claim-evidence

---
name: claim-evidence
description: Builds the evidence file a commercial insurance claim needs to be paid without delay, covering the claims condition clauses in a typical policy, what the Insurance Act 2015's fair presentation duty means once a loss has happened, the FCA's rule against unreasonable rejection, and a practical evidence-gathering sequence of photographs, receipts, stock records and a written incident log. Use after any damage, theft or interruption event, or to have the evidence in place before the loss, not after it.
---

# The proof a claim needs before the insurer asks for it, not after

You give this a description of the loss, the documents and photographs you hold, your policy's claims condition clauses, and the dates things happened. You get back an evidence checklist mapped to the clauses, a notification timeline against their deadline, a proof-of-loss pack built only from supplied documents, and a list of what is missing. It will not value the loss or decide what is paid, and it hands the employee-injury log and policy mapping to this pack's accident-book and cover-audit skills rather than repeating them.

## What it does

1. **Read the claims condition clause first, verbatim.** Most commercial policies require notice "as soon as possible" or within a stated number of days, often as a condition precedent to cover. Copy the clause with its section number and record whether it is a condition precedent.

2. **Notify within the clause's deadline, in writing, and record the mitigation taken separately.** A notification duty arises once there is a genuine, not fanciful, risk of a claim. Record the loss date, notice date and method against the deadline. Many policies also indemnify reasonable mitigation costs, sometimes on condition the insurer is given prior written notice before the cost is incurred; record what was done and whether that notice was given.

3. **Gather proof of loss the way a loss adjuster actually tests it.** For buildings, repair invoices, quotations and evidence of what was there before. For stock, purchase invoices, a physical count or a reconciliation from trading records, since "the onus of proof of loss rests with the insured" and a commercial claimant can reasonably be expected to hold purchase records "going back... typically at least 6 years".

4. **Timestamp photographic and CCTV evidence, and record the retention window.** Photographs of damage and the scene, each dated, alongside CCTV with the date recorded and the date it will be overwritten. A retention window that lapses before the claim is reported destroys evidence that otherwise existed.

5. **Keep a plain written incident log as the spine of the file, cross-referenced to the accident-book skill where an injury is also involved, which builds that log itself.**

6. **Separate the fair presentation question from the claim.** The Insurance Act 2015 duty sits alongside, not inside, the claims conditions; record what was declared at inception or renewal against what is now claimed, and flag any difference for the broker rather than resolving it here.

7. **Hand the mechanical work to Codex and keep the judgement here.** Run, from the folder holding the documents and the incident log:

   ```
   codex exec --sandbox danger-full-access --skip-git-repo-check -C "<working folder>" - < CODEX.md
   ```

   Claude hands over the clause verbatim, the notification dates, the mitigation record, the evidence inventory and the fair presentation comparison. Codex returns the checklist, the timeline, the proof-of-loss pack and a gaps file. Codex estimates no value and decides no entitlement.

## Then it checks

1. The claims condition clause is quoted verbatim with its section number, and marked as a condition precedent or not.
2. The notification date is compared against the clause's own deadline, and any gap is stated, not excused.
3. Every item of proof of loss is traceable to a supplied document, with no invented receipt, count or valuation.
4. Every photograph and CCTV entry carries a date and, for CCTV, a retention window.
5. The fair presentation comparison names any material difference without resolving it.

Any check fails: name it, redo that step once. Failed twice: say what is wrong and stop.

## Rules
- Public information only.
- Never invent a fact, a number or a quote.
- Anything sent in someone's name says whose name it is.
- Never value the loss, suggest a settlement figure, or state what the insurer will pay.
- Never decide whether a claim is fraudulent. Record the facts and leave the conclusion to the insurer and the broker.
- Never treat a missed notification deadline as curable here. Record the breach and its date.
- Never repeat the accident-book skill's injury classification or the cover-audit skill's policy mapping; reference each instead.
- This output is a working document for the owner's own FCA authorised broker or loss adjuster to check. It is not advice on the claim's value and not a statement it will be paid.

## Built from
- FCA Handbook, ICOBS 8.1, https://www.handbook.fca.org.uk/handbook/ICOBS/8/1.html, 8.1.1R effective 06/01/2008, 8.1.2B effective 01/08/2017, read 14 October 2026: fair, prompt claims handling and unreasonable rejection, steps 1 and 6.
- Insurance Act 2015, section 12, https://www.legislation.gov.uk/ukpga/2015/4/section/12, read 14 October 2026: fraudulent claim remedies, step 6.
- Insurance Act 2015, section 3, https://www.legislation.gov.uk/ukpga/2015/4/section/3, read 14 October 2026: the duty of fair presentation, step 6.
- Chartered Institute of Loss Adjusters, Mike Weatherhead, "Validation of Quantum", CILA Property SIG, https://cila.co.uk/wp-content/uploads/2025/05/cila-property-sig-validation-of-quantum.pdf, dated March 2018, read 14 October 2026: the onus of proof and the evidence sequence, step 3.

# claim-evidence

## You are given
The loss event's date, location and cause as stated by the owner. The claims condition clause quoted verbatim with its section number and whether it is a condition precedent. The notice date given to the insurer and the method used. The mitigation record: action taken, date, cost, and whether prior written notice was given where required. Every proof-of-loss document, named, dated and described (invoice, quotation, stock count, bank statement, plan, prior photograph). Every photograph and CCTV entry with its date and, for CCTV, the retention window. The owner's comparison of what was declared at inception or renewal against what is now claimed, with any difference identified. All judgement calls are already made and supplied to you.

## Produce
Write into a `./claim-evidence-output/` folder:

1. `claims-condition.md` recording, on separate lines: the clause quoted verbatim, its section number, whether it is a condition precedent (`yes`, `no` or `not stated`), and the deadline it states in the owner's own words.
2. `notification-timeline.csv` with columns: `date_of_loss`, `date_notice_given`, `method`, `deadline_from_clause`, `within_deadline`. `within_deadline` is `yes`, `no` or `cannot be determined`, calculated only where both dates and deadline length are supplied.
3. `mitigation-record.csv` with columns: `action_ref` (M001 upward), `action_taken`, `date`, `cost_gbp`, `prior_notice_required`, `prior_notice_given` (each `yes`, `no` or `not stated`).
4. `proof-of-loss.csv` with columns: `item_ref` (P001 upward), `item_description`, `document_type` (one of `purchase invoice`, `repair invoice or quotation`, `stock count`, `stock reconciliation`, `bank or credit card statement`, `plan or prior photograph`, `other`), `document_date`, `source_document`. No row without a named `source_document`.
5. `photographic-evidence.csv` with columns: `photo_ref`, `description`, `date_taken`, `is_cctv` (`yes`/`no`), `cctv_retention_window` (empty where not CCTV).
6. `fair-presentation-comparison.md` recording, on separate lines, each difference the owner identified between what was declared and what is now claimed, with the item reference it relates to, and a line stating that this comparison is not a determination of fraud or breach.
7. `gaps.md` a numbered list of: any claims condition deadline with no supplied length; any notification date missing; any mitigation action with `prior_notice_required` as `yes` and `prior_notice_given` as `no` or `not stated`; any proof-of-loss item with no source document; any photograph with no date; and any CCTV entry with no retention window.

## Rules
- Codex transcribes, compares dates against supplied deadlines, and sorts. It never values a loss, never decides fraud, and never decides timeliness where the deadline is ambiguous or not stated.
- Never fill `document_date` or `cost_gbp` from an estimate; leave empty and record the gap.
- Never record `within_deadline` as `yes` or `no` where the deadline length was not supplied; record `cannot be determined`.
- British English, GBP as `GBP`, DD Month YYYY dates, no em dashes.
- Every file ends: this is a working document for the owner's own FCA authorised broker or loss adjuster. It is not advice on value and not a statement the claim will be paid.

## Return
The absolute path of every file written, the row count of each CSV, the notification timeline result, the count of mitigation actions where required prior notice was not given, the count of proof-of-loss items by document type, the count of photographs with no CCTV retention window recorded, every difference listed in `fair-presentation-comparison.md`, and the `gaps.md` item count.