Claim CLM-2024-001027

Claim CLM-2024-001027
34/60

Key Facts

LOB:MOTOR
Loss Type:Collision - Third Party
Outcome:Settled
Amount:GBP 7,016
Risk Score:4 (low)
Date of Loss:2024-11-30
Settlement:GBP 7,016

Timeline

2024-11-30Incident occurred
2024-12-01Claim reported
2024-12-05Assessment completed
2024-12-13Decision made
2024-12-18Claim closed

Analysis

NEEDS REVIEW
5 FAIL2 WARN18 PASS
FAILS2Timeline Coherence
FAILS2Repair Cycle Time Outlier
FAILS2Closed with Open Financial Items

Inspections

27 inspections
Summary
FileTimeline CoherenceFAILS274%Payment dated before loss2
RepairRepair Cycle Time OutlierFAILS292%Major delay2
FinanceClosed with Open Financial ItemsFAILS271%Unclean closure3
RecoveryRecovery Reserve Without ActionFAILS292%Recovery reserve but no action for 30 days2
EvidenceCritical Document MissingFAILS289%Critical gap2
FileClaim Story ConfidenceWARNS388%Needs attention2
LiabilityDispute Without Evidence PackWARNS295%Needs attention2
TL/ValSalvage Handling MissingINCS243%Insufficient evidence to determine2
RecoveryExcess Recovery MissingINCS246%Insufficient evidence to determine2
FileRequired Evidence PresencePASSS278%All required documents present2
FileDocument Extractability / OCR RiskPASSS381%Documents are text-extractable2
FileStructured vs Narrative MismatchPASSS272%Structured fields match narrative2
LiabilityLiability Stance ContradictionPASSS285%No contradictions found1
LiabilityTP Present but Liability Not SetPASSS386%TP liability tracked1
CommsFirst Contact DelayPASSS272%First contact within SLA2
CommsNo-Update GapPASSS289%Regular updates provided2
CommsPromised Follow-Up Not CompletedPASSS280%Commitments honored2
CommsFinal Decision Explanation MissingPASSS283%Closure letter present2
TL/ValMissing Valuation Evidence PackPASSS175%Valuation evidence pack complete2
TL/ValDeductions Without JustificationPASSS278%Evidence supports adjustments1
FinancePayment Without Supporting ArtifactPASSS289%Artifacts linked2
FinanceReserve Category MismatchPASSS381%Exposure aligned1
FinanceDuplicate or Near-Duplicate PaymentsPASSS189%No duplicate payments detected2
RecoverySubrogation Expected but Not Set UpPASSS182%Subrogation properly set up2
RecoveryTP Insurer Details MissingPASSS294%Contact info present2
EvidenceDocument Quality Too LowPASSS392%OCR confidence high1
EvidenceTranscript Not AvailablePASSS392%Transcript available2
Evidence

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