Claim CLM-2024-001055

Key Facts

LOB:MOTOR
Loss Type:Vandalism
Outcome:Repaired
Amount:GBP 5,357
Risk Score:4 (low)
Date of Loss:2024-11-17
Settlement:GBP 5,357

Timeline

2024-11-17Incident occurred
2024-11-18Claim reported
2024-11-24Assessment completed
2024-12-09Decision made
2024-12-13Claim closed

Analysis

NEEDS REVIEW
4 FAIL5 WARN13 PASS
FAILS1Subrogation Expected but Not Set Up
FAILS2Liability Stance Contradiction
FAILS2Repair Cycle Time Outlier

Inspections

24 inspections
Summary
LiabilityLiability Stance ContradictionFAILS270%Contradiction detected2
RepairRepair Cycle Time OutlierFAILS292%Major delay3
FinanceClosed with Open Financial ItemsFAILS277%Claim closed with 800 open reserve2
RecoverySubrogation Expected but Not Set UpFAILS188%Recovery missed3
FileDocument Extractability / OCR RiskWARNS383%Needs attention1
FileClaim Story ConfidenceWARNS389%Needs attention1
RepairRework Loop DetectedWARNS293%Needs attention1
EvidenceCritical Document MissingWARNS278%Needs attention1
EvidenceDocument Quality Too LowWARNS394%Needs attention1
FileRequired Evidence PresenceINCS248%Insufficient evidence to determine1
RepairInvoice vs Authorization MismatchINCS233%Insufficient evidence to determine2
FileTimeline CoherencePASSS284%No sequence anomalies2
FileStructured vs Narrative MismatchPASSS285%Structured fields match narrative1
CommsFirst Contact DelayPASSS286%Timely customer engagement2
CommsNo-Update GapPASSS291%Regular updates provided1
CommsPromised Follow-Up Not CompletedPASSS281%Follow-ups completed as promised2
CommsFinal Decision Explanation MissingPASSS287%Decision explanation sent1
RepairSupplier Delay Attribution MissingPASSS390%Ownership clear1
FinancePayment Without Supporting ArtifactPASSS292%Artifacts linked1
FinanceReserve Category MismatchPASSS381%Reserve categories correct2
FinanceDuplicate or Near-Duplicate PaymentsPASSS174%Ledger clean1
RecoveryTP Insurer Details MissingPASSS279%TP insurer details captured2
RecoveryRecovery Reserve Without ActionPASSS280%Progress evidenced1
EvidenceTranscript Not AvailablePASSS388%Transcript available2
Evidence

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