Claim CLM-2024-001056

Claim CLM-2024-001056
22/60

Key Facts

LOB:MOTOR
Loss Type:Fire
Outcome:Total Loss
Amount:GBP 13,904
Risk Score:16 (low)
Date of Loss:2024-11-04
Settlement:GBP 13,904

Timeline

2024-11-04Incident occurred
2024-11-05Claim reported
2024-11-07Assessment completed
2024-11-20Decision made
2024-11-22Claim closed

Analysis

NEEDS REVIEW
1 FAIL4 WARN15 PASS
FAILS2Critical Document Missing
WARNS1Duplicate or Near-Duplicate Payments
WARNS2Liability Stance Contradiction

Inspections

24 inspections
Summary
EvidenceCritical Document MissingFAILS277%Critical gap3
LiabilityLiability Stance ContradictionWARNS277%Liability stance ambiguous in notes2
CommsFinal Decision Explanation MissingWARNS270%Needs attention2
TL/ValSalvage Handling MissingWARNS274%Needs attention1
FinanceDuplicate or Near-Duplicate PaymentsWARNS192%Needs attention1
CommsFirst Contact DelayINCS246%Insufficient evidence to determine2
RepairSupplier Delay Attribution MissingINCS342%Insufficient evidence to determine1
FinancePayment Without Supporting ArtifactINCS231%Insufficient evidence to determine2
RecoveryTP Insurer Details MissingINCS244%Insufficient evidence to determine1
FileRequired Evidence PresencePASSS275%All required documents present1
FileDocument Extractability / OCR RiskPASSS371%Documents are text-extractable2
FileTimeline CoherencePASSS282%No sequence anomalies1
FileStructured vs Narrative MismatchPASSS289%Structured fields match narrative1
FileClaim Story ConfidencePASSS373%Key facts documented2
CommsNo-Update GapPASSS273%Regular updates provided2
CommsPromised Follow-Up Not CompletedPASSS287%Commitments honored1
RepairRepair Cycle Time OutlierPASSS291%Repair cycle within expected range1
RepairRework Loop DetectedPASSS287%No rework detected2
RepairInvoice vs Authorization MismatchPASSS274%Invoice matches authorization1
FinanceReserve Category MismatchPASSS378%Exposure aligned1
FinanceClosed with Open Financial ItemsPASSS286%Clean financial closure2
RecoverySubrogation Expected but Not Set UpPASSS180%Recovery reserve created1
EvidenceDocument Quality Too LowPASSS392%Document quality acceptable1
EvidenceTranscript Not AvailablePASSS375%Communication documented2
Evidence

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