Claims Decision · Reconstructability · Regulatory Scrutiny

When a claim is reopened
18 months later,
do you defend the decision —
or defend the narrative?

Most insurers can describe their governance framework. Far fewer can independently reconstruct the exact decision-state, policy version, authority delegation, override logic, and human acceptance long after execution.

Veriscopic conducts independent reconstruction testing across automated and AI-assisted claims workflows, identifying where defensibility is structurally durable — and where exposure scales silently.

Independent evidentiary reconstruction. No compliance certification. No retrospective narrative engineering.

Why reconstructability matters

A single poorly evidenced claim can trigger ombudsman escalation, litigation exposure, reserve volatility, and reputational scrutiny.

Reconstruction failure rarely arises from intent. It arises from missing version history, authority ambiguity, override opacity, or decision-state drift.

The cost of one contested claim can materially exceed the cost of systemic defensibility testing.

Engagement Levels

LEVEL 1

Reconstruction Diagnostic

£12,000 – £15,000

Interview-led simulation of how one historic claims decision would perform under regulatory or ombudsman scrutiny.

  • Scenario-based reconstruction walkthrough
  • Decision boundary and version review
  • Gap identification
  • Executive summary briefing

Designed for awareness and initial exposure mapping.

LEVEL 2

Structural Defensibility Assessment

£45,000 – £60,000

Independent reconstruction across multiple live claims pathways, producing defensibility ratings and systemic exposure analysis.

  • Reconstruction testing across 2–3 workflows
  • Authority-chain validation
  • Policy and version traceability review
  • Override governance analysis
  • Structural defensibility rating
  • Board-ready architecture report

Moves from single-decision protection to systemic insight.

LEVEL 3

Claims Defensibility Programme

£85,000 – £120,000

Multi-workflow reconstruction, anchored evidence issuance, and systemic defensibility architecture designed to withstand regulator, ombudsman, reinsurer, and litigation scrutiny.

  • Reconstruction testing across 3–5 claim pathways
  • Decision-state reproducibility analysis
  • Cross-team authority consistency review
  • Anchored evidence artefact generation
  • Structural exposure rating
  • Executive and board session
  • Regulator-facing defensibility memorandum

Where Level 2 identifies fragility, Level 3 establishes scrutiny-ready posture.

FORENSIC SIMULATION BRIEFING

Review a reconstructed claims decision under scrutiny conditions

Institutional-style example demonstrating where evidentiary durability typically breaks down 12–18 months after execution.

Pressure-test your claims deployment before it is reopened under scrutiny.