Read every document. Separate what is confirmed from what is claimed, and note what is missing.
From: Claims Director
Confirmed fraud savings are up 30% year on year. We propose auto-declining claims that score above 0.95 to cut SIU workload.
| Measure | Result |
|---|---|
| Claims scored | 10,000 |
| Routed to SIU | 600 |
| Confirmed fraud | 90 |
| Cleared as genuine | 410 |
| Still open after 30 days | 100 |
| Average days held, genuine claims | 23 working days |
From: Pricing analytics (informal)
| Area deprivation band | Share of claims | SIU referral rate |
|---|---|---|
| 1 (least deprived) | 22% | 3% |
| 2 | 21% | 4% |
| 3 | 20% | 6% |
| 4 | 19% | 8% |
| 5 (most deprived) | 18% | 11% |
My roof was damaged in the storm. Seven weeks later I still have tarpaulin on it and nobody will tell me why. I have been with you for 22 years. I feel like I am being treated as a criminal.
Your claim is currently under review. We will contact you when the review is complete. Thank you for your patience.
Keep these three apart. A decision-maker needs to know which is which.
What does the evidence pack establish?
What is asserted by the supplier or the business but not yet evidenced?
Show any calculation. Say what the figures do and do not tell you.
Name the specific documents, data or tests you would ask for
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