Why Claims Fail Vetting (and How the 14-Point Gate Stops Them Early)

You've taken the call, gathered the documents, and sent the claim to your panel — only to get "not viable" back three weeks later. The claim wasn't unlucky. It failed one of a handful of checks you could have run on day one. Here's the framework that catches them before you spend a penny.

1. The old checklist is gone — and so are its assumptions

If you run a CMC or a housing-disrepair desk, you know the pattern. The call comes in: mould in the bedroom, boiler dead since winter, a tenant who has chased the landlord for months. You take details, gather what you can, and send it to the panel. Three weeks later: "not viable." You've burned intake time, correspondence, and a referral relationship — and learned only that you should have spotted the problem sooner.

Claims don't fail vetting because of bad luck. They trip one of a small number of checks — notice, limitation, tenant access, causation, evidence — and nobody ran them early enough. The good news: since 08/08/2026, England practice runs on a defined 14-point gate with explicit scoring, and every point can be assessed at intake.

First, the corrections — the old 11-point checklist taught four things that are now wrong:

1. Private landlords are not "out of scope." They are in scope, routed through section 11 of the Landlord and Tenant Act 1985 and the Homes (Fitness for Human Habitation) Act 2018. Awaab's Law — the statutory response clock under SI 2025/1042 — applies only to social landlords: councils and housing associations. If your old checklist rejected every private-landlord claim, you've thrown away viable cases.
2. There is no "12 weeks" notice rule. The pre-action protocol gives the landlord 20 working days to reply to the Letter of Claim (plus two days for deemed service). Notice is criterion c4 — a hard stop: pass or fail, nothing in between.
3. There is no £1,000 arrears ceiling and no £1,000 quantum threshold. Arrears are not a legal disqualifier — they're a funding and set-off risk (flagged to your funder above £500). Quantum is banded: £1,500+ strong; £800–£1,500 borderline; below £800 weak.
4. The hazard framework shrank. HHSRS now runs on 21 hazards under SI 2026/571 (in force 23/06/2026), scored HIGH ≥1,000 / MEDIUM 100–999 / LOW <100 — not the old 29.

The gate has 14 criteria: three hard stops (c4, c12, c14), ten scored criteria, and c13 (medical evidence), which applies only when health damages are claimed. It is an England gate — Wales runs under a separate framework this gate does not model.

2. The three hard stops — fail one, and the claim is RED

A hard stop is pass/fail only. No partial credit, no "we'll come back to it." Fail one, and the claim is RED before you look at any other criterion.

c4 — Notice to landlord (written). The landlord must have received written, timestamped notice: email, letter, or text. Verbal notice is a fail. It also starts the protocol clock — 20 working days to reply, plus two deemed-service days — and the landlord's failure to act is the backbone of your case. No notice, no claim.

c12 — Limitation period. The gate computes a conservative deadline: notice date plus six years. If the notice is more than six years old, the claim is out, full stop. But treat those six years as a ceiling, not a comfort zone: the Limitation Act 1980 clock actually runs from when the damage first occurred, so a claim can be time-barred well before the gate's conservative figure. The s.14A "discovery" exception is rarely available in housing claims, so assume it doesn't save you. If you can't establish the notice date at intake, the hard stop is unverified — which caps the whole claim at AMBER until you can.

c14 — Tenant access and landlord cooperation. If the landlord offered to inspect or repair and the tenant refused without a legitimate reason, that's a contractual bar. A claim can be otherwise perfect and still die here. Check at intake: has the tenant ever refused access? Why? Can you evidence the reason?

One hard stop unverified caps the rating at AMBER pending clarification. Only an explicit pass on all three keeps GREEN possible.

3. How the scoring actually works

Each criterion scores pass / partial / fail (or N/A where it genuinely doesn't apply). A pass earns the criterion's maximum points, a partial earns half (minimum 0.5), a fail earns zero.

• GREEN: all hard stops pass AND at least 18 points of the available maximum (26 when c13 is scored, 24 when it's N/A).
• AMBER: all hard stops pass but 12–17 points, or one hard stop unverified.
• RED: any hard stop failed, fewer than 12 points, a c3 fail (tenant-caused defect) with no mitigation, or c9 and c10 both failing (unverified evidence plus suspected spoliation).

One subtlety catches teams out: c13 is only scored when health damages are claimed. When N/A it's excluded from both the points total and the ceiling — scored out of 24, not penalised out of 26.

Vulnerability doesn't change the score, but it matters: where the tenant is disabled, chronically ill, under five, or elderly, the Equality Act 2010 triggers reasonable-adjustments duties, and person-centred factors strengthen the "significant hazard" assessment under Awaab's Law.

4. Where claims quietly die — the other eleven criteria

c1 — Landlord type and Awaab's Law gating. Awaab's Law (SI 2025/1042) applies to both kinds of social landlord — councils included. Since 27/10/2025, Phase 1 requires a 24-hour emergency response and a ten-working-day investigation for significant hazards. Private landlords are in scope via s.11 LTA 1985 and the HFHA 2018, but there's no Awaab's clock. Verify housing-association status against the RSH register — misclassification misroutes the claim.

c2 — Tenancy status and duration. A live tenancy of at least six months at claim date. Watch the s.11 exemptions — resident-landlord HMOs, licences. Post-vacation claims (ended over three months, damages-only) are weak.

c3 — Defect causation. Defect-type-specific: a building defect is the landlord's liability; a lifestyle or ventilation contribution reduces it; tenant-caused damage is a RED trigger. Mixed causation is AMBER pending an expert survey. Cosmetic-only condensation is not actionable.

c5 — Outstanding works and landlord response. Outstanding and unresponsive is strong; in progress is neutral; completed leaves a damages-only claim.

c6 — Recoverable quantum. Repair cost plus specials plus general damages (discomfort × duration). £1,500+ strong; £800–£1,500 borderline; under £800 weak — unless there's an Awaab's emergency breach, which is actionable regardless of quantum. And remember CPR 26.9: the claim sits outside the small claims track where the repair cost AND general damages each exceed £1,000, per Bellion v Nottingham. That shapes costs exposure and whether the claim is worth running.

c7 — Rent arrears. Not a disqualifier. Above £500, flag it to your funder and tell the client: it's a set-off and funding risk, not a legal one.

c8 — Design flaw vs repair failure. A repair failure is straightforward liability. An inherent design flaw with a maintenance duty is usually still the landlord's responsibility. A pure design defect with no duty is rarely actionable.

c9 — Baseline evidence verification. Every claim needs a baseline: written notice plus a dated photo, the landlord's written acknowledgement, or a third-party witness. Missing the initial notice is fatal (RED); missing a photo is recoverable (AMBER); allegation-only is RED.

c10 — Evidence spoliation. Redecoration within a week of notice, over the defect, is suspicious and invites an adverse inference; more than four weeks later is normally innocent. Ask about DIY at intake — you can't un-paint a wall.

c11 — HHSRS hazard index. Map the defect to the current 21-hazard framework under SI 2026/571, in the HIGH / MEDIUM / LOW bands. Damp and mould is hazard 11; excess cold is hazard 9. If the defect can't be mapped to a hazard, the fitness route is weak.

c13 — Medical evidence. Only when health impact is claimed: GP or hospital documentation with a temporal link. Unsubstantiated health damages fail this limb. Person-centred factors — a child under five, an elderly tenant, chronic respiratory conditions — strengthen the "significant hazard" case.

5. Worked walkthrough: one boiler claim, fourteen criteria

Marcus, a council tenant for 12 years, elderly, with chronic asthma. The boiler has been dead for 18 months. He emailed the housing team about it eight months ago (timestamped, acknowledged). Nothing has been repaired. Photos are dated; his GP confirms his asthma worsened over the same period. He has never refused access. Estimated repairs £4,800; general damages around £2,500.

All three hard stops pass and points exceed 18: GREEN. Awaab's Law applies (social landlord), the vulnerability flag (elderly, asthma) is on, and because the repair cost and general damages each exceed £1,000 the claim is not small claims under CPR 26.9. Instruct with confidence.

Now change one fact: Marcus told the housing team verbally — no email, letter, or text. c4 fails, a hard stop. The claim is RED whether it scores 0 or 24. No surveyor instruction, no panel referral, no wasted spend.

One more: the notice email exists but the date is unclear. c4 is unverified — the claim caps at AMBER until the notice is produced. Not dead, but not going anywhere until you can prove the hard stop.

6. Put the gate to work — seven steps

1. Rebuild your intake form around the 14 criteria, in order. Collect the same fields every call: landlord type (verify HA status on the RSH register), tenancy start, defect and cause, notice date and format, outstanding works, quantum estimate, arrears, baseline evidence, DIY history, health impact, access history.
2. Ask the notice question twice. "Did the landlord know?" is not the same as "Show me the written, timestamped notice." Train staff to accept nothing verbal.
3. Date everything at intake. The notice date drives c4 and c12 — the criteria that most often kill claims. No date, no claim.
4. Run the hard stops first. Notice, limitation, access. If any of the three fails, reject in minutes — don't complete the other eleven.
5. Don't reject private-landlord claims on principle. Route them via s.11 LTA 1985 / HFHA 2018. Awaab's Law won't apply, but the claim can be perfectly viable.
6. Record a one-line rejection reason per criterion. "c4 — verbal-only notice" teaches your team more than any training session.
7. Automate the checklist, not the judgment. The gate is mechanical — let software run it. HDR Compass (hdrcompass.co.uk) automates this exact 14-point England gate: connect a local folder and it reads the documents in your browser — nothing uploaded, no case data stored — on your firm's own AI key, exporting a 13-section vetting report to firm storage. It is advisory and human-in-the-loop: a fee earner reviews every output before use. The machine runs the checklist; the fee earner makes the call.

7. The takeaway

The claims that fail your vetting next month will fail for the same reasons they failed last month: a missing notice, a stale limitation clock, a refused access, unverified evidence. None of it is mysterious, and none of it needs to cost you a panel referral.

Run the 14 criteria at intake. Let the three hard stops do the rejecting. Score the rest, and let AMBER buy you time to verify rather than guess. That's the difference between a vetting process that burns money and one that filters it.

Do this this week: score your last ten rejected claims against the 14-point gate. Count how many failed on a hard stop you could have caught on the first call, then rebuild your intake form around the criteria that failed. And if you'd rather have the checklist run for you, see how fast the gate at hdrcompass.co.uk turns a stack of documents into a decision.