CLM-2024-0891

Pending Review

POL-2019-0044721 · Submitted by Thabo Nkosi · 04/06/2026 09:25

2 fields require manual verification

Claimant ID Number: ID number could not be fully verified against SARS format — confirm manually
Deceased ID Number: Handwriting ambiguous on digit 7 — verify against death certificate

Source Document

Page 1 of 3

Life Insurance Claim Form

Section 1 of 3

Policy Number

POL-2019-0044721

Bank Account No.

4082736591

Bank Name

First National Bank

Extracted Fields

Overall extraction confidence: 91% — all fields are editable

Bank Account Number

High 97%

Bank Name

High 94%

Policy Number

High 99%

Cause of Death

High 89%

Claimant Full Names

High 91%

Claimant Surname

High 96%

Claimant ID Number

Medium 78%

ID number could not be fully verified against SARS format — confirm manually

Deceased Full Names

High 93%

Deceased Surname

High 97%

Deceased ID Number

Medium 72%

Handwriting ambiguous on digit 7 — verify against death certificate

Deceased Date of Birth

High 88%

Policyholder Full Names

High 91%

Policyholder Surname

High 96%

Policyholder ID Number

High 91%

PDF uploaded
Thabo Nkosi
claim_form_MKH_2024_0891.pdf — 3 pages
04/06/2026 09:14
Extraction started
System (OCR Engine)
04/06/2026 09:14
Extraction completed
System (OCR Engine)
Overall confidence: 91% — 2 medium-confidence fields flagged
04/06/2026 09:14
Field override — Claimant ID
Thabo Nkosi
Manually corrected last 3 digits from 082 to 086
04/06/2026 09:22
Submitted for review
Thabo Nkosi
04/06/2026 09:25