurred
2024-11-24Claim reported
2024-11-30Assessment completed
2024-12-05Decision made
2024-12-08Claim closed

Analysis

NEEDS REVIEW
1 FAIL3 WARN16 PASS
FAILS3Transcript Not Available
WARNS2Dispute Without Evidence Pack
WARNS2Promised Follow-Up Not Completed

Inspections

24 inspections
Summary
EvidenceTranscript Not AvailableFAILS379%No transcript of FNOL call2
LiabilityDispute Without Evidence PackWARNS288%Needs attention2
CommsPromised Follow-Up Not CompletedWARNS290%Follow-up delayed but completed1
RepairSupplier Delay Attribution MissingWARNS373%Needs attention1
LiabilityTP Present but Liability Not SetINCS342%Insufficient evidence to determine1
CommsFinal Decision Explanation MissingINCS238%Insufficient evidence to determine2
FinanceClosed with Open Financial ItemsINCS240%Insufficient evidence to determine1
RecoveryRecovery Reserve Without ActionINCS238%Insufficient evidence to determine2
FileRequired Evidence PresencePASSS274%Evidence pack complete2
FileDocument Extractability / OCR RiskPASSS384%No OCR issues detected1
FileTimeline CoherencePASSS288%No sequence anomalies1
FileStructured vs Narrative MismatchPASSS270%No field/notes conflict1
FileClaim Story ConfidencePASSS393%Claim story is complete2
CommsFirst Contact DelayPASSS286%First contact within SLA2
CommsNo-Update GapPASSS278%Regular updates provided2
RepairRepair Cycle Time OutlierPASSS294%Duration acceptable1
RepairRework Loop DetectedPASSS280%No rework detected1
RepairInvoice vs Authorization MismatchPASSS291%Invoice matches authorization2
FinancePayment Without Supporting ArtifactPASSS281%Artifacts linked1
FinanceReserve Category MismatchPASSS393%Reserve categories correct2
FinanceDuplicate or Near-Duplicate PaymentsPASSS184%No duplicate payments detected2
RecoverySubrogation Expected but Not Set UpPASSS190%Subrogation properly set up2
EvidenceCritical Document MissingPASSS272%All expected documents present1
EvidenceDocument Quality Too LowPASSS379%OCR confidence high2
Evidence

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