Acceptance should mean that the production package meets a versioned carrier standard—not that the claim is covered, payable, settled or closed. Keep those decisions separate in both workflow permissions and reporting.
The following is a proposed property insurance claim file quality assurance checklist. Tailor it to the loss, jurisdiction and carrier requirements; do not treat it as an exhaustive investigation standard.
| Acceptance area | Required check |
|---|---|
| Identity and completeness | Correct claim, property and assignment; all required outputs present and readable |
| Inspection evidence | Relevant photographs, measurements and notes are indexed; missing or conflicting evidence is explicitly flagged |
| Scope and quantities | Included and omitted work can be explained; quantities reconcile to the sketch, measurement or documented calculation |
| Estimate settings | Applicable price-list version, location and carrier-approved settings are recorded; adjustments are explained |
| File consistency | Narrative, photographs, sketch, estimate and QA findings do not materially contradict one another |
| Exceptions | Uncertainty, specialist questions and coverage-related issues are escalated without invented conclusions |
| Approval and portability | Required review occurred; edits and reviewer identity are recorded; editable and readable deliverables work as specified |
Verisk’s published QR material describes separate review workflows, comparison of original and corrected estimates, reviewer calibration and checks involving measurements, scope and documentation. It establishes that such review functions exist; it does not establish a universal acceptable error rate. (verisk.com)
How should errors be classified?
Adopt a carrier-approved severity rubric before scoring:
- Critical: fabricated evidence, wrong-claim contamination, unauthorised decision/action or another defect with potentially serious consumer, legal or security consequences. Contain, investigate and retest before continuation.
- Material: unsupported or omitted scope, significant quantity error, wrong assumptions or another defect requiring substantive correction before the file is usable.
- Minor: a defect that requires correction but does not materially change the technical content or decision support.
- Preference only: an optional presentation change that does not fail the published standard.
Record overstatement and understatement separately. Do not allow them to cancel each other in a net dollar-error measure. A lower estimate is not, by itself, a better production outcome under this scorecard.
Sources cited on this page
- verisk.comverisk.com