Claim CLM-2024-001030

Claim CLM-2024-001030
35/60

Key Facts

LOB:MOTOR
Loss Type:Vandalism
Outcome:Denied
Amount:GBP 1,271
Risk Score:4 (low)
Date of Loss:2024-11-01
Settlement:GBP 1,271

Timeline

2024-11-01Incident occurred
2024-11-02Claim reported
2024-11-06Assessment completed
2024-11-25Decision made
2024-11-27Claim closed

Analysis

NEEDS REVIEW
1 FAIL2 WARN20 PASS
FAILS2TP Insurer Details Missing
WARNS1Subrogation Expected but Not Set Up
WARNS3Document Quality Too Low

Inspections

25 inspections
Summary
RecoveryTP Insurer Details MissingFAILS287%Contact missing3
RecoverySubrogation Expected but Not Set UpWARNS173%Needs attention2
EvidenceDocument Quality Too LowWARNS376%Needs attention2
FileDocument Extractability / OCR RiskINCS331%Insufficient evidence to determine2
FinanceClosed with Open Financial ItemsINCS244%Insufficient evidence to determine2
FileRequired Evidence PresencePASSS283%All required documents present1
FileTimeline CoherencePASSS284%No sequence anomalies2
FileStructured vs Narrative MismatchPASSS281%Structured fields match narrative2
FileClaim Story ConfidencePASSS383%Key facts documented1
LiabilityTP Present but Liability Not SetPASSS393%Liability properly set for TP claim2
LiabilityDispute Without Evidence PackPASSS292%Dispute has evidence support1
LiabilitySplit Liability Settlement InconsistencyPASSS286%Split liability correctly reflected1
CommsFirst Contact DelayPASSS277%First contact within SLA2
CommsNo-Update GapPASSS281%No communication gaps2
CommsPromised Follow-Up Not CompletedPASSS278%Follow-ups completed as promised1
CommsFinal Decision Explanation MissingPASSS280%Decision explanation sent2
RepairRepair Cycle Time OutlierPASSS283%Repair cycle within expected range1
RepairRework Loop DetectedPASSS282%No rework detected1
RepairInvoice vs Authorization MismatchPASSS277%Invoice matches authorization2
RepairSupplier Delay Attribution MissingPASSS382%Ownership clear1
FinancePayment Without Supporting ArtifactPASSS288%Payments have supporting docs1
FinanceReserve Category MismatchPASSS388%Exposure aligned2
FinanceDuplicate or Near-Duplicate PaymentsPASSS193%Ledger clean1
EvidenceCritical Document MissingPASSS271%File complete1
EvidenceTranscript Not AvailablePASSS392%Transcript available1
Evidence

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