Key Facts
LOB:MOTOR
Loss Type:Collision - Third Party
Outcome:Denied
Amount:GBP 12,608
Risk Score:4 (low)
Date of Loss:2024-11-20
Settlement:GBP 12,608
Timeline
Analysis
WARNING
0 FAIL7 WARN13 PASS
WARNS1Duplicate or Near-Duplicate Payments
WARNS2Required Evidence Presence
WARNS2Payment Without Supporting Artifact
Inspections
23 inspectionsSummary
FileRequired Evidence PresenceWARNS287%Some supporting docs unclear1
FileDocument Extractability / OCR RiskWARNS384%Needs attention2
FinancePayment Without Supporting ArtifactWARNS289%Needs attention2
FinanceDuplicate or Near-Duplicate PaymentsWARNS186%Needs attention1
FinanceClosed with Open Financial ItemsWARNS288%May be intentional1
RecoveryRecovery Reserve Without ActionWARNS287%Needs attention2
EvidenceTranscript Not AvailableWARNS385%Needs attention2
CommsFinal Decision Explanation MissingINCS231%Insufficient evidence to determine2
RecoveryTP Insurer Details MissingINCS243%Insufficient evidence to determine1
EvidenceDocument Quality Too LowINCS347%Insufficient evidence to determine2
FileTimeline CoherencePASSS271%No sequence anomalies2
FileStructured vs Narrative MismatchPASSS274%Structured fields match narrative2
FileClaim Story ConfidencePASSS387%Key facts documented2
LiabilityLiability Stance ContradictionPASSS271%No contradictions found1
LiabilityTP Present but Liability Not SetPASSS395%Liability properly set for TP claim1
CommsFirst Contact DelayPASSS277%Timely customer engagement2
CommsNo-Update GapPASSS278%No communication gaps1
CommsPromised Follow-Up Not CompletedPASSS286%Commitments honored1
RepairInvoice vs Authorization MismatchPASSS279%Costs aligned1
FinanceReserve Category MismatchPASSS384%Exposure aligned1
RecoverySubrogation Expected but Not Set UpPASSS171%Recovery reserve created2
RecoveryExcess Recovery MissingPASSS271%Amount monitored2
EvidenceCritical Document MissingPASSS279%File complete2
Evidence
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