Claim CLM-2024-001032

Claim CLM-2024-001032
53/60

Key Facts

LOB:MOTOR
Loss Type:Weather Damage
Outcome:Cash Settlement
Amount:GBP 14,083
Risk Score:0 (low)
Date of Loss:2024-11-18
Settlement:GBP 14,083

Timeline

2024-11-18Incident occurred
2024-11-19Claim reported
2024-11-23Assessment completed
2024-12-01Decision made
2024-12-05Claim closed

Analysis

NEEDS REVIEW
4 FAIL8 WARN12 PASS
FAILS2Timeline Coherence
FAILS2Deductions Without Justification
FAILS2Payment Without Supporting Artifact

Inspections

27 inspections
Summary
FileTimeline CoherenceFAILS291%Closure before assessment3
TL/ValDeductions Without JustificationFAILS282%Unexplained adjustment3
FinancePayment Without Supporting ArtifactFAILS293%3500 payment without invoice3
EvidenceCritical Document MissingFAILS280%Police report missing for theft claim3
FileStructured vs Narrative MismatchWARNS291%Review recommended2
FileClaim Story ConfidenceWARNS383%Needs attention2
LiabilityLiability Stance ContradictionWARNS287%Liability stance ambiguous in notes2
LiabilityDispute Without Evidence PackWARNS287%Needs attention1
RepairRework Loop DetectedWARNS279%Needs attention1
FinanceDuplicate or Near-Duplicate PaymentsWARNS193%Needs attention2
RecoveryExcess Recovery MissingWARNS280%Monitor status1
EvidenceDocument Quality Too LowWARNS382%Needs attention1
FileDocument Extractability / OCR RiskINCS347%Insufficient evidence to determine1
CommsFinal Decision Explanation MissingINCS235%Insufficient evidence to determine1
RecoverySubrogation Expected but Not Set UpINCS147%Insufficient evidence to determine2
FileRequired Evidence PresencePASSS287%All required documents present2
LiabilityTP Present but Liability Not SetPASSS375%TP liability tracked1
CommsFirst Contact DelayPASSS283%First contact within SLA2
CommsNo-Update GapPASSS271%Regular updates provided1
CommsPromised Follow-Up Not CompletedPASSS278%Commitments honored1
RepairRepair Cycle Time OutlierPASSS274%Repair cycle within expected range1
RepairInvoice vs Authorization MismatchPASSS283%Invoice matches authorization2
RepairSupplier Delay Attribution MissingPASSS386%Delays documented and attributed1
FinanceReserve Category MismatchPASSS375%Exposure aligned1
FinanceClosed with Open Financial ItemsPASSS291%No open items2
RecoveryRecovery Reserve Without ActionPASSS285%Progress evidenced1
EvidenceTranscript Not AvailablePASSS385%Transcript available1
Evidence

Select an inspection to view evidence