Claim CLM-2024-001039

Claim CLM-2024-001039
56/60

Key Facts

LOB:MOTOR
Loss Type:Rear-end Collision
Outcome:Settled
Amount:GBP 1,326
Risk Score:0 (low)
Date of Loss:2024-10-27
Settlement:GBP 1,326

Timeline

2024-10-27Incident occurred
2024-10-28Claim reported
2024-11-02Assessment completed
2024-11-21Decision made
2024-11-26Claim closed

Analysis

NEEDS REVIEW
3 FAIL2 WARN17 PASS
FAILS2Split Liability Settlement Inconsistency
FAILS2First Contact Delay
FAILS2TP Insurer Details Missing

Inspections

25 inspections
Summary
LiabilitySplit Liability Settlement InconsistencyFAILS282%50/50 split but full payment made3
CommsFirst Contact DelayFAILS284%5 days to first contact2
RecoveryTP Insurer Details MissingFAILS282%TP insurer field blank3
FinanceClosed with Open Financial ItemsWARNS280%Small reserve open at closure2
EvidenceTranscript Not AvailableWARNS391%Needs attention1
FileRequired Evidence PresenceINCS234%Insufficient evidence to determine2
CommsNo-Update GapINCS244%Insufficient evidence to determine2
CommsPromised Follow-Up Not CompletedINCS245%Insufficient evidence to determine1
FileDocument Extractability / OCR RiskPASSS371%No OCR issues detected2
FileTimeline CoherencePASSS276%Timeline events are coherent1
FileStructured vs Narrative MismatchPASSS295%No field/notes conflict2
FileClaim Story ConfidencePASSS389%Claim story is complete1
CommsFinal Decision Explanation MissingPASSS287%Decision explanation sent2
RepairRepair Cycle Time OutlierPASSS271%Duration acceptable2
RepairRework Loop DetectedPASSS291%Single repair cycle2
RepairInvoice vs Authorization MismatchPASSS283%Invoice matches authorization1
RepairSupplier Delay Attribution MissingPASSS383%Delays documented and attributed2
TL/ValMissing Valuation Evidence PackPASSS189%Valuation evidence pack complete1
FinancePayment Without Supporting ArtifactPASSS281%Artifacts linked2
FinanceReserve Category MismatchPASSS388%Exposure aligned2
FinanceDuplicate or Near-Duplicate PaymentsPASSS184%Ledger clean2
RecoverySubrogation Expected but Not Set UpPASSS176%Subrogation properly set up1
RecoveryExcess Recovery MissingPASSS282%Amount monitored2
EvidenceCritical Document MissingPASSS278%All expected documents present2
EvidenceDocument Quality Too LowPASSS385%OCR confidence high1
Evidence

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