“Insurer Worded Engineering Reports”: How They Impact Insurance Claims

In the intricate dance of insurance claims, especially following disasters or accidents, a pivotal player often goes unnoticed: the engineering report. This technical document, penned by engineers typically hired by insurance companies, holds the power to sway the fate of a claim. However, a growing concern shadows this process—bias in these engineering reports.

If an engineering report is inaccurate, it can prevent you from having your claim covered. That’s why it’s crucial to understand how these reports work and where bias can sneak in.

Understanding Insurance Engineering Reports

An insurance engineering report is a document prepared by an engineer, usually retained by an insurance company, to assess and provide professional opinions on various aspects related to a policy claim. These reports can cover a range of topics, such as the cause of damage, the extent of damage, the necessary repairs, and the estimated costs of those repairs.

Insurance engineering reports are often used in claims related to property damage, like those resulting from natural disasters, accidents, or other incidents, to determine the legitimacy and value of the claim. The accuracy and impartiality of these reports are crucial, as they can significantly impact the outcome of an insurance claim, with potential impacts including:

• Assessment of Damage and Cause: These reports provide a technical evaluation of the damage and its cause. This assessment is crucial in determining whether the damage is covered under the policy.
• Estimation of Repair Costs: They offer an estimate of the repair costs, which influences the amount the insurer will pay.
• Policy Coverage Determination: The report can influence whether a claim falls within the policy’s coverage based on the cause and nature of the damage.
• Claim Settlement: A report that aligns with the insurer’s perspective (e.g., attributing damage to non-covered causes) can lead to claim denial or reduced payouts.
• Disputes and Legal Challenges: If policyholders disagree with the report’s findings, it can lead to conflicts, requiring further investigation or legal intervention.

What Is an Insurer-Worded Engineering Report?

Because of the variety of ways in which the engineering report impacts your claim, impartiality is crucial. The problem is that most of these reports are prepared by engineers who are being paid by the insurance company, either as full-time employees or preferred contractors. As such, engineers have incentives to write reports that lead to insurers paying less, even if that doesn’t reflect the reality of the situation.

That’s why “insurer-worded engineering reports” occur. These biased reports are written by engineers retained by insurance companies. They favor insurers by being worded in a way that supports the insurer’s interests, such as by dovetailing with policy exclusions or limitations. This practice can result in wrongful denials of policy claims.

There are a few other factors that make these inaccurate and biased reports more likely. First, every accident and natural disaster is different, and the damage to every property is unique. Every piece has to be custom-written, which means that there is a lot of room for the engineer to take “creative liberties” that benefit their employer.

Second, there isn’t a standard peer review process for these reports. While many firms do employ some form of peer review to confirm the accuracy of a report, the amount of actual review can vary dramatically. Furthermore, if the reviewer is also incentivized to favor the insurer, they may overlook problems with the report that would lead the insurer to pay out a larger settlement.

The issue of biased engineering reports is not isolated; it is a recurrent problem, particularly highlighted in cases like Superstorm Sandy, where policyholders’ claims were denied based on manipulated reports. Insurers rely on policyholders taking their word in the report regarding the damage and coverage to avoid paying claims that by rights should have been covered.

Identifying Unfair or Inaccurate Insurance Engineering Reports

In an ideal world, engineers and insurance companies would remain independent, so there would never be any bias involved in claims. However, that’s not currently the case. As such, it’s crucial to understand how to identify whether your claim has been properly evaluated, especially if your claim is denied or underpaid.

To identify if an engineering report is inaccurate or biased, consider the following steps:

• Expertise of the Engineer: Verify the engineer’s qualifications and area of expertise. Ensure they are relevant to the type of assessment being made.
• Comparison with Independent Reports: Obtain an independent assessment from another engineer or expert. Compare the findings for discrepancies.
• Consistency with Observable Damage: Check if the report’s conclusions align with the actual, visible damage.
• Language and Tone: Look for language that seems to favor the insurer unjustifiably, such as focusing excessively on policy exclusions or limitations.
• Review of Methodology: Assess the methods and tests used in the report. They should be standard, accepted practices in the field.
• Historical Performance: Research if the engineer or their firm has a history of biased reporting or if their reports have been challenged in legal settings.
• Conformity with Industry Standards: Ensure the report adheres to recognized industry standards and practices.

Verifying the accuracy of an insurance report is a complex task that requires time and in-depth experience. The best way to ensure that the engineering report is accurate is to consult with an outside expert.

Seek Expert Legal Counsel for Your Insurance Claim

The integrity of engineering reports in insurance claims is a cornerstone of a fair and just process. Awareness and proactive steps by policyholders can safeguard against the repercussions of biased reporting. As the insurance landscape evolves, so must the scrutiny we place on these critical evaluations, ensuring they serve their intended purpose – impartial assessment, not covert manipulation.

If you have an insurance claim and you’re concerned about the accuracy of your engineering report, do not hesitate to get impartial assistance. The San Francisco-based insurance attorneys at Oksenendler Law, P.C. are available to help you understand your engineering report and determine if it demonstrates bias. Schedule your consultation today to learn more about how we can assist you in pursuing full compensation for your claim, regardless of biased insurance reports.