Rules · 05

Business rules

The commercial and process rules the panel enforces for you.

These are the rules Claimpanel enforces for you. Most are built in as checks, so the panel will refuse an action that breaks one. The next chapter lists the refusal messages.

The principle behind the rules

Claimpanel is built so that the insurer decides, staff record, money is checked and everything is traceable. A rule exists wherever getting it wrong would cost us money, break an insurer agreement or breach the law.

1 · Instruction types and authority

Instruction type	What it means	Ends with
Survey & assessment	We survey and report; we do not buy repairs.	A reviewed report delivered to the insurer, then an assessment invoice.
Managed repairs	We survey (or use the insurer's scope), price, get approval, run the repair through contractors and invoice.	Validated repair phases, sales invoice, payment, ledger closed.

Choose the type at intake. A claim without a type is shown as unclassified and must be classified before it progresses.
An assessment can be extended into managed repairs. You need dated supporting authorisation from the insurer; the original type is kept in the history; the claim is not duplicated.
The assessment method (site visit, desktop review, existing insurer scope) is separate from the instruction type.

Rule: the insurer decides

The insurer decides coverage, declinature, cash settlement and repair approval. Staff record the decision and its supporting correspondence; the panel gives nobody delegated settlement authority.

Rule: no repair without authority

Before any purchase order or work phase, the latest recorded insurer decision must approve repairs and its supporting file must still be active on the claim. For an insurer-provided scope, staff must also record a review of that scope. For our own assessment, a reviewed report must have been delivered.

Rule: schedule control

A schedule of works is issued once. Further or changed work is a supplement. You cannot issue again until the insurer's decision on the previous issue is recorded. Lines are never silently edited after issue.

2 · Pricing and contractor confidentiality

Two prices per line. Every schedule-of-rates item has a client rate (what the insurer pays) and a contractor rate (what we pay).
Off-schedule work is priced by contractors first. The insurer rate is the awarded contractor rate plus the markup, built into the line rate, never shown as a separate line.
Markup order: a per-quote override beats the insurer's default markup, which beats the organisation default set in Settings → Pricing.
Competition. Several contractors can be asked to price the same scope. If you award a price that is not the lowest returned, you must record why.
Provisional sums are client-only: they are held with the insurer and are not given to contractors.

Rule: contractor prices never reach the insurer

Contractor rates, markup and margin must never appear on an insurer-facing document or screen, nor be visible to a user without the contractor-pricing permission. The RFQ document leaves with codes, descriptions, rooms, units and quantities only: no rate, total, insurer, insurer reference or policyholder name.

A purchase order is built from the awarded contractor price, never from the insurer quote, so our markup is never accidentally owed to the contractor.

3 · Contractor and surveyor compliance

Nobody gets work unless they pass two tests, in this order:

Onboarding: status must be Approved (not Onboarding, and not Suspended).
Compliance: every required record must be present, reviewed and valid on the date that matters, and any minimum cover must be met.

Required records start from a UK legal baseline: public and employers' liability insurance, Gas Safe, an electrical competent-person scheme, waste carrier registration, asbestos awareness or licence, F-gas, health and safety policy, RAMS, a UK GDPR data processing agreement, signed subcontractor agreement, professional indemnity and DBS, as applicable by trade and role.
Requirements can be added by network role, trade or insurance client (additive: general requirements always apply).
Evidence is a private PDF or image (up to 10 MB). Replacing evidence or editing its details clears the approval, and it must be reviewed again.
For an external surveyor, evidence must be valid today and on the appointment date.
Rejections and suspensions are audited decisions with a reason.
The compliance queue shows records expiring in 7, 14 and 30 days.

Not legal advice

The legal baseline is a starting point for review, not certification. Settings let management tighten or relax requirements; compliance and legal advisers should confirm them.

Construction Industry Scheme (CIS)

Each contractor carries a CIS status that sets the deduction: Gross (0%), Registered (20%), Not matched (30%) or Not construction work (does not apply).

4 · Money rules

Rule	Why
A contractor invoice cannot exceed what is left on its purchase order.	Stops overpaying a phase.
A payment is positive, cannot exceed the invoice balance and cannot predate the invoice. A payment reference is unique per invoice.	Stops double payments.
Paying a contractor needs verified bank details, or a payment reference and a written override reason.	Protects against payment fraud.
Bank details are entered by users who may record payments. Any change clears verification. Verification is a separate step by call-back to a known number, done by someone other than the person who changed them (a sole CEO may verify their own change).	Segregation of duties.
Bank numbers are encrypted and never shown in full or written to the audit log. Only the last four digits show.	Confidentiality.
A sales invoice cannot exceed the insurer-authorised value still to invoice. A final invoice needs every phase validated.	Never bill ahead of the work or the approval.
A credit note cannot exceed the invoice's unpaid balance, nor the net or VAT left on it. A credit after payment is a refund, which is not recorded.	Keeps the ledger consistent.
An assessment invoice needs the report delivered first.	You are paid for a delivered report.
An insurer receipt is positive, cannot exceed the invoice balance, cannot predate the invoice, and its reference is unique.	Clean receipts.
Additional costs (no purchase order) need restricted supplier evidence and cannot be recorded twice.	Complete cost trail.
A closed ledger refuses new invoices, credits, receipts, costs and cash payments until the CEO reopens it with a reason.	Final figures stay final.
A cash payment records what the insurer paid the policyholder or a third party. It needs a recorded insurer decision that allows payment (approved, cash settlement or partial repudiation), a payable category (not Professional fees) and an amount above zero. It is never edited: a wrong one is voided with a reason and stops counting in spend.	The insurer holds settlement authority; we keep an honest record.
Withdrawn outcomes decide the fee: prior to site survey allows no fee invoice; after site survey allows a survey fee once the survey is recorded as completed (no report needed); only survey report submitted and full client report submitted allow the fee. A withdrawn claim invoices an assessment fee against the agreed fee, never repair invoices.	You are paid for what was delivered before the instruction ended.
Spend passing the reserve turns the reserve balance red. It is a warning only and never blocks a record.	Alerts you to raise the reserve without halting work.
A repudiated or declined claim becomes Rejected. Partial repudiation does not authorise repairs by itself: the approved part is recorded on the schedule decision.	Repair authority comes only from a recorded approval.
Financial close needs: the remaining authorised value invoiced, insurer receipts recorded, every additional cost paid, every repair phase validated (or the assessment report delivered), customer acceptance recorded with defects resolved, and contractor invoices reconciled and paid.	Profit is only real when the money has moved.

The margin formula. Gross margin = revenue (net of credits) − contractor cost − other costs. For example: £5,000 approved − £3,700 contractor cost − £300 other costs = £1,000.

5 · Deadlines and working days

Deadlines are service levels set by management (see Settings). Defaults: first contact 1 hour; survey booked 2 working days; report 2 working days; schedule issued 5; pre-commencement 3; assign contractors 2; send instruction 1; contractor acceptance 2; pre-start meeting 3; book start 3; completion report 3; contractor invoice paid in 30 days; customer call 5 working days.
Working days skip Saturdays, Sundays and England and Wales bank holidays. The bank-holiday list is refreshed from GOV.UK every Monday at 03:15, and only ever adds dates.
Complaints use the FCA 8-week final response deadline.
The application runs on UK time (Europe/London). The database stores UK wall-clock times.

6 · Reasons and the audit trail

Anything important needs a reason: amending a claim, closing or reopening it, rejecting a phase, overriding a payment gate, awarding a non-lowest price, reopening the ledger, suspending a contractor, a document removal.
Every important change is recorded with who, when, what changed (old → new) and why. Instruction decisions are append-only: they are never edited or deleted.
Security-significant events (bank details changed or verified, exports of financial data, role changes) are logged explicitly.

7 · Data, access and privacy

Organisation boundary: every record belongs to an organisation. Another organisation's records are invisible and answer "not found", whatever the URL.
Least privilege: you see and do only what your role allows. Contractor prices, margin and finance are hidden from roles that do not hold those permissions.
Private files: documents are never public. Each is opened through a permission check and a 60-second signed link.
Contractors do not log in. They receive PDFs and emails; staff key in what they send back.
Two-factor is optional by decision, and recommended for CEO and CTO.
Customer and insurance information is sensitive business data. UK GDPR requirements (lawful basis, retention, subject requests) should be confirmed with your legal or compliance adviser: the panel does not claim certification.