After a notification of loss, an insurer may engage an expert. That expert investigates, for example, the cause, the extent of the damage, repair options or the costs. The findings often end up in an expert report. Such a report can play an important role in the further handling of your claim, but it does not by itself determine the outcome of your file.
Read the report carefully. Look at the instructions, the facts on which the report relies, the photographs, quotations and calculations used, and the points that were or were not investigated. If you disagree with a report, it is usually wise first to set out your questions and objections concretely and in writing.
Short answer: a report is important, but not automatically decisive
An expert report is a substantiation for a position on loss. Whether you and the insurer are bound by a report depends, among other things, on the policy conditions (polisvoorwaarden) and any separate agreements. An expert report drawn up after a loss event is not automatically binding merely because it exists.
That also does not mean you can ignore a report without reason. The more concretely you can explain which facts, photographs, cost items or research questions are, in your view, missing or incorrect, the better the insurer or expert can respond.
What is usually in an expert report?
The content differs per type of loss and insurance. A report may address, among other things, the cause of the loss, the extent of damage, repair costs, value, documents used, and the assessment of the loss in relation to the policy. In a home or contents claim, photographs, quotations and repair methods can play a major role. In other claims, technical data, statements or financial documents may be important.
| Section | Practical question for your file |
|---|---|
| Instructions to the expert | Which questions was the expert required to answer? |
| Facts and investigation | Which information, photographs, quotations or observations were used? |
| Extent of damage | Which heads of loss were and were not included? |
| Cause and coverage | Is a distinction made between the factual cause and the policy question? |
| Estimate | Is it clear how repair costs, value or diminution in value have been calculated? |
| Conclusion | Does the conclusion align with the data set out in the report? |
First check the facts and your own documents
Request a copy of the report if you do not yet have it. Compare it with your own file. Think of photographs from before and after the loss, purchase receipts, quotations, invoices, emails, notification forms and earlier correspondence with the insurer.
A disagreement about a report can have various causes. Sometimes a cost item is missing. Sometimes a photograph has been misinterpreted. Sometimes the cause of the loss has been insufficiently investigated. And sometimes the main dispute is not about the report, but about whether the loss is covered under the policy. By making that distinction, you can respond more purposefully.
What can you do if you disagree with the report?
Start with a clear written response. For each point, specify what you believe is incorrect or unclear and attach documents that support your point. If necessary, request clarification of calculations, assumptions or data used.
If technical or financial questions are central, you may consider engaging your own expert. This is often called a counter-expertise (contra-expertise). The instructions to that expert must be clear: which heads of loss, causation issues or calculations must be investigated? Your own report is most useful if it addresses concretely the points on which the first report raises questions.
Also read for this route: Counter-expertise under insurance: costs, policy and practical steps.
Costs of your own expert or counter-expertise
Article 7:959 paragraph 1 BW (Dutch Civil Code, Burgerlijk Wetboek) concerns the reasonable costs incurred to establish the loss. Whether the costs of your own expert in a specific file are eligible for reimbursement depends, among other things, on the facts, the instructions, the costs, the policy and the reasonableness of the investigation.
Your own expert is therefore not an automatic cost item that is always reimbursed in full. Before commissioning, discuss the research question, the fee, the cost estimate and the manner of reporting. Inform the insurer in writing and keep the engagement confirmation, invoices and the report.
Is an expert report binding?
A report is not automatically binding simply because it was prepared by an expert. Policy conditions or a separate agreement can, however, have consequences for how the parties deal with a report. Therefore read the relevant policy conditions carefully and ask for an explanation if it is not clear which arrangement applies.
Article 7:960 BW concerns the indemnity principle and prior valuation (voortaxatie). This provision does not in itself make an expert report drawn up after a loss automatically binding. The significance of a report remains dependent on the file, the policy and any agreements between the parties.
When might a Kifid complaint be appropriate?
If you cannot resolve the matter with the insurer, the insurer’s internal complaints procedure usually comes first. For many financial complaints, Kifid (the Dutch Financial Services Complaints Institute) may then be a possible route. Kifid does not handle every complaint. Therefore check the current Kifid quick check and the conditions before you submit a complaint.
A complaint to Kifid is not the same as a new technical investigation. Therefore clearly describe the issue you raise: for example an incomplete loss assessment, the way the insurer responded, a policy question or the substantiation of a rejection. Attach the relevant correspondence and reports.
When is legal assistance useful?
Legal assistance can be particularly relevant when the report is complex, the financial consequences are significant, the policy conditions give rise to debate, or multiple experts reach different conclusions. The right step differs per file. Sometimes a substantive explanation is sufficient. Sometimes additional evidence is needed. Sometimes the focus is not the report, but policy coverage or an exclusion.
Also read in case of a rejection: Rejection of a claim by the insurer: what can you do? and Claim rejected after loss investigation: what now?.
Frequently asked questions
Do I always have to accept an expert report?
No. Read the report and check whether, in your view, the facts, documents and conclusions are complete and correct. Describe your questions or objections concretely and in writing.
Can I engage my own expert?
You may consider your own expert. First check the policy, the instructions and the cost arrangement. A targeted engagement and a clear agreement on costs are important.
Does the insurer reimburse the costs of my expert?
Article 7:959 BW concerns reasonable costs to establish the loss. Whether a cost reimbursement is applicable in your file depends on the facts, the instructions, the costs and the policy conditions.
Can I take a report to Kifid?
That is possible with a complaint that falls within the current Kifid rules. You must first have submitted the complaint to the insurer in writing. Check the Kifid quick check in advance and add relevant documents.
Official sources
- Dutch Civil Code (Burgerlijk Wetboek) Book 7, Article 959
- Dutch Civil Code (Burgerlijk Wetboek) Book 7, Article 960
- Kifid — A financial complaint? Kifid can help in many cases
- Kifid — Can Kifid handle my complaint?
Need help?
Do you have questions about an expert report or would you like to discuss which documents are relevant for your insurance file? Then contact Arslan Advocaten. We can discuss with you which information and next steps require attention in your situation.