Sort the claims inbox

Fields

• Email subject
• Email or letter text
• Attachment text

Questions

1. What is this claims item, judged by what the sender needs from us? Choice

   Read the subject, the body and the attachment text together, and classify the item by what the sender needs from us, not by what is attached. An invoice attached to an email that chases progress is a progress chaser. Choose Complaint only when complaining is the main purpose and the sender asks for nothing else on the claim; dissatisfaction inside a chaser or another request is recorded by the complaint question, not here.

   • New claim notification Reports a loss or incident we have not been told about before and asks to make a claim.
   • Further information on an open claim Sends photos, statements, documents or answers to our questions on a claim already open, without chasing or complaining as the main point.
   • Repair estimate or supplier invoice A repairer, contractor or supplier sends a quote or a bill for work, and asking for payment or approval of it is the point of the item.
   • Medical records or report Clinical notes, a medical report or treatment bills sent as evidence on an injury claim.
   • Legal correspondence A letter from a solicitor or claims representative: a letter of representation, a letter of claim, a settlement offer or legal argument. Court papers have their own option.
   • Court papers A claim form, particulars of claim, a court order or other papers issued or filed in court.
   • Complaint The main purpose is to complain about us; the sender asks for nothing else on the claim beyond putting it right.
   • Progress chaser Asks what is happening on the claim, when something will be done, or why nobody has replied, even if it also complains or encloses documents.
   • Settlement response Accepts, rejects or questions an offer we made to settle the claim.
   • Recovery demand Another insurer, a credit hire company or another party asks us to pay them back for a loss our customer caused.
   • Withdrawal The customer asks to withdraw or close the claim.
   • Supplier update A repairer, loss adjuster or other supplier reports progress on work we instructed, without asking for payment.
   • Not claims correspondence About a policy rather than a claim (renewal, cover change, cancellation), or marketing, a newsletter, spam or an automatic reply.

2. Does the sender express dissatisfaction with our service, decision or conduct? Yes / No

   Use the complaint definition in the context. Dissatisfaction counts whatever the main purpose of the item, and whether or not the sender uses the word "complaint". Frustration with the loss itself, such as the weather or a third party, is not dissatisfaction with us. Yes: The sender is unhappy with something we did, failed to do, or decided. No: The item expresses no dissatisfaction with us.

3. Does a solicitor or other legal representative act for the sender or claimant? Yes / No

   Answer from what the item says or where it comes from. A claims management company or a solicitor writing on the claimant's behalf counts. A friend or relative helping the customer does not. Yes: The item comes from a legal representative, or says one now acts for the claimant. No: Nothing in the item says a legal representative acts for anyone on this claim.

4. Does the sender say they are thinking of instructing a solicitor or taking legal action? Yes / No

   This is about the sender considering a solicitor or court action, without saying one already acts for them. It is a sign we need to contact the customer sooner and put the service right, never a reason to discourage them from getting legal advice. Going to the Financial Ombudsman Service is a complaint escalation, not legal action. Yes: The sender says they may instruct a solicitor, have spoken to one, or may take us to court. No: No such intention is stated, or a representative already acts for them, or the only escalation mentioned is the ombudsman.

5. Does the item demand payment or action by a stated date or within a stated period? Yes / No

   Use the time-limited demands in the context: a Part 36 offer, a letter of claim, court papers with a response date, or a demand that we pay or act by a stated date or within a stated period. A deadline the sender sets for escalating a complaint, such as going to the ombudsman by Friday, is not a demand. Do not work out whether any date has passed; that is done elsewhere. Yes: The item makes a demand of that kind or encloses papers that set one. No: No demand with a stated time appears, or the only deadline is for escalating a complaint.

6. Does the sender mention circumstances that may mean the customer needs extra support? Yes / No

   Use the four drivers in the context: health, life events, resilience and capability. Count only what the item says about the customer or someone in their household. Do not infer anything from tone, writing style or spelling. Yes: The item mentions health problems, disability, bereavement, old age, money trouble, a language or literacy barrier, or similar circumstances. No: The item mentions none of these.

7. Does the sender ask us to pay or reimburse something, or say a payment has not arrived? Yes / No

   Money mentioned only as background, or an invoice enclosed without any request, does not count. Yes: The sender asks us to pay, reimburse or cover a cost, or says a payment we agreed has not arrived. No: No payment is asked for or chased.

8. Does the sender ask the claim handler to decide or authorise something? Yes / No

   A decision is approving a repair or a supplier, agreeing a cost, accepting or denying liability, or authorising alternative accommodation or a hire car. Asking for information, an update or a date is not a decision, and a request to be paid or reimbursed is covered by the payment question, not this one. Yes: The sender asks for a decision or an authorisation of that kind. No: The sender asks for information, an update, a payment, or nothing at all.

9. How urgent is it to act on this claims item? Scale

   Judge the worst consequence of the item waiting in normal queue order, from what the item says. Do not compare dates with today; use only words such as "today", "tomorrow" or "this week".

   • Routine Can wait its turn in the normal queue with no harm to anyone.
   • Soon Should be handled within two working days: a chaser, a question, or an inconvenience the customer can live with for now.
   • Urgent Same day: the customer has no heating, hot water, cooking facilities or usable home or vehicle, or a stated deadline is close.
   • Emergency Ongoing danger to people or property now, such as an active leak near electrics, a gas smell or an unsafe structure.

10. Is the item complete and readable enough to judge what it is? Yes / No

    Scanned letters come through OCR and can be garbled, cut off or blank. Poor spelling or grammar does not make an item unreadable if its meaning is clear. Yes: Enough of the text is readable to tell what the item is and what the sender wants. No: The text is too garbled, truncated or empty to judge.

Lens columns

item_type, item_type_probability, complaint_expressed, complaint_expressed_probability, legal_representation, legal_representation_probability, considering_legal_action, considering_legal_action_probability, time_limited_demand, time_limited_demand_probability, vulnerability_signal, vulnerability_signal_probability, payment_issue, payment_issue_probability, needs_decision, needs_decision_probability, urgency, urgency_average, text_readable, text_readable_probability