Claim CLM-2024-001029

Claim CLM-2024-001029
45/60

Key Facts

LOB:MOTOR
Loss Type:Fire
Outcome:Cash Settlement
Amount:GBP 16,463
Risk Score:2 (low)
Date of Loss:2024-11-15
Settlement:GBP 16,463

Timeline

2024-11-15Incident occurred
2024-11-16Claim reported
2024-11-18Assessment completed
2024-11-22Decision made
2024-11-26Claim closed

Analysis

NEEDS REVIEW
2 FAIL1 WARN20 PASS
FAILS2Timeline Coherence
FAILS2Promised Follow-Up Not Completed
WARNS3Document Quality Too Low

Inspections

25 inspections
Summary
FileTimeline CoherenceFAILS279%Closure before assessment2
CommsPromised Follow-Up Not CompletedFAILS282%Promised callback not made3
EvidenceDocument Quality Too LowWARNS383%Needs attention1
FileDocument Extractability / OCR RiskINCS332%Insufficient evidence to determine2
FinanceDuplicate or Near-Duplicate PaymentsINCS140%Insufficient evidence to determine1
FileRequired Evidence PresencePASSS277%All required documents present2
FileStructured vs Narrative MismatchPASSS282%Structured fields match narrative2
FileClaim Story ConfidencePASSS373%Claim story is complete2
LiabilityTP Present but Liability Not SetPASSS372%Liability properly set for TP claim2
CommsFirst Contact DelayPASSS289%Timely customer engagement2
CommsNo-Update GapPASSS280%Regular updates provided2
CommsFinal Decision Explanation MissingPASSS280%Decision explanation sent1
RepairRepair Cycle Time OutlierPASSS272%Duration acceptable1
RepairRework Loop DetectedPASSS295%Single repair cycle1
RepairInvoice vs Authorization MismatchPASSS271%Invoice matches authorization2
RepairSupplier Delay Attribution MissingPASSS381%Delays documented and attributed2
TL/ValDeductions Without JustificationPASSS292%Evidence supports adjustments1
TL/ValSettlement Amount OutlierPASSS293%Settlement aligned with valuation1
FinancePayment Without Supporting ArtifactPASSS280%Artifacts linked1
FinanceReserve Category MismatchPASSS380%Exposure aligned1
FinanceClosed with Open Financial ItemsPASSS279%No open items1
RecoveryTP Insurer Details MissingPASSS291%TP insurer details captured1
RecoveryRecovery Reserve Without ActionPASSS292%Progress evidenced2
EvidenceCritical Document MissingPASSS274%All expected documents present1
EvidenceTranscript Not AvailablePASSS374%Communication documented1
Evidence

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